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The presence of pathogenic bacteria is highly associated with advanced stages of MRONJ lesions; however, the exact role of indigenous microbes in MRONJ development is unknown. Here, we report that the normal oral flora in mice protects against inflammation-induced osteonecrosis. In mice that developed osteonecrosis following tooth extraction, there was increased bacterial infiltration when compared with healed controls. Antibiotic-mediated oral dysbiosis led to a local inhibition of bone resorption in the presence of ligature-induced periodontitis (LIP). There was no significant difference in empty lacunae, necrotic bone formation, osteoclast number, and surface area in antibiotic-treated as compared with conventionally colonized mice following extraction of healthy teeth after zoledronic acid infusions. However, extraction of LIP teeth led to increased empty lacunae, necrotic bone, and osteoclast surface area in antibiotic- and zoledronic acid\u2013treated mice as compared with conventionally colonized mice. Our findings suggest that the presence of the indigenous microbiota protects against LIP-induced osteonecrosis.<\/jats:p>","DOI":"10.1177\/0022034520908594","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T19:08:39Z","timestamp":1582916919000},"page":"676-684","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Indigenous Microbiota Protects against Inflammation-Induced Osteonecrosis"],"prefix":"10.1177","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7718-2098","authenticated-orcid":false,"given":"D.W.","family":"Williams","sequence":"first","affiliation":[{"name":"The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA"},{"name":"Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.E.","family":"Vuong","sequence":"additional","affiliation":[{"name":"Department of Integrative Biology and Physiology, UCLA Division of Life Sciences, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Kim","sequence":"additional","affiliation":[{"name":"The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA"},{"name":"Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Lenon","sequence":"additional","affiliation":[{"name":"The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Ho","sequence":"additional","affiliation":[{"name":"The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.Y.","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Department of Integrative Biology and Physiology, UCLA Division of Life Sciences, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.C.","family":"Sung","sequence":"additional","affiliation":[{"name":"Section of Special Patient Care, UCLA School of Dentistry, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.H.","family":"Kim","sequence":"additional","affiliation":[{"name":"The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA"},{"name":"Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA"},{"name":"UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,2,28]]},"reference":[{"key":"bibr1-0022034520908594","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2013.05.002"},{"key":"bibr2-0022034520908594","doi-asserted-by":"publisher","DOI":"10.1016\/j.coms.2015.06.001"},{"key":"bibr3-0022034520908594","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.379"},{"key":"bibr4-0022034520908594","doi-asserted-by":"publisher","DOI":"10.1038\/s41587-019-0209-9"},{"key":"bibr5-0022034520908594","doi-asserted-by":"crossref","unstructured":"Bosshardt DD, Lang NP. 2005. 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