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In a retrospective cohort study we investigated a possible role of\n                    <jats:italic>Actinomyces spp.<\/jats:italic>\n                    in the pathogenesis of MRONJ. Deep biopsies of necrotic bone were collected during surgical treatment of MRONJ and evaluated by histology and microbiology for the presence of\n                    <jats:italic>Actinomyces spp<\/jats:italic>\n                    . Microbiological, demographic and clinicpathological data were analyzed for risk of\n                    <jats:italic>Actinomyces<\/jats:italic>\n                    -associated MRONJ. Between 2005 and 2014, 111 patients suffering from histologically-confirmed MRONJ were identified.\n                    <jats:italic>Actinomyces spp.<\/jats:italic>\n                    were detected in 99 cases (89%) by histology and in six further patients by microbiological culture. A diverse microbial flora was found in all specimens without association with\n                    <jats:italic>Actinomyces spp.<\/jats:italic>\n                    Demographic and clinicopathological characteristics did not separate significantly\n                    <jats:italic>Actinomyces<\/jats:italic>\n                    -positive from\n                    <jats:italic>Actinomyces<\/jats:italic>\n                    -negative cases. Our observations confirm previous reports of a high prevalence of\n                    <jats:italic>Actinomyces spp.<\/jats:italic>\n                    in MRONJ in the single largest cohort available up to now. The high prevalence of Actinomyces\n                    <jats:italic>spp<\/jats:italic>\n                    . and the lack of clinicopathological risk factors underline the prominent role of\n                    <jats:italic>Actinomyces spp<\/jats:italic>\n                    . in MRONJ and may change the current understanding of MRONJ. Established prolonged antimicrobial treatment regimens against\n                    <jats:italic>Actinomyces spp.<\/jats:italic>\n                    infection could therefore be a mainstay of future MRONJ management.\n                  <\/jats:p>","DOI":"10.1038\/srep31604","type":"journal-article","created":{"date-parts":[[2016,8,17]],"date-time":"2016-08-17T05:26:27Z","timestamp":1471411587000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["The association of medication-related osteonecrosis of the jaw with Actinomyces spp. infection"],"prefix":"10.1038","volume":"6","author":[{"given":"Guenter","family":"Russmueller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf","family":"Seemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Stadler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Speiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Perisanidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"Fuereder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Willinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Sulzbacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Steininger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,8,17]]},"reference":[{"key":"BFsrep31604_CR1","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1016\/S1470-2045(08)70305-X","volume":"9","author":"BJ Edwards","year":"2008","unstructured":"Edwards, B. J. et al. Pharmacovigilance and reporting oversight in US FDA fast-track process: bisphosphonates and osteonecrosis of the jaw. The Lancet. Oncology 9, 1166\u20131172 (2008).","journal-title":"The Lancet. Oncology"},{"key":"BFsrep31604_CR2","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-2014 update. J Oral Maxillofac Surg 72, 1938\u20131956 (2014).","journal-title":"J Oral Maxillofac Surg"},{"key":"BFsrep31604_CR3","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1016\/j.ijom.2015.01.026","volume":"44","author":"R Fliefel","year":"2015","unstructured":"Fliefel, R., Troltzsch, M., Kuhnisch, J., Ehrenfeld, M. & Otto, S. 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