Jabbour Z, do Nascimento C, El-Hakim M, Henderson J E, de Albuquerque Junior R F
Division of Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, QC, Canada; Bone Engineering Labs, Research Institute, McGill University Health Center, Montreal, QC, Canada.
Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of Sao Paulo, Brazil.
Int J Oral Maxillofac Surg. 2016 Sep;45(9):1162-9. doi: 10.1016/j.ijom.2015.12.017. Epub 2016 Jan 15.
The microbial aetiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remains undefined. This study investigated the oral microbiota and socket healing after zoledronic acid (ZA) and dexamethasone (DX) administration. Fourteen rats assigned randomly to experimental (n=8) and control (n=6) groups were injected with ZA+DX or saline, respectively, for 3 weeks prior to and 9 weeks after the extraction of left first upper and lower molars. Whole genomic DNA probes of 38 bacterial species and five Candida species were hybridized to DNA extracted from biofilm samples on exposed bone and adjacent teeth. Only experimental rats exhibited exposed bone at euthanasia. All BRONJ-like lesions were colonized by Staphylococcus pasteuri, Streptococcus parasanguinis, and Streptococcus mitis. A significant correlation was observed between the mean proportions of species colonizing BRONJ-like lesions and the teeth of experimental rats (r=0.818, P<0.001). Significant differences were seen in several species colonizing the teeth of control rats compared to experimental rats (P<0.05). Micro-computed tomography analyses revealed higher residual bone in mandibular (P=0.001) and maxillary (P=0.108) tooth sockets of experimental rats. BRONJ-like lesions were colonized mainly by non-pathogenic bacteria. ZA+DX administered to rats at doses equivalent to those given to cancer patients resulted in changes to the oral biofilm and impaired bone healing following tooth extraction.
双膦酸盐相关颌骨坏死（BRONJ）的微生物病因仍不明确。本研究调查了唑来膦酸（ZA）和地塞米松（DX）给药后的口腔微生物群及拔牙创愈合情况。将14只大鼠随机分为实验组（n = 8）和对照组（n = 6），在拔除左侧上颌和下颌第一磨牙前3周及拔牙后9周，分别给实验组大鼠注射ZA + DX，给对照组大鼠注射生理盐水。将38种细菌和5种念珠菌的全基因组DNA探针与从暴露骨和相邻牙齿上的生物膜样本中提取的DNA进行杂交。仅实验组大鼠在安乐死时出现骨暴露。所有BRONJ样病变均被巴氏葡萄球菌、副血链球菌和缓症链球菌定植。在定植于BRONJ样病变的菌种平均比例与实验组大鼠牙齿之间观察到显著相关性（r = 0.818，P < 0.001）。与实验组大鼠相比，对照组大鼠牙齿定植的几种菌种存在显著差异（P < 0.05）。显微计算机断层扫描分析显示，实验组大鼠下颌（P = 0.001）和上颌（P = 0.108）牙槽窝中的残余骨较多。BRONJ样病变主要由非致病细菌定植。以等同于癌症患者的剂量给大鼠注射ZA + DX会导致口腔生物膜改变，并损害拔牙后的骨愈合。
