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Kim HY, Jung YS, Park W, Choi YJ, Kim JY. Can medication-related osteonecrosis of the jaw be attributed to specific microorganisms through oral microbiota analyses? A preliminary study. BMC Oral Health 2024; 24:160. [PMID: 38302952 PMCID: PMC10832156 DOI: 10.1186/s12903-024-03945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/27/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Medication-related osteonecrosis of the jaw (MRONJ) can cause significant pain and loss of aesthetics and function if not treated properly. However, diagnosis still relies on detailed intraoral examinations and imaging. Prognosis varies even among patients with similar stages or conditions of MRONJ, emphasizing the need for a deeper understanding of its complex mechanisms. Thus, this study aimed to identify the oral microbiota of patients with MRONJ. METHODS This single-center prospective cohort study included patients with confirmed MRONJ who visited the Department of Oral and Maxillofacial Surgery at Yonsei University Dental Hospital between 2021 and 2022. Oral swab samples were collected from the affected and unaffected sides of each patient. The composition and enumeration of the microbial communities were analyzed, and the diversity was compared to verify ecological changes in the groups using a next-generation sequencing-based 16S metagenomic analysis. A statistical analysis was performed using Wilcoxon signed-rank test with SPSS version 22, and values of P less than 0.05 were considered statistically significant. RESULTS The final study sample included 12 patients. The mean age was 82.67 ± 5.73 (range, 72-90) years. Changes in microbial composition were observed at different taxonomic levels (phylum, genus, and species). The identified microorganisms were commonly associated with periodontitis, gingival disease, and endodontic infection, suggesting a multifactorial etiology of MRONJ. CONCLUSIONS Although this study is based on a small number of cases, it shows that MRONJ is not caused by a specific microorganism but can rather be caused by a variety of factors. By addressing these findings in large-scale studies, the significance of oral microbiome in pathogenesis can be further elucidated and can facilitate the development of effective therapeutic interventions for patients with MRONJ.
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Affiliation(s)
- Heon-Young Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Centre, Seoul, Republic of Korea
| | - Young-Soo Jung
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Wonse Park
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
| | - Yoon Jeong Choi
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jun-Young Kim
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
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Sobczak-Jaskow H, Kochańska B, Drogoszewska B. A Study of Oral Health Parameters and the Properties and Composition of Saliva in Oncological Patients with and without Medication-Related Osteonecrosis of the Jaw Who Take Bisphosphonates. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1073. [PMID: 37374277 DOI: 10.3390/medicina59061073] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: The aim of this study was to examine how the status of the oral cavity, composition and properties of saliva change in oncological patients with and without Medication-Related Osteonecrosis of the Jaw (MRONJ) undergoing bisphosphonate therapy. Materials and Methods: A retrospective case-control study of 49 oncological patients using bisphosphonates (BPs) was conducted. The study population was divided into two groups-Group I consisted of 29 patients with MRONJ and Group II of 20 patients without MRONJ. The control group consisted of 32 persons without oncological history and without antiresorptive therapy. Standard dental examination included the assessment of the number of teeth remaining, teeth with caries and fillings, Approximal Plaque Index (API) and Bleeding on Probing (BOP). In terms of MRONJ, localization and stage were assessed. Laboratory tests of saliva included determination of pH and concentrations of Ca and PO4 ions, total protein, lactoferrin, lysozyme, sIgA, IgA, cortisol, neopterin, activity of amylase at rest, and stimulated saliva. The buffering capacity and microbiological tests (Streptococcus mutans, Lactobacillus spp. load) of stimulated saliva were also determined. Results: There were no statistically significant differences between the selected oral parameters and saliva of Group I and Group II. Significant differences were found between Group I and the control group. BOP, lysozyme and cortisol concentration were higher, while the number of teeth with fillings, Ca and neopterin concentrations were lower in comparison to the control group. In Group I, a significantly higher percentage of patients with a high colony count (>105) of Streptococcus mutans and Lactobacillus spp. was also found. The significant differences between Group II and the control group concerned the concentrations of lysozyme, Ca ions, sIgA, neopterin and the colony count of Lactobacillus spp. In the Group I patients who received a significantly higher cumulative dose of BP compared to the Group II, a significant positive correlation was found between the received BP dose and the BOP. Most MRONJ foci were stage 2 and were mainly located in the mandible. Conclusions: Among oncological patients with and without MRONJ undergoing BP therapy compared to the control group, there are statistically significant differences in the dental, periodontal and microbiological status and in the composition of the saliva. Particularly noteworthy are the statistically significant differences in the decreased level of Ca ions, the increased level of cortisol and the elements of saliva related to the immune response (lysozyme, sIgA, neopterin). Additionally, a higher cumulative dose of BPs may affect the susceptibility to the development of osteonecrosis of the jaws. Patients undergoing antiresorptive therapy should receive multidisciplinary medical care, including dental care.
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Affiliation(s)
- Hanna Sobczak-Jaskow
- Department of Maxillofacial Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Barbara Kochańska
- Department of Conservative Dentistry, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Barbara Drogoszewska
- Department of Maxillofacial Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland
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The Study of Nanosized Silicate-Substituted Hydroxyapatites Co-Doped with Sr 2+ and Zn 2+ Ions Related to Their Influence on Biological Activities. Curr Issues Mol Biol 2022; 44:6229-6246. [PMID: 36547086 PMCID: PMC9776463 DOI: 10.3390/cimb44120425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Nanosized silicate-substituted hydroxyapatites, characterized by the general formula Ca9.8-x-nSrnZnx(PO4)6-y(SiO4)y(OH)2 (where: n = 0.2 [mol%]; x = 0.5-3.5 [mol%]; y = 4-5 [mol%]), co-doped with Zn2+ and Sr2+ ions, were synthesized with the help of a microwave-assisted hydrothermal technique. The structural properties were determined using XRD (X-ray powder diffraction) and Fourier-transformed infrared spectroscopy (FT-IR). The morphology, size and shape of biomaterials were detected using scanning electron microscopy techniques (SEM). The reference strains of Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa were used to assess bacterial survivability and the impact on biofilm formation in the presence of nanosilicate-substituted strontium-hydroxyapatites. Safety evaluation was also performed using the standard cytotoxicity test (MTT) and hemolysis assay. Moreover, the mutagenic potential of the materials was assessed (Ames test). The obtained results suggest the dose-dependent antibacterial activity of nanomaterials, especially observed for samples doped with 3.5 mol% Zn2+ ions. Moreover, the modification with five SiO4 groups enhanced the antibacterial effect; however, a rise in the toxicity was observed as well. No harmful activity was detected in the hemolysis assay as well as in the mutagenic assay (Ames test).
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Kim S, Mun S, Shin W, Han K, Kim MY. Identification of Potentially Pathogenic Variants Associated with Recurrence in Medication-Related Osteonecrosis of the Jaw (MRONJ) Patients Using Whole-Exome Sequencing. J Clin Med 2022; 11:jcm11082145. [PMID: 35456240 PMCID: PMC9030961 DOI: 10.3390/jcm11082145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Bisphosphonates are antiresorptive and antiangiogenic drugs that prevent and treat bone loss and mineralization in women with postmenopausal osteoporosis and cancer patients. Medication-related osteonecrosis of the jaw (MRONJ) is commonly caused by tooth extraction and dental trauma. Although genetic and pathological studies about MRONJ have been conducted, the pathogenesis of MRONJ still remains unclear. Methods: We aimed to identify genetic variants associated with MRONJ, using whole-exome sequencing (WES). Ten MRONJ patients prescribed bisphosphonates were recruited for WES, and jawbone tissue and blood samples were collected from the patients. Results: The analysis of the WES data found a total of 1866 SNP and 40 InDel variants which are specific to MRONJ. The functional classification assay using Gene Ontology and pathway analysis discovered that genes bearing the MRONJ variants are significantly enriched for keratinization and calcium ion transport. Some of the variants are potential pathogenic variants (24 missense mutations and seven frameshift mutations) with MAF < 0.01. Conclusions: The variants are located in eight different genes (KRT18, MUC5AC, NBPF9, PABPC3, MST1L, ASPN, ATN1, and SLAIN1). Nine deleterious SNPs significantly associated with MRONJ were found in the KRT18 and PABPC3 genes. It suggests that KRT18 and PABPC3 could be MRONJ-related key genes.
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Affiliation(s)
- Songmi Kim
- Center for Bio Medical Engineering Core Facility, Dankook University, Cheonan 31116, Korea (S.M.)
- Department of Microbiology, Dankook University, Cheonan 31116, Korea
| | - Seyoung Mun
- Center for Bio Medical Engineering Core Facility, Dankook University, Cheonan 31116, Korea (S.M.)
- Department of Microbiology, Dankook University, Cheonan 31116, Korea
| | - Wonseok Shin
- NGS Clinical Laboratory, Dankook University Hospital, Cheonan 31116, Korea;
| | - Kyudong Han
- Center for Bio Medical Engineering Core Facility, Dankook University, Cheonan 31116, Korea (S.M.)
- Department of Microbiology, Dankook University, Cheonan 31116, Korea
- Correspondence: (K.H.); (M.-Y.K.); Tel.: +82-41-550-1240 (K.H.); +82-41-550-1912 (M.-Y.K.)
| | - Moon-Young Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan 31116, Korea
- Correspondence: (K.H.); (M.-Y.K.); Tel.: +82-41-550-1240 (K.H.); +82-41-550-1912 (M.-Y.K.)
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Matrix-Bound Zolzoledronate Enhances the Biofilm Colonization of Hydroxyapatite: Effects on Osteonecrosis. Antibiotics (Basel) 2021; 10:antibiotics10111380. [PMID: 34827318 PMCID: PMC8615173 DOI: 10.3390/antibiotics10111380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/27/2022] Open
Abstract
(1) Background: The aim of this study was to test whether matrix-bound zoledronate (zol) molecules enhanced the oral biofilm colonization of a mineralized matrix, rendering the alveolar bone more susceptible to medication-related osteonecrosis of the jaw (MRONJ) following invasive dental procedures. (2) Methods: We tested the effect of matrix-bound zol on the growth and attachment of Porphyromonas gingivalis (Pg), Fusobacterium nucleatum (Fn) and Actinomyces israelii (Ai), and whether the nitrogen-containing component of zol contributed to such effect. The role of oral bacteria in the induction of osteonecrosis was then tested using an extra-oral bone defect model. (3) Results: The attachment of biofilm to hydroxyapatite discs increased when the discs were pre-treated with zol. Bacterial proliferation was not affected. Matrix-bound zol was more potent than non-nitrogen-containing etidronate in enhancing the colonization. Stimulation was dampened by pre-treating the bacteria with histidine. The delivery of oral biofilm to a tibial defect caused osteonecrosis in zol-treated rats. (4) Conclusions: We conclude that matrix-bound zol enhances the oral biofilm colonization of hydroxyapatite. This enhancement depended on the presence of the nitrogen-containing group. The oral biofilm rendered the extra-oral bone susceptible to medication-related osteonecrosis, suggesting that it has an important role in the induction of MRONJ.
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Yang G, Kim YN, Kim H, Lee BK. Effect of Human Umbilical Cord Matrix-Derived Mesenchymal Stem Cells on Bisphosphonate-Related Osteonecrosis of the Jaw. Tissue Eng Regen Med 2021; 18:975-988. [PMID: 34347277 DOI: 10.1007/s13770-021-00372-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/17/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a severe sequela caused by bisphosphonates (BPs), which are widely used to treat osteoporosis or other malignancies. However, the mechanism underlying BRONJ remains unclear. Recently, human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) have been studied for treatment of diverse diseases and injuries. This study aimed to investigate the therapeutic effects of hUC-MSCs in BRONJ. METHODS The therapeutic effects of hUC-MSCs were examined in rat bone marrow (rBM)-derived cells using cell viability, colony-forming, and real-time PCR assays and FACS for analyzing essential proinflammatory and bone regeneration markers in vitro. To demonstrate the in vivo therapeutic and adverse effects of transfused hUC-MSCs, micro-CT, H&E staining, IHC (Angiogenesis marker gene expression) staining, and parathyroid hormone (PTH)/calcium assay were conducted in a BRONJ-induced animal model. RESULTS BP-induced cytotoxicity and inflammation in rBM-derived cells decreased, after co-culture with hUC-MSCs. The expression levels of bone regeneration markers (RUNX2, OSX, and BMP-2) significantly increased in BP-treated rBM-derived cells, after co-culture with hUC-MSCs. The BP-induced abnormal shift in RANKL/OPG expression ratio in rBM-derived cells was normalized by hUC-MSCs. Consistent with these in vitro results, transfused hUC-MSCs markedly decreased BRONJ and significantly healed injured mucosa in the BRONJ-induced animal model. The animals exhibited serious destruction of the kidney structure and increases in serum PTH and calcium levels, which were significantly normalized by hUC-MSC transfusion. CONCLUSION hUC-MSCs exerted therapeutic effects on BRONJ in vitro and in vivo through their anti-cytotoxicity, anti-inflammatory activity and ability to recover bone regeneration.
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Affiliation(s)
- Gwanghyun Yang
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Young-Nam Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Hyunjeong Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Bu-Kyu Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea. .,Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.
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Kligman S, Ren Z, Chung CH, Perillo MA, Chang YC, Koo H, Zheng Z, Li C. The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation. J Clin Med 2021; 10:1641. [PMID: 33921531 PMCID: PMC8070594 DOI: 10.3390/jcm10081641] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant's surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation.
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Affiliation(s)
- Stefanie Kligman
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Zhi Ren
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Michael Angelo Perillo
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Yu-Cheng Chang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Hyun Koo
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
- Center for Innovation & Precision Dentistry, School of Dental Medicine and School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zhong Zheng
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
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Otto S, Pautke C, Arens D, Poxleitner P, Eberli U, Nehrbass D, Zeiter S, Stoddart MJ. A Drug Holiday Reduces the Frequency and Severity of Medication-Related Osteonecrosis of the Jaw in a Minipig Model. J Bone Miner Res 2020; 35:2179-2192. [PMID: 32568416 PMCID: PMC7689727 DOI: 10.1002/jbmr.4119] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 01/08/2023]
Abstract
Treatment of medication-related osteonecrosis of the jaw (MRONJ) is challenging and no clear consensus has been achieved. This study investigated preventive measures recommended for tooth extractions under antiresorptive (AR) treatment and the role of discontinuation of AR therapy to avoid the onset of MRONJ in a minipig model. Thirty-six Göttingen minipigs were divided into four groups. Group 1 (negative control): tooth extractions but no zoledronate (ZOL). Group 2 (positive control): weekly ZOL infusions for 12 weeks followed by tooth extractions without wound management followed by 8 weeks of ZOL treatment. Group 3: weekly ZOL infusions for 12 weeks followed by tooth extractions; surgical wound management (resection of sharp bone edges, mucoperiosteal coverage); and continuation of ZOL infusions for 8 weeks plus antibiotic treatment. Group 4: 12 weeks of ZOL infusions followed by a drug holiday for 6 weeks. Tooth extractions with preventive wound management followed by antibiotic treatment for 8 weeks but no ZOL infusions. Jawbones were subjected to macroscopic, radiological (CT and micro-CT) and histopathological investigations. No clinical cases of MRONJ were observed in the negative group, in the positive control all animals developed MRONJ. Group 3 developed MRONJ in 83% of cases. With a drug holiday, 40% developed MRONJ in areas of tooth extraction. This is the first large animal model that reduces the occurrence of MRONJ following tooth extraction by the implementation of a drug holiday combined with antibiotic prophylaxis and smoothening of sharp bony edges. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research..
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Affiliation(s)
- Sven Otto
- Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University, Munich, Germany
| | - Christoph Pautke
- Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University, Munich, Germany
| | | | - Philipp Poxleitner
- Department of Oral and Maxillofacial Surgery, Albert-Ludwigs-University, Freiburg, Germany
| | | | | | | | - Martin J Stoddart
- AO Research Institute Davos, Davos, Switzerland.,Department of Oral and Maxillofacial Surgery, Albert-Ludwigs-University, Freiburg, Germany
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Junka A, Bartoszewicz M, Dziadas M, Szymczyk P, Dydak K, Żywicka A, Owczarek A, Bil-Lula I, Czajkowska J, Fijałkowski K. Application of bacterial cellulose experimental dressings saturated with gentamycin for management of bone biofilm in vitro and ex vivo. J Biomed Mater Res B Appl Biomater 2019; 108:30-37. [PMID: 30883023 DOI: 10.1002/jbm.b.34362] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/24/2019] [Accepted: 02/27/2019] [Indexed: 11/11/2022]
Abstract
Bacterial cellulose is one of the most promising polymers of recent years. Herein, we present a possibility of BC application as a carrier of gentamycin antibiotic for the treatment and prevention of bone infections. We have shown that BC saturated with gentamycin significantly reduces the level of biofilm-forming bone pathogens, namely Staphylococcus aureus and Pseudomonas aeruginosa, and displays very low cytotoxicity in vitro against osteoblast cell cultures. Another beneficial feature of our prototype dressing is prolonged release of gentamycin, which provides efficient protection from microbial contamination and subsequent infection. Moreover, it seems that bacterial cellulose (BC) alone without any antimicrobial added, may serve as a barrier by significantly hampering the ability of the pathogen to penetrate to the bone structure. Therefore, a gentamycin-saturated BC dressing may be considered as a possible alternative for gentamycin collagen sponge broadly used in clinical setting. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:30-37, 2020.
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Affiliation(s)
- Adam Junka
- Department of Pharmaceutical Microbiology and Parasitology, Wroclaw Medical University, 50-556, Wrocław, Poland
| | - Marzenna Bartoszewicz
- Department of Pharmaceutical Microbiology and Parasitology, Wroclaw Medical University, 50-556, Wrocław, Poland
| | - Mariusz Dziadas
- Faculty of Chemistry, University of Wroclaw, 50-353, Wrocław, Poland
| | - Patrycja Szymczyk
- Centre for Advanced Manufacturing Technologies, Faculty of Mechanical Engineering, Wroclaw Technical University, 50-371, Wrocław, Poland
| | - Karolina Dydak
- Department of Pharmaceutical Microbiology and Parasitology, Wroclaw Medical University, 50-556, Wrocław, Poland
| | - Anna Żywicka
- Department of Immunology, Microbiology and Physiological Chemistry, Faculty of Biotechnology and Animal Husbandry, West Pomeranian University of Technology in Szczecin, 70-311, Szczecin, Poland
| | - Artur Owczarek
- Department of Drug Form Technology, Wroclaw Medical University, 50-556, Wrocław, Poland
| | - Iwona Bil-Lula
- Department of Clinical Chemistry, Wroclaw Medical University, 50-556, Wrocław, Poland
| | - Joanna Czajkowska
- Laboratory of Microbiology, Wroclaw Research Centre EIT+, 54-066, Wrocław, Poland
| | - Karol Fijałkowski
- Department of Immunology, Microbiology and Physiological Chemistry, Faculty of Biotechnology and Animal Husbandry, West Pomeranian University of Technology in Szczecin, 70-311, Szczecin, Poland
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Junka A, Żywicka A, Chodaczek G, Dziadas M, Czajkowska J, Duda-Madej A, Bartoszewicz M, Mikołajewicz K, Krasowski G, Szymczyk P, Fijałkowski K. Potential of Biocellulose Carrier Impregnated with Essential Oils to Fight Against Biofilms Formed on Hydroxyapatite. Sci Rep 2019; 9:1256. [PMID: 30718663 PMCID: PMC6362291 DOI: 10.1038/s41598-018-37628-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 12/10/2018] [Indexed: 12/25/2022] Open
Abstract
In this research, bacterial cellulose (BC), one of the most promising biopolymers of the recent years, was saturated with thyme, eucalyptus and clove essential oils (EOs) and applied against staphylococcal and pseudomonal biofilms formed on hydroxyapatite (HA). BC dressings were thoroughly analyzed with regard to their physical properties. Moreover, the exact composition and ability of particular EO molecules to adhere to HA was assessed. Additionally, cytotoxicity of oil-containing, cellulose-based dressings towards osteoblasts and fibroblasts as well as their impact on reactive oxygen species (ROS) production by macrophages was assessed. The results revealed the high ability of BC dressings to absorb and subsequently release EOs from within their microstructure; the highest number of compounds able to adhere to HA was found in the thyme EO. The eucalyptus EO displayed low, while thyme and clove EOs displayed high cytotoxicity towards fibroblast and osteoblast cell lines. The clove EO displayed the highest eradication ability toward staphylococcal, while the thyme EO against pseudomonal biofilm. Taken together, the results obtained indicate the suitability of EO-saturated BC dressings to eradicate pseudomonal and staphylococcal biofilm on HA surface and moreover, to not trigger reactive oxygen species production by immune system effector cells. However, due to cytotoxic effects of thyme and clove EOs towards cell lines in vitro, the eucalyptus EO-saturated BC dressing is of highest potential to be further applied.
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Affiliation(s)
- Adam Junka
- Department of Pharmaceutical Microbiology and Parasitology, Wrocław Medical University, Borowska 211A, 50-556, Wrocław, Poland
| | - Anna Żywicka
- Department of Immunology, Microbiology and Physiological Chemistry, Faculty of Biotechnology and Animal Husbandry, West Pomeranian University of Technology, Szczecin, Piastów 45, 70-311, Szczecin, Poland
| | - Grzegorz Chodaczek
- Laboratory of Confocal Microscopy, Polish Center for Technology Development PORT, Stablowicka 147, 54-066, Wrocław, Poland
| | - Mariusz Dziadas
- Faculty of Chemistry, University of Wroclaw, Joliot-Curie 14, 50-353, Wrocław, Poland
| | - Joanna Czajkowska
- Laboratory of Microbiology, Polish Center for Technology Development PORT, Stabłowicka 147, 54-066, Wrocław, Poland
| | - Anna Duda-Madej
- Department of Medical Microbiology, Wroclaw Medical University, Chałubińskiego 4, 50-534, Wrocław, Poland
| | - Marzenna Bartoszewicz
- Department of Pharmaceutical Microbiology and Parasitology, Wrocław Medical University, Borowska 211A, 50-556, Wrocław, Poland
| | - Katarzyna Mikołajewicz
- Laboratory of Confocal Microscopy, Polish Center for Technology Development PORT, Stablowicka 147, 54-066, Wrocław, Poland
| | | | - Patrycja Szymczyk
- Centre for Advanced Manufacturing Technologies (CAMT/FPC), Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Łukasiewicza 5, 50-371, Wrocław, Poland
| | - Karol Fijałkowski
- Department of Immunology, Microbiology and Physiological Chemistry, Faculty of Biotechnology and Animal Husbandry, West Pomeranian University of Technology, Szczecin, Piastów 45, 70-311, Szczecin, Poland.
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11
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Xue XM, Liu YQ, Pang P, Sun CF. Congenital Loss of Permanent Teeth in a Patient With Congenital Insensitivity to Pain With Anhidrosis due to 2 Novel Mutations in the NTRK1 Gene. J Oral Maxillofac Surg 2018; 76:2582.e1-2582.e9. [DOI: 10.1016/j.joms.2018.06.170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/20/2018] [Accepted: 06/28/2018] [Indexed: 01/24/2023]
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12
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Açil Y, Arndt ML, Gülses A, Wieker H, Naujokat H, Ayna M, Wiltfang J. Cytotoxic and inflammatory effects of alendronate and zolendronate on human osteoblasts, gingival fibroblasts and osteosarcoma cells. J Craniomaxillofac Surg 2018; 46:538-546. [DOI: 10.1016/j.jcms.2017.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/03/2017] [Accepted: 12/15/2017] [Indexed: 02/02/2023] Open
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13
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Kellesarian SV, Subhi ALHarthi S, Saleh Binshabaib M, Javed F. Effect of local zoledronate delivery on osseointegration: a systematic review of preclinical studies. Acta Odontol Scand 2017; 75:530-541. [PMID: 28708011 DOI: 10.1080/00016357.2017.1350994] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the present systematic review was to assess the effect of local zoledronate (ZOL) delivery (topical or as implant surface coatings) on osseointegration. MATERIALS AND METHODS In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. To address the focused question, 'Does local zoledronate delivery enhance osseointegration?' indexed databases were searched without time or language restrictions up to and including April 2017 using various combination of the following keywords: 'zoledronate', 'bisphosphonates', 'osseointegration' and 'topical administration'. Letters to the Editor, historic reviews, commentaries, case-series and case-reports were excluded. RESULTS Initially, 383 articles were identified out of which, 23 experimental studies fulfilled the inclusion criteria. In 18 studies, ZOL was incorporated into implants surfaces as a coating and in five studies ZOL was applied topically (bone graft or irrigation) into the bone cavities. Results from 87% studies reported that local delivery of ZOL (coating or topical) is effective in enhancing osseointegration or new bone formation around implants. CONCLUSIONS Local ZOL delivery (coating or topical) seems to enhance osseointegration in animals; however, from a clinical perspective, further randomized control trials with long-term follow-up are needed in this regard.
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Affiliation(s)
- Sergio Varela Kellesarian
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Shatha Subhi ALHarthi
- Department of Periodontology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Munerah Saleh Binshabaib
- Department of Periodontology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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14
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What is the effect of anti-resorptive drugs (ARDs) on the development of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients: A systematic review. J Craniomaxillofac Surg 2017; 45:1493-1502. [DOI: 10.1016/j.jcms.2017.05.028] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/03/2017] [Accepted: 05/29/2017] [Indexed: 01/12/2023] Open
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15
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Jakiel J, Rahnama M, Szczerba-Gwóźdź J. Treatment of bisphosphonate-related osteonecrosis of the jaws - a report of seven cases. Contemp Oncol (Pozn) 2017; 20:486-490. [PMID: 28239288 PMCID: PMC5320463 DOI: 10.5114/wo.2016.65610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/07/2016] [Indexed: 12/29/2022] Open
Abstract
AIM OF THE STUDY The aim of the study was to report on seven cases of BRONJ treated with surgical debridement, oral antibiotics and gentamicin-collagen sponge (Collatamp EG) placed in the bone wound. MATERIAL AND METHODS Seven patients with 9 sites of BRONJ stage 2 were included in the study. Perioperative oral antibiotics, surgical debridement and/or sequestrotomy and gentamicin-collagen sponge (Collatamp EG) were used. Postoperative monitoring was carried out for the next 3 months. RESULTS Three weeks after the surgery, six sites of BRONJ in five patients were treated successfully. In two patients on three sites BRONJ stage 1 was observed. Three months after surgery another two sites healed fully. In one patient there was still BRONJ stage 1, however, the area of exposed bone was visibly reduced. CONCLUSIONS The use of surgical debridement together with oral antibiotic therapy and collagen-gentamycin sponge indicates positive results regarding the surgical treatment of BRONJ.
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Affiliation(s)
- Joanna Jakiel
- Oral Surgery Department, Medical University of Lublin, Poland
| | - Mansur Rahnama
- Oral Surgery Department, Medical University of Lublin, Poland
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16
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Abstract
Background:
Bisphosphonates are drugs commonly used for the medication and prevention of diseases caused by decreased mineral density. Despite such important medicinal use, they display a variety of physiologic activities, which make them promising anti-cancer, anti-protozoal, antibacterial and antiviral agents.
Objective:
To review physiological activity of bisphosphonates with special emphasis on their ongoing and potential applications in medicine and agriculture.
Method:
Critical review of recent literature data.
Results:
Comprehensive review of activities revealed by bisphosphonates.
Conclusion:
although bisphosphonates are mostly recognized by their profound effects on bone physiology their medicinal potential has not been fully evaluated yet. Literature data considering enzyme inhibition suggest possibilities of far more wide application of these compounds. These applications are, however, limited by their low bioavailability and therefore intensive search for new chemical entities overcoming this shortage are carried out.
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17
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Neto T, Horta R, Balhau R, Coelho L, Silva P, Correia-Sá I, Silva Á. Resection and microvascular reconstruction of bisphosphonate-related osteonecrosis of the jaw: The role of microvascular reconstruction. Head Neck 2016; 38:1278-85. [PMID: 27159622 DOI: 10.1002/hed.24395] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 10/22/2015] [Accepted: 12/17/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Current treatment guidelines caution against osseous reconstruction using free flap tissue to treat bisphosphonate-related osteonecrosis of the jaw (BRONJ). The primary rationale for this stance is the theoretical risk of nonunion and recurrence of disease within the reconstruction. Emerging evidence suggests that these theoretical risks may be overestimated. We performed a literature review of this procedure for the treatment of advanced BRONJ. We also present a new case report of resection and microvascular reconstruction in a 58-year-old man with stage III BRONJ. METHODS A MEDLINE search was performed to gather all reports of maxillary and mandibular reconstruction using free tissue flap transfer for BRONJ. Inclusion criteria were confirmed stage II or III BRONJ, free tissue transfer and reconstruction, and reported complications. Articles were excluded if they contained only local flap reconstruction, wound closure without reconstruction, or osteoradionecrosis. Outcomes from our case report were added to the analysis. RESULTS We identified 10 articles that met criteria. Adding our case, we identified 40 cases of free flap reconstruction. The rate of nonunion was 5% (2 of 40). Fistulas formed in 4 cases (10%). BRONJ recurred in 2 cases (5%). CONCLUSION Complication rates after free flap microvascular reconstruction in BRONJ seem acceptable. Nonunion is relatively rare and should not be the sole reason to recommend against free flap reconstruction. A randomized clinical trial would help clarify the role of this procedure in refractory BRONJ; however, we believe that segmental resection and microvascular reconstruction is a viable option in select cases of BRONJ. © 2016 Wiley Periodicals, Inc. Head Neck 38:1278-1285, 2016.
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Affiliation(s)
- Tiago Neto
- Maxillofacial Surgery Unit, Department of Plastic, Reconstructive, Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Hospital São João, Porto, Portugal
| | - Ricardo Horta
- Department of Plastic, Reconstructive, Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Hospital São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Balhau
- Maxillofacial Surgery Unit, Department of Plastic, Reconstructive, Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Hospital São João, Porto, Portugal
| | - Lígia Coelho
- Maxillofacial Surgery Unit, Department of Plastic, Reconstructive, Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Hospital São João, Porto, Portugal
| | - Pedro Silva
- Department of Plastic, Reconstructive, Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Hospital São João, Porto, Portugal
| | - Inês Correia-Sá
- Department of Plastic, Reconstructive, Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Hospital São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Álvaro Silva
- Department of Plastic, Reconstructive, Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Hospital São João, Porto, Portugal
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GRISCHKE J, EBERHARD J, STIESCH M. Antimicrobial dental implant functionalization strategies —A systematic review. Dent Mater J 2016; 35:545-58. [DOI: 10.4012/dmj.2015-314] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jasmin GRISCHKE
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School
| | - Jörg EBERHARD
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School
| | - Meike STIESCH
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School
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