Department of Periodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 May;115(5):660-6. doi: 10.1016/j.oooo.2013.03.001.
Clinico-pathological evaluation of bisphosphonate (BP)-related osteonecrosis of jaws, comparison between oral (PO) and intravenous (IV) BPs and histomorphometric analysis of associated actinomyces.
Retrospective clinical and histomorphometric analysis. Data on background, clinical, treatment and follow-up were analyzed. Actinomyces colonies were identified by typical filamentous colony morphology, Gram, and PAS stains. Colony density and relative colony surface area were measured.
Fifty-two patients were included, 37 (71.2%) IV, 15 (28.8%) PO BPs. with a mean duration of 2.33 and, 4.33 years respectively. One hundred percent of cases exhibited actinomyces colonization. The relative colony surface area was significantly higher in PO treatment (P = .024), with no differences in density, healing time or antibiotic treatment periods. High frequency of diabetes mellitus (60% PO cases) and corticosteroid treatment (25% of cases) were recorded.
Infection with actinomyces is a common denominator in BP-related osteonecrosis of the jaws (BRONJ), regardless of administration route. Diabetes and corticosteroid treatment seem to be important contributing factors for BRONJ.
对双膦酸盐（BP）相关下颌骨坏死进行临床病理评估，比较口服（PO）和静脉内（IV）BP 以及相关放线菌的组织形态计量学分析。
回顾性临床和组织形态计量学分析。分析背景、临床、治疗和随访数据。通过典型的丝状菌落形态、革兰氏和 PAS 染色鉴定放线菌菌落。测量菌落密度和相对菌落表面积。
共纳入 52 例患者，37 例（71.2%）为 IV 组，15 例（28.8%）为 PO 组，平均治疗时间分别为 2.33 年和 4.33 年。100%的病例均有放线菌定植。PO 治疗的相对菌落表面积显著更高（P=0.024），但菌落密度、愈合时间或抗生素治疗期无差异。记录到糖尿病（PO 组 60%）和皮质类固醇治疗（25%的病例）的高频率。
无论给药途径如何，感染放线菌都是双膦酸盐相关下颌骨坏死（BRONJ）的共同决定因素。糖尿病和皮质类固醇治疗似乎是 BRONJ 的重要促成因素。
