PDF(Pubmed)
Abstract：
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) represents a serious health condition, impacting the lives of many patients worldwide. The condition challenges clinical care due to its complex etiology and limited therapeutic options. A thorough understanding of the pathophysiological and patient-related factors that promote disease development is essential. Recently, the oral microbiome has been implicated as a potential driver and modulating factor of BRONJ by several studies. Modern genomic sequencing methods have provided a wealth of data on the microbial composition of BRONJ lesions; however, the role of individual species in the process of disease development remains elusive. A comprehensive PubMed search was conducted to identify relevant studies on the microbiome of BRONJ patients using the terms \"microbiome\", \"osteonecrosis of the jaws\", and \"bisphosphonates\". Studies focusing on symptoms, epidemiology, pathophysiology, risk factors, and treatment options were included. The principal risk factors for BRONJ are tooth extraction, surgical procedures, and the administration of high doses of bisphosphonates. Importantly, the oral microbiome plays a significant role in the progression of the disease. Several studies have identified alterations of microbial composition in BRONJ lesions. However, there is no consensus regarding bacterial species that are associated with BRONJ across studies. The bacterial genera typically found include Actinomyces, Fusobacterium, and Streptococcus. It is postulated that these microbes contribute to the pathogenesis of BRONJ by promoting inflammation and disrupting normal bone remodeling processes. Current therapeutic approaches are disease-stage-specific and the necessity for more effective treatment strategies remains. This review examines the potential causes of and therapeutic approaches to BRONJ, highlighting the link between microbial colonization and BRONJ development. Future research should seek to more thoroughly investigate the interactions between bisphosphonates, the oral microbiome, and the immune system in order to develop targeted therapies.
摘要：
双膦酸盐相关的颌骨坏死（BRONJ）代表了严重的健康状况，影响全世界许多患者的生活。由于其复杂的病因和有限的治疗选择，该疾病对临床护理提出了挑战。彻底了解促进疾病发展的病理生理和患者相关因素至关重要。最近,多项研究认为口腔微生物组是BRONJ的潜在驱动因子和调节因子。现代基因组测序方法为BRONJ病变的微生物组成提供了丰富的数据；然而，单个物种在疾病发展过程中的作用仍然难以捉摸。进行了全面的PubMed搜索，以使用术语“微生物组”来确定BRONJ患者微生物组的相关研究，“颌骨坏死”，和“双膦酸盐”。专注于症状的研究，流行病学,病理生理学,危险因素，并包括治疗方案。BRONJ的主要危险因素是拔牙，外科手术,以及高剂量双膦酸盐的给药。重要的是,口腔微生物组在疾病的进展中起着重要作用。一些研究已经确定了BRONJ病变中微生物组成的改变。然而,关于与BRONJ相关的细菌种类的研究没有达成共识.通常发现的细菌属包括放线菌，梭杆菌,和链球菌。据推测，这些微生物通过促进炎症和破坏正常的骨重建过程来促进BRONJ的发病机理。目前的治疗方法是疾病阶段特异性的，并且仍然需要更有效的治疗策略。这篇综述探讨了BRONJ的潜在原因和治疗方法，强调微生物定植与BRONJ发育之间的联系。未来的研究应该寻求更彻底的调查二膦酸盐之间的相互作用，口腔微生物组，和免疫系统以开发靶向治疗。
