This study was published in 2008 in the Journal of Oral and Maxilofacial
Surgery.
Identification of microbial biofilms in osteonecrosis of the jaws secondary to
bisphosphonate therapy.
Sedghizadeh PP, Kumar SK, Gorur A, Schaudinn C, Shuler CF, Costerton JW.

Division of Diagnostic Sciences, and Center for Craniofacial Molecular Biology,
University of Southern California, School of Dentistry, Los Angeles, CA
90089-0641, USA. sedghiza@...

PURPOSE: Biofilm theory has emerged to explain the etiology of the chronic
infections that have come to constitute between 65% to 80% of the microbial
diseases treated by physicians in the developed world. The purpose of this
article is to report for the first time the observation of multispecies
microbial biofilms on affected bone in patients with osteonecrosis of the jaws
(ONJ) secondary to bisphosphonate therapy. PATIENTS AND METHODS: A program has
been established at the University of Southern California to monitor and
evaluate patients with ONJ as a multidisciplinary collaboration between the
School of Dentistry, Center for Biofilms, Center for Craniofacial Molecular
Biology and the Keck School of Medicine. From this cohort, 4 patients with
active ONJ who were scheduled for necessary treatment in the form of
sequestrectomy gave informed consent for this study. Bone samples were evaluated
using conventional histopathologic techniques and scanning electron microscopy,
a technique applicable to biofilm characterization. RESULTS: Bone specimens from
affected sites in all patients showed large areas occluded with biofilms
comprising mainly bacteria, and occasionally yeast, embedded in extracellular
polymeric substance. The number of bacterial morphotypes in the biofilms ranged
from 2 to 15, and they included species from the genus Fusobacterium, bacillus,
actinomyces, staphylococcus, streptococcus, Selenomonas, and 3 different types
of treponemes. The yeast identified was consistent with Candida species.
Co-aggregation was observed between different species within the biofilms.
CONCLUSION: These findings have important clinical and therapeutic implications
and may suggest a role for microbial biofilms in the disease process of ONJ.

PMID: 18355603 [PubMed - indexed for MEDLINE]