Antibiotic effects on bacterial profile in osteonecrosis of the jaw


Deepak Saxena, Ph.D, Department of Basic Sciences and Craniofacial Biology, New York University College of Dentistry, 345 East 24th Street, 921-B, New York, NY 10010-4086. Tel: +1 212 998 9256, Fax: +1 212 995 4087, E-mail:


Oral Diseases (2011) 18, 85–95

Objective:  Oral infection is considered to play a critical role in the pathogenesis of bisphosphonate-related osteonecrosis of the jaw (BRONJ), and antibiotic therapy has become a mainstay of BRONJ therapy. This study was aimed to investigate the effect of antibiotics on bacterial diversity in BRONJ tissues.

Materials and methods:  The bacterial profile from soft tissues associated with the BRONJ lesion was determined using 16S rRNA-based denaturing gradient gel electrophoresis (DGGE) and sequencing. Twenty BRONJ subjects classified as stage 0–2 were enrolled in this study, and patient groups were divided into an antibiotic cohort (n = 10) treated with systemic antibiotic and a non-antibiotic cohort (n = 10) with no prior antibiotic therapy.

Results:  The DGGE fingerprints indicated no significant differences in bacterial diversity of BRONJ tissue samples. Patients on antibiotics had higher relative abundance of phylum Firmicutes with bacterial species, Streptococcus intermedius, Lactobacillus gasseri, Mogibacterium timidum, and Solobacterium moorei, whereas patients without antibiotics had greater amounts of Parvimonas micra and Streptococcus anginosus. Thirty percent of bacterial populations were uncultured (yet-to be cultured) phylotypes.

Conclusion:  This study using limited sample size indicated that oral antibiotic therapy may have a limited efficacy on the bacterial population associated with BRONJ lesions.