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The purpose of this study was to identify the oral bacterial species in sequestra from patients with bisphosphonate-related osteonecrosis
of the jaw (BRONJ). Fifteen patients with BRONJ (2 males and 13 females) were evaluated. Clinical features, radiographic findings,
and bisphosphonate intake history were investigated. All patients were treated with surgical methods (curettage or sequestrectomy).
Infected bone samples were collected from the affected BRONJ site. Ten bacterial species were selected for polymerase chain reaction
(PCR) detection. Two to nine bacterial species were detected by PCR. Gram-negative species were predominant and all identified bacteria
were anaerobes. Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were detected at high levels. These are major
pathogenic species in periodontal disease. Orthopantomographic radiographs showed generalized alveolar bone loss in most patients.
These radiographic findings may provide evidence of chronic periodontitis as a pre-existing inflammatory disease. Most patients had
experienced a predisposing dental procedure, such as tooth extraction. Sequestra (necrotic bone) infected with oral bacterial species may
be an important risk factor for BRONJ. As such, prevention and management of BRONJ may rely on effective control of bacteria in the
oral cavity.
Key words : BRONJ , Bacteria, Sequestra, Necrotic bone