颌骨药物相关性骨坏死中的细菌多样性
Bacterial diversity in medication-related osteonecrosis of the jaw.
作者信息
Hallmer Fredrik, Bjørnland Tore, Andersson Gunilla, Becktor Jonas P, Kristoffersen Anne K, Enersen Morten
机构信息
Consultant, Department of Oral and Maxillofacial Surgery, Skåne University Hospital, Lund, Sweden; Department of Oral and Maxillofacial Surgery, Malmö University, Faculty of Odontology, Malmö, Sweden.
Professor and Chairman, Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Apr;123(4):436-444. doi: 10.1016/j.oooo.2016.11.011. Epub 2016 Dec 7.
OBJECTIVE
The aim was to study the association between microflora and medication-related osteonecrosis of the jaw (MRONJ) by using culture-independent molecular techniques to detect bacteria in necrotic bone lesions.
STUDY DESIGN
Included were 18 consecutive patients with MRONJ, 10 with osteoporosis and 8 cancer patients. Bone biopsies were retrieved from the center of the necrotic bone and from visually healthy bone, and 16 S rRNA gene fragments from bacterial DNA were amplified with polymerase chain reaction.
RESULTS
The study revealed a diversity of bacteria represented by 16 S rRNA sequences in all the necrotic bone samples and in 60% of the visually healthy bone. Eight dominating taxa groups were identified at the genus level: Porphyromonas, Lactobacillus, Tannerella, Prevotella, Actinomyces, Treponema, Streptococcus, and Fusobacterium.
CONCLUSIONS
The necrotic bone lesions contained mainly anaerobic bacteria, representative of periodontal microflora, suggesting that a periodontal infection in combination with antiresorptive treatment could initiate osteonecrosis.
目的
旨在通过使用非培养分子技术检测坏死骨病变中的细菌，研究微生物群与药物相关性颌骨坏死（MRONJ）之间的关联。
研究设计
纳入18例连续性MRONJ患者，其中10例为骨质疏松患者，8例为癌症患者。从坏死骨中心和外观健康的骨组织获取骨活检样本，并用聚合酶链反应扩增细菌DNA中的16S rRNA基因片段。
结果
研究显示，在所有坏死骨样本以及60%外观健康的骨组织中，均存在以16S rRNA序列为代表的多种细菌。在属水平上鉴定出8个主要分类群：卟啉单胞菌属、乳杆菌属、坦纳菌属、普雷沃菌属、放线菌属、密螺旋体属、链球菌属和梭杆菌属。
结论
坏死骨病变主要包含厌氧细菌，这些细菌是牙周微生物群的代表，提示牙周感染与抗吸收治疗相结合可能引发骨坏死。
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