The Role of Microbial Biofilms in Osteonecrosis of the Jaw Associated with Bisphosphonate Therapy
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Microbial biofilms have been observed and described in bone specimens of patients with bisphosphonate (BP)-associated osteonecrosis of the jaw (BONJ) and investigators are more recently suggesting that this condition essentially represents an osteomyelitis of the jaw clinically, with greater susceptibility in some patients on BP therapy. This article explains the role of microbial biofilms in BONJ and also discusses associated factors in the disease pathogenesis, which include BP effects on bone remodeling, anti-angiogenesis, matrix necrosis, microcracks, soft tissue toxicity, and inflammation and wound healing. Recent findings suggest a key role for microbial biofilms in the pathogenesis of BONJ; this has important therapeutic implications because biofilm organisms represent a clinical target for prevention and treatment efforts aimed at reducing the significant morbidity and costs associated with this condition.
KeywordsBisphosphonate BONJ Osteonecrosis Bone Microcrack Infection
Owing to journal requirements for references, certain key contributions in the field of BONJ and microbial biofilms may not have been cited in this manuscript and the authors would like to acknowledge all such scientific contributions.
No potential conflicts of interest relevant to this article were reported.
Papers of particular interest, published recently, have been highlighted as follows: •Of importance ••Of major importance
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