Culprit found for Jaw Decay Linked to Bisphosphonates

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A group of University of Southern California School of Dentistry researchers says it has identified the slimy culprits killing the jawbones of some people taking drugs that treat osteoporosis.

Microbial biofilms, a mix of bacteria and sticky extracellular material, are causing jaw tissue infections in patients taking bisphosphonate drugs, said Parish Sedghizadeh, lead researcher and assistant clinical professor at the USC School of Dentistry.

Sold under brand names such as Fosamax, Boniva and Actonel, bisphosphonates are prescribed to millions of patients to combat osteoporosis, a bone-wasting disease that increases the risk of fractures.

Sedghizadeh said there have been increasing reports of osteonecrosis (bone death) of the jaw in patients who have been taking the drugs for osteoporosis or for treatment from the bone-wasting effects of cancer. He said he decided to investigate further after seeing patients in USC dentistry clinics who had the unusual jaw infection.

“This is the first study that identifies microbial biofilms in the bone of bisphosphonate patients who have osteonecrosis of the jaw,” Sedghizadeh said.

Jaw osteonecrosis occurs when bacteria-laden biofilms infect the jaw after the bone is exposed, typically because of a tooth extraction or injury.

The USC research team includes renowned biofilm expert J. William Costerton, director of the Center for Biofilms at the USC School of Dentistry.

Pioneered by Costerton, biofilm theory has moved scientists beyond thinking of bacteria as free-floating organisms. Instead, bacteria build biofilm communities, attaching to surfaces and communicating and defending against antimicrobial invaders.

The team used powerful scanning electron microscopes to study patients’ jawbone samples. The images revealed biofilm bacteria sprawling over pitted tissue.

The scientists are now trying to determine why bisphosphonate drugs seem to open the door for biofilm-associated infections of the jaw.

“Now that we’ve know biofilms are behind the infection of the jaw, we are studying ways to effectively treat or prevent the osteonecrosis,” Sedghizadeh said.

Source:
Contact: Angelica Urquijo
University of Southern California

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3 Responses to “ Culprit found for Jaw Decay Linked to Bisphosphonates ”

  • M Aswathaiah. DDS May 8th, 2008

    I have these following questions regarding your statements as quoted below.

    Pioneered by Costerton, biofilm theory has moved scientists beyond thinking of bacteria as free-floating organisms. Instead, bacteria build biofilm communities, “attaching to surfaces and communicating and defending against antimicrobial invaders.”
    1. Attaching to which surfaces?… is it the surface of the oral cavity (soft tissue) which is covered with epithelium? or, are you referring to the extraction site? or any other breached (of epithelial lining) surface?
    2. This “biofilm community (of bacteria)” is “communicating” with “antimicrobial invaders” located where? (orientation of invaders and biofilm please)
    3. This “attached biofilm comunity” is “defending against antimicrobial invaders” …again what is the orientation and relation of the “antimicrobial invaders to biofilm” please? in other words, where are these “antimicrobial invaders” located?… is it in the topical, in tissue fluid, or in the vascular or in the lymphatic system.
    4. Isn’t formation of dental plaque involve “bacteria (microbia) building or living in biofilm communities”? or is that bacteria being “sheltered” in the plaque?
    I would be willing to communicate with you, in a different format upon your finding my questions be not too clear for your understanding and interpretation.
    Sincerely,
    amdds@hotmail.com

  • Steven W. Beadnell, DMD May 9th, 2008

    I have been involved in diagnosing and managing patients with the Bisphosphonate-Related Osteonecrosis of the Jaw since 2003 and have closely followed the literature on the subject. The title and information in your article are VERY misleading. There is no substantive proof that the pathogenesis of this disorder has anything to do with Biofilm that was shown to be present, in fact none of the theories on pathogenesis have been proven. Many of the changes in the bone, evident on plain films and CT scans,occur prior to any exposure of the involved bone and development of the Biofilm. For your article to state that the Biofilm kills the jaw doesn’t seem to be validated or agreed upon in the professional community or by currently available research.

    Steven W. Beadnell, DMD
    Practice limited to OMFS

  • Mrs. Poonam May 12th, 2008

    Recently I have been prescribed these bisphosphonate drugs (ALENDRONIC ACID once weekly) for treating Osteoporosis & I am under dental treatment. Any time I have to extract few lower teeth. Is it safe for me to take these tablets? So far I have taken only two. Please guide me as soon as possible.

    Mrs. Daswani.

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