The importance of an opportunistic microflora in the development of jaws osteonecrosses

Aim. To define the significance of oral opportunistic microflora for the development of jaws osteonecrosis of various etiology.

Materials and methods. Microflora was assessed in 15 patients with mandibular osteonecrosis (MON), 6 patients with bisphosphonate osteonecrosis, 4 patients after radiation therapy and 5 desomorphine addicts. A quantitative assessment was performed on 12 groups of facultative and obligate anaerobic microorganisms, Candida spp. Fungi, and 5 parodontium pathogens by real-time polymerase chain reaction.

Results. The parameters of aerobic and anaerobic microflora content in the oral fluid and bone tissue are presented for patients with ON. In the oral fluid, a high index of anaerobic pathogens was detected, which is 1–3 orders of magnitude higher than in healthy individuals. In bone tissue, the rate of all anaerobic microorganisms was higher than in the oral fluid by 2–4 orders. The frequent use of antibiotics led to the increase of fungi Candida spp. and four periodontium pathogens in bone tissue and in the oral fluid.

Conclusion. In patients with MON of various origin, a high level of anaerobic pathogens was detected in the oral fluid and bone tissue. Bone tissue is most susceptible to the effects of microorganisms’ community. Surgical treatment leads to an effective sanitation for a long period. The courses of adequately selected antibiotic therapy contribute to the positive dynamics with respect to the level of dissemination of oral fluid in such category of patients.

Key words: osteonecrosis of jaws, conditionally pathogenic microorganisms, polymerase chain reaction in real time. Authors declare no conflict of interests for this article. Source of financing. Unspecified.

For citations: Polyakov K.A., Ivanyushko Т.P., Arazashvili L.D., Medvedev Yu.A., Trofimov D.Yu., Abramov D.D., Korshunova A.V., Obraztsova Т.А. The importance of an opportunistic microflora in the development of jaws osteonecrosses. Golova I Sheya Head and neck. Russian Journal. 2018;6(2):15–19 (in Russian).

The authors are responsible for the originality of the presented data and the possibility of publishing illustrative material – tables, drawings, photographs of patients.