{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:21:55Z","timestamp":1793294515868,"version":"4.5.0"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002332","name":"Semmelweis University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002332","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Medication-Related Osteonecrosis of the Jaws (MRONJ) is a difficult-to-treat complication of the therapy of osteoporosis and some malignancies cured with bisphosphonates and antiresorptive drugs. The pathomechanism is unclear, but there is increasing observation that Actinomyces infection may play a role in its development and progression. The aim of our study was to demonstrate that histological examination using a validated triple staining procedure for Actinomyces bacteria strains can detect a high rate of Actinomyces infection in patient's samples with MRONJ. 112 previously hematoxylin-eosin (HE) stained samples submitted with the clinical diagnosis of MRONJ were re-evaluated histologically using an appropriate triple special staining validated for the identification of Actinomyces infection. During the first evaluation, when pathologists did not specifically look for Actinomyces, only 8.93% of the samples were reported as positive. In contrast, re-evaluation with triple staining provided a yield of 93.7% positive samples, therefore, we suggest the triple special staining to be standard in MRONJ histology evaluation. These results show that if the clinician suspects Actinomyces infection and brings this to the attention of the pathologist, it could significantly increase the number of correct diagnoses. It serves as an aid for clinicians in therapeutic success of MRONJ by selecting a long-term adequate antibiotic medication which is suitable for the elimination of actinomyces infection.<\/jats:p>","DOI":"10.1038\/s41598-022-07375-1","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T06:03:01Z","timestamp":1646114581000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Targeted histological evaluation shows high incidence of actinomyces infection in medication-related osteonecrosis of the jaws"],"prefix":"10.1038","volume":"12","author":[{"given":"Andrea","family":"Brody","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1lint","family":"Scheich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"Dobo-Nagy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,1]]},"reference":[{"key":"7375_CR1","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s00432-014-1853-6","volume":"141","author":"TI Gabbert","year":"2015","unstructured":"Gabbert, T. I., Hoffmeister, B. & Felsenberg, D. Risk factors influencing the duration of treatment with bisphosphonates until occurrence of an osteonecrosis of the jaw in 963 cancer patients. J. Cancer Res. Clin. Oncol. 141, 749\u2013758 (2015).","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"7375_CR2","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/j.amjmed.2004.04.015","volume":"117","author":"G Lugassy","year":"2004","unstructured":"Lugassy, G., Shaham, R., Nemets, A., Ben-Dor, D. & Nahlieli, O. Severe osteomyelitis of the jaw in long-term survivors of multiple myeloma: A new clinical entity. Am. J. Med. 117, 440\u2013441 (2004).","journal-title":"Am. J. Med."},{"key":"7375_CR3","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/S0278-2391(03)00720-1","volume":"61","author":"RE Marx","year":"2003","unstructured":"Marx, R. E. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: A growing epidemic. J. Oral Maxillofac. Surg. 61, 1115\u20131117 (2003).","journal-title":"J. Oral Maxillofac. Surg."},{"key":"7375_CR4","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1111\/jop.12038","volume":"42","author":"S Schipmann","year":"2013","unstructured":"Schipmann, S. et al. Osteopathology associated with bone resorption inhibitors\u2014which role does Actinomyces play? A presentation of 51 cases with systematic review of the literature. J. Oral Pathol. Med. 42, 587\u2013593 (2013).","journal-title":"J. Oral Pathol. Med."},{"key":"7375_CR5","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.1016\/j.joms.2014.04.031","volume":"72","author":"SL Ruggiero","year":"2014","unstructured":"Ruggiero, S. L. et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw\u20132014 update. J. Oral Maxillofac. Surg. 72, 1938\u20131956 (2014).","journal-title":"J. Oral Maxillofac. Surg."},{"key":"7375_CR6","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1111\/ors.12329","volume":"11","author":"F Domah","year":"2018","unstructured":"Domah, F., Shah, N., Domah, J. & Shah, R. Medication-related osteonecrosis of the jaw\u2014A current review. Oral Surg. 11, 250\u2013258 (2018).","journal-title":"Oral Surg."},{"key":"7375_CR7","first-page":"2","volume":"2","author":"A Cerrato","year":"2020","unstructured":"Cerrato, A. et al. Actinomyces and MRONJ: A retrospective study and a literature review. J. Stomatol. Oral Maxillofac. Surg. 2, 2 (2020).","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"7375_CR8","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.humpath.2005.09.018","volume":"37","author":"T Hansen","year":"2006","unstructured":"Hansen, T., Kunkel, M., Kirkpatrick, C. J. & Weber, A. Actinomyces in infected osteoradionecrosis\u2014underestimated?. Hum. Pathol. 37, 61\u201367 (2006).","journal-title":"Hum. Pathol."},{"key":"7375_CR9","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1016\/j.ijom.2010.04.054","volume":"39","author":"M Kos","year":"2010","unstructured":"Kos, M., Brusco, D., Kuebler, J. & Engelke, W. Clinical comparison of patients with osteonecrosis of the jaws, with and without a history of bisphosphonates administration. Int. J. Oral Maxillofac. Surg. 39, 1097\u20131102 (2010).","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"7375_CR10","doi-asserted-by":"publisher","first-page":"271","DOI":"10.22203\/eCM.v030a19","volume":"30","author":"LE Mulcahy","year":"2015","unstructured":"Mulcahy, L. E. et al. The effect of bisphosphonate treatment on the biochemical and cellular events during bone remodelling in response to microinjury stimulation. Eur. Cell Mater. 30, 271\u2013281 (2015).","journal-title":"Eur. Cell Mater."},{"key":"7375_CR11","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1111\/j.1600-0714.2006.00391.x","volume":"35","author":"T Hansen","year":"2006","unstructured":"Hansen, T., Kunkel, M., Weber, A. & James, K. C. Osteonecrosis of the jaws in patients treated with bisphosphonates\u2014histomorphologic analysis in comparison with infected osteoradionecrosis. J. Oral Pathol. Med. 35, 155\u2013160 (2006).","journal-title":"J. Oral Pathol. Med."},{"key":"7375_CR12","doi-asserted-by":"publisher","first-page":"452737","DOI":"10.1155\/2014\/452737","volume":"2014","author":"A Hinson","year":"2014","unstructured":"Hinson, A., Smith, C., Siegel, E. & Stack, B. Is bisphosphonate-related osteonecrosis of the jaw an infection? A histological and microbiological ten-year summary. Int. J. Dent. 2014, 452737 (2014).","journal-title":"Int. J. Dent."},{"key":"7375_CR13","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1111\/jop.12156","volume":"43","author":"S Koerdt","year":"2014","unstructured":"Koerdt, S. et al. Histomorphologic characteristics of bisphosphonate-related osteonecrosis of the jaw. J. Oral Pathol. Med. 43, 448\u2013453 (2014).","journal-title":"J. Oral Pathol. Med."},{"key":"7375_CR14","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.bjoms.2010.05.007","volume":"49","author":"V Patel","year":"2011","unstructured":"Patel, V., McLeod, N. M., Rogers, S. N. & Brennan, P. A. Bisphosphonate osteonecrosis of the jaw\u2014a literature review of UK policies versus international policies on bisphosphonates, risk factors and prevention. Br. J. Oral Maxillofac. Surg. 49, 251\u2013257 (2011).","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"7375_CR15","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.jcms.2017.01.006","volume":"45","author":"S Panya","year":"2017","unstructured":"Panya, S. et al. Role of microbiological culture and polymerase chain reaction (PCR) of actinomyces in medication-related osteonecrosis of the jaw (MRONJ). J. Craniomaxillofac. Surg. 45, 357\u2013363 (2017).","journal-title":"J. Craniomaxillofac. Surg."},{"key":"7375_CR16","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1016\/j.oooo.2013.03.001","volume":"115","author":"K Anavi-Lev","year":"2013","unstructured":"Anavi-Lev, K. et al. Bisphosphonate related osteonecrosis of the jaws: Clinico-pathological investigation and histomorphometric analysis. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 115, 660\u2013666 (2013).","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"7375_CR17","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s00198-015-3335-3","volume":"27","author":"A Khan","year":"2016","unstructured":"Khan, A., Morrison, A., Cheung, A., Hashem, W. & Compston, J. Osteonecrosis of the jaw (ONJ): Diagnosis and management in 2015. Osteoporos Int. 27, 853\u2013859 (2016).","journal-title":"Osteoporos Int."},{"key":"7375_CR18","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1556\/650.2020.31633","volume":"161","author":"T Vereb","year":"2020","unstructured":"Vereb, T., Janovszky, A., Mucsi, M., Piffko, J. & Seres, L. Aktualit\u00e1sok a gy\u00f3gyszer okozta \u00e1llcsontelhal\u00e1s primer \u00e9s szekunder prevenci\u00f3j\u00e1nak strat\u00e9gi\u00e1j\u00e1ban az evidenci\u00e1k \u00e9s a nemzetk\u00f6zi aj\u00e1nl\u00e1sok t\u00fckr\u00e9ben. Orv. Hetil. 161, 214\u2013223 (2020).","journal-title":"Orv. Hetil."},{"key":"7375_CR19","doi-asserted-by":"publisher","first-page":"e025600","DOI":"10.1136\/bmjopen-2018-025600","volume":"9","author":"E Veszelyn\u00e9Kot\u00e1n","year":"2019","unstructured":"Veszelyn\u00e9Kot\u00e1n, E. et al. Database analysis of the risk factors of bisphosphonate-related osteonecrosis of the jaw in Hungarian patients. BMJ Open 9, e025600 (2019).","journal-title":"BMJ Open"},{"key":"7375_CR20","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1177\/0022034515572021","volume":"94","author":"H Katsarelis","year":"2015","unstructured":"Katsarelis, H., Shah, N. P., Dhariwal, D. K. & Pazianas, M. Infection and medication-related osteonecrosis of the jaw. J. Dent. Res. 94, 534\u2013539 (2015).","journal-title":"J. Dent. Res."},{"key":"7375_CR21","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/S1368-8375(99)00080-9","volume":"36","author":"MM Curi","year":"2000","unstructured":"Curi, M. M., Dib, L. L., Kowalski, L. P., Landman, G. & Mangini, C. Opportunistic actinomycosis in osteoradionecrosis of the jaws in patients affected by head and neck cancer: Incidence and clinical significance. Oral Oncol. 36, 294\u2013299 (2000).","journal-title":"Oral Oncol."},{"key":"7375_CR22","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.tripleo.2009.06.019","volume":"108","author":"I Kaplan","year":"2009","unstructured":"Kaplan, I. et al. The clinical spectrum of Actinomyces-associated lesions of the oral mucosa and jawbones: Correlations with histomorphometric analysis. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol. 108, 738\u2013746 (2009).","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol."},{"key":"7375_CR23","doi-asserted-by":"publisher","first-page":"e257","DOI":"10.1016\/j.oooo.2019.10.008","volume":"129","author":"JD Raguse","year":"2020","unstructured":"Raguse, J. D. et al. Replacing one evil with another: Is the fibula really a dispensable spare part available for transfer in patients with medication-related osteonecrosis of the jaws?. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 129, e257\u2013e263 (2020).","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"7375_CR24","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.14219\/jada.archive.2009.0049","volume":"140","author":"PP Sedghizadeh","year":"2009","unstructured":"Sedghizadeh, P. P. et al. Microbial biofilms in osteomyelitis of the jaw and osteonecrosis of the jaw secondary to bisphosphonate therapy. J. Am. Dent. Assoc. 140, 1259\u20131265 (2009).","journal-title":"J. Am. Dent. Assoc."},{"key":"7375_CR25","doi-asserted-by":"publisher","first-page":"2143","DOI":"10.1007\/s00784-018-2655-z","volume":"23","author":"M Zirk","year":"2019","unstructured":"Zirk, M. et al. Microbial diversity in infections of patients with medication-related osteonecrosis of the jaw. Clin. Oral Investig. 23, 2143\u20132151 (2019).","journal-title":"Clin. Oral Investig."},{"key":"7375_CR26","doi-asserted-by":"publisher","first-page":"96","DOI":"10.33891\/FSZ.113.3.96-104","volume":"113","author":"S Anette","year":"2020","unstructured":"Anette, S., Barrak, I., Gajd\u00e1cs, M., Bar\u00e1th, Z. & Urb\u00e1n, E. A cervicofaci\u00e1lis actinomycosisok jellemz\u0151i \u00e9s korszer\u0171 diagnosztik\u00e1ja: \u00f6sszefoglal\u00f3 az irodalmi adatok alapj\u00e1n. Fogorv. Sz. 113, 96\u2013104 (2020).","journal-title":"Fogorv. Sz."},{"key":"7375_CR27","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.jds.2013.02.031","volume":"12","author":"B Sezer","year":"2017","unstructured":"Sezer, B., Akdeniz, B. G., G\u00fcnbay, S., Hilmio\u011flu-Polat, S. & Ba\u015fdemir, G. Actinomycosis osteomyelitis of the jaws: Report of four cases and a review of the literature. J. Dent. Sci. 12, 301\u2013307 (2017).","journal-title":"J. Dent. Sci."},{"key":"7375_CR28","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1128\/CMR.00100-14","volume":"28","author":"E K\u00f6n\u00f6nen","year":"2015","unstructured":"K\u00f6n\u00f6nen, E. & Wade, W. G. Actinomyces and related organisms in human infections. Clin. Microbiol. Rev. 28, 419\u2013442 (2015).","journal-title":"Clin. Microbiol. Rev."},{"key":"7375_CR29","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3390\/antibiotics9040139","volume":"9","author":"A St\u00e1jer","year":"2020","unstructured":"St\u00e1jer, A., Ibrahim, B., Gajd\u00e1cs, M., Urb\u00e1n, E. & Bar\u00e1th, Z. Diagnosis and management of cervicofacial actinomycosis: lessons from two distinct clinical cases. Antibiotics 9, 2 (2020).","journal-title":"Antibiotics"},{"key":"7375_CR30","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1007\/s10006-017-0667-5","volume":"22","author":"M Akashi","year":"2018","unstructured":"Akashi, M. et al. Differences between osteoradionecrosis and medication-related osteonecrosis of the jaw. Oral Maxillofac. Surg. 22, 59\u201363 (2018).","journal-title":"Oral Maxillofac. Surg."},{"key":"7375_CR31","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1186\/s12903-019-0843-0","volume":"19","author":"A Brody","year":"2019","unstructured":"Brody, A., Zalatnai, A., Csomo, K., Belik, A. & Dobo-Nagy, C. Difficulties in the diagnosis of periapical translucencies and in the classification of cemento-osseous dysplasia. BMC Oral Health 19, 139 (2019).","journal-title":"BMC Oral Health"},{"key":"7375_CR32","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/0278-2391(94)90008-6","volume":"52","author":"RE Marx","year":"1994","unstructured":"Marx, R. E., Carlson, E. R., Smith, B. R. & Toraya, N. Isolation of Actinomyces species and Eikenella corrodens from patients with chronic diffuse sclerosing osteomyelitis. J. Oral Maxillofac. Surg. 52, 26\u201333 (1994).","journal-title":"J. Oral Maxillofac. Surg."},{"key":"7375_CR33","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.mpdhp.2016.09.005","volume":"22","author":"AE Rosenberg","year":"2016","unstructured":"Rosenberg, A. E. & Khurana, J. S. Osteomyelitis and osteonecrosis. Diagn. Histopathol. 22, 355\u2013368 (2016).","journal-title":"Diagn. Histopathol."},{"key":"7375_CR34","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.ijom.2018.07.002","volume":"48","author":"A Shuster","year":"2019","unstructured":"Shuster, A. et al. Comparison of the histopathological characteristics of osteomyelitis, medication-related osteonecrosis of the jaw, and osteoradionecrosis. Int. J. Oral Maxillofac. Surg. 48, 17\u201322 (2019).","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"7375_CR35","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/1472-6831-11-21","volume":"11","author":"MH Smith","year":"2011","unstructured":"Smith, M. H. et al. Mandibular actinomyces osteomyelitis complicating florid cemento-osseous dysplasia: Case report. BMC Oral Health 11, 21 (2011).","journal-title":"BMC Oral Health"},{"key":"7375_CR36","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.ijom.2011.12.016","volume":"41","author":"RE Marx","year":"2012","unstructured":"Marx, R. E. & Tursun, R. Suppurative osteomyelitis, bisphosphonate induced osteonecrosis, osteoradionecrosis: A blinded histopathologic comparison and its implications for the mechanism of each disease. Int. J. Oral Maxillofac. Surg. 41, 283\u2013289 (2012).","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"7375_CR37","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1086\/648075","volume":"49","author":"NH Naik","year":"2009","unstructured":"Naik, N. H. & Russo, T. A. Bisphosphonate-related osteonecrosis of the jaw: The role of actinomyces. Clin. Infect. Dis. 49, 1729\u20131732 (2009).","journal-title":"Clin. Infect. Dis."},{"key":"7375_CR38","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/j.medcli.2012.05.039","volume":"139","author":"JA Arranz Caso","year":"2012","unstructured":"Arranz Caso, J. A. et al. Bisphosphonate related osteonecrosis of the jaw and infection with actinomyces. Med. Clin. (Barc). 139, 676\u2013680 (2012).","journal-title":"Med. Clin. (Barc)."},{"key":"7375_CR39","doi-asserted-by":"publisher","first-page":"31604","DOI":"10.1038\/srep31604","volume":"6","author":"G Russmueller","year":"2016","unstructured":"Russmueller, G. et al. The association of medication-related osteonecrosis of the jaw with Actinomyces spp. infection. Sci. Rep. 6, 31604 (2016).","journal-title":"Sci. Rep."},{"key":"7375_CR40","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1556\/650.2019.31621","volume":"161","author":"S Szentp\u00e9teri","year":"2020","unstructured":"Szentp\u00e9teri, S., Rest\u00e1r, L., N\u00e9meth, Z. & Vaszilk\u00f3, M. Prognostic factors of the medication-related osteonecrosis of the jaw. Orv. Hetil. 161, 283\u2013289 (2020).","journal-title":"Orv. Hetil."},{"key":"7375_CR41","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1007\/s10096-014-2160-5","volume":"33","author":"J De Ceulaer","year":"2014","unstructured":"De Ceulaer, J., Tacconelli, E. & Vandecasteele, S. J. Actinomyces osteomyelitis in bisphosphonate-related osteonecrosis of the jaw (BRONJ): The missing link?. Eur. J. Clin. Microbiol. Infect. Dis. 33, 1873\u20131880 (2014).","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"7375_CR42","doi-asserted-by":"publisher","first-page":"82","DOI":"10.26444\/jpccr\/94379","volume":"12","author":"A Gaweda","year":"2018","unstructured":"Gaweda, A., Ka\u0142u\u017ca, A., Wojciechowicz, J., Wachowicz, M. & Dweik, S. Necrosis BRONJ of the mandible, complicated by Actinomyces infection\u2014Case report. J. Pre Clin. Clin. Res. 12, 82\u201386 (2018).","journal-title":"J. Pre Clin. Clin. Res."},{"key":"7375_CR43","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.ijom.2004.06.010","volume":"34","author":"G St\u00f8re","year":"2005","unstructured":"St\u00f8re, G., Eribe, E. R. & Olsen, I. DNA-DNA hybridization demonstrates multiple bacteria in osteoradionecrosis. Int. J. Oral Maxillofac. Surg. 34, 193\u2013196 (2005).","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"7375_CR44","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3390\/dj7030085","volume":"7","author":"M Gajd\u00e1cs","year":"2019","unstructured":"Gajd\u00e1cs, M., Urb\u00e1n, E. & Terhes, G. Microbiological and clinical aspects of cervicofacial actinomyces infections: An overview. Dent. J. 7, 2 (2019).","journal-title":"Dent. J."},{"key":"7375_CR45","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1097\/ID.0b013e3182310f03","volume":"20","author":"CYS Lee","year":"2011","unstructured":"Lee, C. Y. S., Pien, F. D. & Suzuki, J. B. Identification and treatment of bisphosphonate-associated actinomycotic osteonecrosis of the jaws. Implant Dent. 20, 2 (2011).","journal-title":"Implant Dent."},{"key":"7375_CR46","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1007\/s00428-007-0516-2","volume":"451","author":"T Hansen","year":"2007","unstructured":"Hansen, T. et al. Actinomycosis of the jaws\u2013histopathological study of 45 patients shows significant involvement in bisphosphonate-associated osteonecrosis and infected osteoradionecrosis. Virchows Arch. 451, 1009\u20131017 (2007).","journal-title":"Virchows Arch."},{"key":"7375_CR47","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1136\/bcr-2020-235744","volume":"13","author":"N Gupta","year":"2020","unstructured":"Gupta, N., Aggarwal, A., Ramteke, P. & Soneja, M. Mandibular osteomyelitis due to Actinomyces spp. BMJ Case Rep. 13, 2 (2020).","journal-title":"BMJ Case Rep."},{"key":"7375_CR48","unstructured":"Itzhak B. Treatment of Actinomycosis. UpToDate. 2021;https:\/\/www.uptodate.com\/contents\/treatment-of-actinomycosis."},{"key":"7375_CR49","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1093\/jac\/dki206","volume":"56","author":"AJ Smith","year":"2005","unstructured":"Smith, A. J., Hall, V., Thakker, B. & Gemmell, C. G. Antimicrobial susceptibility testing of Actinomyces species with 12 antimicrobial agents. J. Antimicrob. Chemother. 56, 407\u2013409 (2005).","journal-title":"J. Antimicrob. Chemother."},{"key":"7375_CR50","doi-asserted-by":"publisher","first-page":"126","DOI":"10.20453\/reh.v30i2.3765","volume":"30","author":"L Mallmann","year":"2020","unstructured":"Mallmann, L. et al. Cervicofacial actinomycosis: Important considerations on a mimicking disease. Rev. Estomatol. Hered. 30, 126\u2013133 (2020).","journal-title":"Rev. Estomatol. Hered."},{"key":"7375_CR51","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1016\/S1079-2104(97)90313-9","volume":"83","author":"R Nagler","year":"1997","unstructured":"Nagler, R., Peled, M. & Laufer, D. Cervicofacial actinomycosis: A diagnostic challenge. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 83, 652\u2013656 (1997).","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"7375_CR52","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1007\/s11908-005-0030-0","volume":"7","author":"O Oostman","year":"2005","unstructured":"Oostman, O. & Smego, R. A. Cervicofacial actinomycosis: Diagnosis and management. Curr. Infect. Dis. Rep. 7, 170\u2013174 (2005).","journal-title":"Curr. Infect. Dis. Rep."},{"key":"7375_CR53","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1016\/j.oooo.2014.04.017","volume":"118","author":"E Franco-Pretto","year":"2014","unstructured":"Franco-Pretto, E., Pacheco, M., Moreno, A., Messa, O. & Gnecco, J. Bisphosphonate-induced osteonecrosis of the jaws: Clinical, imaging, and histopathology findings. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 118, 408\u2013417 (2014).","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-07375-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-07375-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-07375-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T18:15:30Z","timestamp":1669313730000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-07375-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["7375"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-07375-1","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,1]]},"assertion":[{"value":"13 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3406"}}