Assitant Professor Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry Seodaemun-gu, Seoul-t'ukpyolsi, Republic of Korea
Disclosure(s):
Jun-Young Kim, DDS, PhD.: No financial relationships to disclose
Abstract: Statement of the problem Medication-related osteonecrosis of the jaw(MRONJ), an intractable disease, is a potentially devastating complication of anti-resorptive drugs used for the treatment of bone disorders such as osteoporosis, skeletal complications associated with osseous metastasis, and multiple myeloma. Although many cases of MRONJ have been reported over the years, but the pathophysiology is unclear, making diagnosis, treatment, and prevention difficult. Therefore, the purpose of this study is to compare and analyze microbial communities through metagenomics analysis via microbial genome extraction from the saliva and oral mucosa of both healthy and MRONJ disease groups.
Material and methods For this study, subjects were selected from 2021 to 2022 according to the selection and exclusion criteria. Among the patients diagnosed with MRONJ because of examination according to the American Association of Oral and Maxillofacial Surgeons position paper in 2014, a total of 15 patients participated in the study after obtaining consent. The affected area was designated as the experimental group, and a swab was collected for the oral mucosa and infectious fluid around the lesion. In contrast to that, in the control group, samples were taken from the oral mucosa on the opposite side of the affected side and the asymptomatic normal side in the form of a split-mouth in each patient. After DNA extraction from each sample, polymerase chain reaction (PCR) amplification was performed on the V3-V4 hypervariable region on the 16S rRNA gene, and metagenome sequencing and bioinformatics analysis were performed using a next-generation sequencing method(NGS).
Methods of data analysis Clinical data were considered statistically significant when the p-value was less than 0.05 using SPSS version 22. To evaluate the effectiveness, metagenomic analysis was performed, and the existence of significant strains and the alpha and beta diversity between the control and experimental groups were confirmed.
Result In the comparison of alpha diversity between the two groups, the total amount and richness were relatively high in the control group, although there was no significant difference, and the evenness showed a significant difference and tended to be high in the control group. In the comparative analysis of the oral microbiome at the phylum, genus, and species levels, statistically, significant differences were observed between the two groups for specific pathogenic strains.
Outcomes Data When the oral microbiome at the phylum, genus, and species level of the control group and the experimental group was compared with the Wilcoxon signed-rank test, the relative abundance at the phylum level was significantly higher for Cyanobacteria and proteobacteria in the control group (p < 0.05), Bacteroidetes were significantly higher in the experimental group (P < 0.05). In addition, significant differences were found at the genus and species levels.
Conclusions relevant to the problem Within the limitations of this study, risk strains associated with the pathogenesis of MRONJ could be predicted. Future studies will need to verify various possibilities to understand disease mechanisms and establish disease prediction models.
References VAHTSEVANOS, Konstantinos, et al. Longitudinal cohort study of risk factors in cancer patients of bisphosphonate-related osteonecrosis of the jaw. Journal of Clinical Oncology, 2009, 27.32: 5356-5362. SEDGHIZADEH, Parish P., et al. Metagenomic investigation of microbes and viruses in patients with jaw osteonecrosis associated with bisphosphonate therapy. Oral surgery, oral medicine, oral pathology and oral radiology, 2012, 114.6: 764-770.
