{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:03:03Z","timestamp":1778594583253,"version":"3.51.4"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Chinese Medicine Science and Technology Research Project of Guangdong Provincial Hospital of Chinese Medicine","award":["No.YN2022QN25"],"award-info":[{"award-number":["No.YN2022QN25"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No.31972856"],"award-info":[{"award-number":["No.31972856"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Top Talents Project of Guangdong Provincial Hospital of Chinese Medicine","award":["No.BJ2022YL08"],"award-info":[{"award-number":["No.BJ2022YL08"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Herpes zoster (HZ) is one of the most common skin diseases caused by viruses. Facial HZ develops when the <jats:italic>varicella-zoster virus<\/jats:italic> affects the trigeminal nerve, and alveolar osteonecrosis is a rare complication. However, the exact pathogenesis of postherpetic alveolar osteonecrosis remains unclear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case description<\/jats:title>\n                <jats:p>We encountered a patient who presented to the dermatology clinic with facial HZ and tooth exfoliation in the upper right jaw, and panoramic radiography revealed decreased bone density and poor alveolar socket healing in his right maxilla. Biopsy of the alveolar process revealed fragments of nonvital lamellar bone, which were devoid of osteoblasts and osteocytes and were surrounded by numerous neutrophils and bacterial aggregates. Thus, the diagnosis of alveolar osteonecrosis following facial HZ was confirmed. He then underwent resection of the osteonecrotic tissue. The pathological findings of postoperative tissue were similar to those of previous biopsies. <jats:italic>Varicella-zoster virus<\/jats:italic> and multiple types of bacteria were detected through next-generation sequencing, and the species of bacteria were consistent with the results of bacterial culture. Antibiotics and valaciclovir were administered during the perioperative period. The patient showed good recovery at the 9-month follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The coexistence of bacterial and viral infection may play an important role in the pathogenesis of alveolar osteonecrosis following HZ. To our knowledge, we are the first to directly explore microbial pathogens in a case of postherpetic alveolar osteonecrosis through next-generation sequencing and bacterial culture. We recommend that oral examinations be carefully conducted for patients who are diagnosed with facial HZ, even if their facial rashes have faded away. We suggest that a prolonged and full-dose antiviral therapy course may be beneficial for the treatment of facial HZ with intraoral lesions. The implementation of dental preventive measures should be considered for patients with facial HZ. The application of antibiotics and excision of necrotic bone may reduce the abundance of bacteria in lesions and improve wound healing.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12903-024-04202-z","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T10:01:53Z","timestamp":1712052113000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Infection may play an important role in the pathogenesis of alveolar osteonecrosis following facial herpes zoster: a case report and literature review"],"prefix":"10.1186","volume":"24","author":[{"given":"Kaikai","family":"Huang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youyuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhua","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanshan","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pinghua","family":"Qu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoying","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingyu","family":"Zhen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenting","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"issue":"4","key":"4202_CR1","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1111\/1346-8138.13639","volume":"44","author":"K Sato","year":"2017","unstructured":"Sato K, Adachi K, Nakamura H, Asano K, Watanabe A, Adachi R, et al. Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: results from an observational, prospective, physician practice-based cohort study. J Dermatol. 2017;44(4):414\u201322.","journal-title":"J Dermatol"},{"issue":"10","key":"4202_CR2","doi-asserted-by":"publisher","first-page":"e19741","DOI":"10.1016\/j.joms.2014.05.004","volume":"72","author":"T Rudd","year":"2014","unstructured":"Rudd T, Chai BY, Gurunluoglu R, Glasgow M. Mandibular osteonecrosis and Ramsay Hunt syndrome following a case of herpes zoster. J Oral Maxillofac Surg. 2014;72(10):e19741\u20136.","journal-title":"J Oral Maxillofac Surg"},{"issue":"3","key":"4202_CR3","doi-asserted-by":"publisher","first-page":"244","DOI":"10.4103\/0019-5154.110878","volume":"58","author":"VK Mahajan","year":"2013","unstructured":"Mahajan VK, Ranjan N, Sharma S, Sharma NL. Spontaneous tooth exfoliation after trigeminal herpes zoster: a case series of an uncommon complication. Indian J Dermatol. 2013;58(3):244.","journal-title":"Indian J Dermatol"},{"issue":"3","key":"4202_CR4","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1097\/QAD.0000000000000122","volume":"28","author":"N Cloarec","year":"2014","unstructured":"Cloarec N, Zaegel-Faucher O, Bregigeon S, Cano CE, Chossegros C, Wajszczak B, et al. Mandibular osteonecrosis and dental exfoliation after trigeminal zoster in an HIV-infected patient: case report and review of the literature. AIDS. 2014;28(3):448\u201350.","journal-title":"AIDS"},{"issue":"6","key":"4202_CR5","first-page":"451","volume":"48","author":"FD G\u00fcll","year":"2017","unstructured":"G\u00fcll FD, Deppe H, Kesting M, Schwarzer C. Periodontal disease-like bone loss after adjuvant radiotherapy in the head and neck region: a case report and review of the literature. Quintessence Int. 2017;48(6):451\u201357.","journal-title":"Quintessence Int"},{"issue":"5","key":"4202_CR6","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, Tr\u00f6ltzsch M, K\u00fchnisch J, Ehrenfeld M, Otto S. Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review. Int J Oral Maxillofac Surg. 2015;44(5):568\u201385.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"5","key":"4202_CR7","first-page":"463","volume":"57","author":"S Otto","year":"2021","unstructured":"Otto S, Aljohani S, Fliefel R, Ecke S, Ristow O, Burian E, et al. Infection as an important factor in medication-related osteonecrosis of the jaw (MRONJ). Med (Kaunas). 2021;57(5):463.","journal-title":"Med (Kaunas)"},{"issue":"10","key":"4202_CR8","doi-asserted-by":"publisher","first-page":"e110240","DOI":"10.1371\/journal.pone.0110240","volume":"9","author":"YJ Jeon","year":"2014","unstructured":"Jeon YJ, Zhou Y, Li Y, Guo Q, Chen J, Quan S, et al. The feasibility study of non-invasive fetal trisomy 18 and 21 detection with semiconductor sequencing platform. PLoS ONE. 2014;9(10):e110240.","journal-title":"PLoS ONE"},{"issue":"14","key":"4202_CR9","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1093\/bioinformatics\/btp324","volume":"25","author":"H Li","year":"2009","unstructured":"Li H, Durbin R. Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics. 2009;25(14):1754\u201360.","journal-title":"Bioinformatics"},{"issue":"2","key":"4202_CR10","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1111\/j.1365-4632.2004.01837.x","volume":"43","author":"J Arikawa","year":"2004","unstructured":"Arikawa J, Mizushima J, Higaki Y, Hoshino J, Kawashima M. Mandibular alveolar bone necrosis after trigeminal herpes zoster. Int J Dermatol. 2004;43(2):136\u20137.","journal-title":"Int J Dermatol"},{"issue":"5","key":"4202_CR11","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1111\/j.1601-0825.2006.01230.x","volume":"12","author":"P Siwamogstham","year":"2006","unstructured":"Siwamogstham P, Kuansuwan C, Reichart PA. Herpes zoster in HIV infection with osteonecrosis of the jaw and tooth exfoliation. Oral Dis. 2006;12(5):500\u20135.","journal-title":"Oral Dis"},{"issue":"1","key":"4202_CR12","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1902\/jop.2005.76.1.148","volume":"76","author":"C Mendieta","year":"2005","unstructured":"Mendieta C, Miranda J, Brunet LI, Gargallo J, Berini L. Alveolar bone necrosis and tooth exfoliation following herpes zoster infection: a review of the literature and case report. J Periodontol. 2005;76(1):148\u201353.","journal-title":"J Periodontol"},{"issue":"2","key":"4202_CR13","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1212\/WNL.47.2.569","volume":"47","author":"M Melanson","year":"1996","unstructured":"Melanson M, Chalk C, Georgevich L, Fett K, Lapierre Y, Duong H, et al. Varicella-Zoster virus DNA in CSF and arteries in delayed contralateral hemiplegia: evidence for viral invasion of cerebral arteries. Neurology. 1996;47(2):569\u201370.","journal-title":"Neurology"},{"issue":"18","key":"4202_CR14","doi-asserted-by":"publisher","first-page":"2183","DOI":"10.1097\/01.aids.0000194803.89540.a8","volume":"19","author":"WF van Heerden","year":"2005","unstructured":"van Heerden WF, McEachen SE, Boy SC. Alveolar bone necrosis and tooth exfoliation secondary to herpes zoster in the setting of HIV\/AIDS. AIDS. 2005;19(18):2183\u20134.","journal-title":"AIDS"},{"issue":"2","key":"4202_CR15","doi-asserted-by":"publisher","first-page":"214","DOI":"10.4103\/0970-9290.159175","volume":"26","author":"S Gupta","year":"2015","unstructured":"Gupta S, Sreenivasan V, Patil PB. Dental complications of herpes zoster: two case reports and review of literature. Indian J Dent Res. 2015;26(2):214\u20139.","journal-title":"Indian J Dent Res"},{"key":"4202_CR16","doi-asserted-by":"crossref","unstructured":"Preeti N, Harshkant G, Pooja S, Palak JC. Herpes zoster on the face in the elderly. BMJ Case Rep. 2014; 2014: bcr2013200101.","DOI":"10.1136\/bcr-2013-200101"},{"issue":"9","key":"4202_CR17","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1186\/2047-783X-15-9-410","volume":"15","author":"M Woznowski","year":"2010","unstructured":"Woznowski M, Quack I, B\u00f6lke E, Peiper M, Matuschek C, Gatermann SG, et al. Fulminant Staphylococcus lugdunensis septicaemia following a pelvic varicella-zoster virus infection in an immune-deficient patient: a case report. Eur J Med Res. 2010;15(9):410\u20134.","journal-title":"Eur J Med Res"},{"issue":"1","key":"4202_CR18","first-page":"28","volume":"18","author":"NF Fernandes","year":"2009","unstructured":"Fernandes NF, Malliah R, Stitik TP, Rozdeba P, Lambert WC, Schwartz RA. Herpes zoster following intra-articular corticosteroid injection. Acta Dermatovenerol Alp Pannonica Adriat. 2009;18(1):28\u201330.","journal-title":"Acta Dermatovenerol Alp Pannonica Adriat"},{"issue":"1","key":"4202_CR19","doi-asserted-by":"publisher","first-page":"202","DOI":"10.4103\/ijo.IJO_1007_19","volume":"68","author":"EV Chaitanya","year":"2020","unstructured":"Chaitanya EV, Shruthi TV, Shah NA. Late onset DCR surgical site herpes zoster in an immunocompetent patient: a rare presentation. Indian J Ophthalmol. 2020;68(1):202\u20133.","journal-title":"Indian J Ophthalmol"},{"issue":"3","key":"4202_CR20","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1097\/SCS.0b013e31824ddf72","volume":"23","author":"HJ Choi","year":"2012","unstructured":"Choi HJ, Kim JH, Lee YM. Herpes zoster developing within recent subciliary incision scar. J Craniofac Surg. 2012;23(3):930\u20131.","journal-title":"J Craniofac Surg"},{"issue":"11","key":"4202_CR21","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1007\/PL00002318","volume":"176","author":"J Dunst","year":"2000","unstructured":"Dunst J, Steil B, Furch S, Fach A, Bormann G, Marsch W. Herpes zoster in breast cancer patients after radiotherapy. Strahlenther Onkol. 2000;176(11):513\u20136.","journal-title":"Strahlenther Onkol"},{"issue":"4","key":"4202_CR22","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/j.tim.2018.01.009","volume":"26","author":"C Shih","year":"2018","unstructured":"Shih C, Yang CC, Choijilsuren G, Chang CH, Liou AT. Hepatitis B virus. Trends Microbiol. 2018;26(4):386\u20137.","journal-title":"Trends Microbiol"},{"issue":"20","key":"4202_CR23","doi-asserted-by":"publisher","first-page":"3652","DOI":"10.1016\/j.cell.2022.08.026","volume":"185","author":"B Damania","year":"2022","unstructured":"Damania B, Kenney SC, Raab-Traub N. Epstein-Barr virus: biology and clinical disease. Cell. 2022;185(20):3652\u201370.","journal-title":"Cell"},{"issue":"2","key":"4202_CR24","doi-asserted-by":"publisher","first-page":"e13778","DOI":"10.1111\/tid.13778","volume":"24","author":"N Redondo","year":"2022","unstructured":"Redondo N, Navarro D, Aguado JM, Fern\u00e1ndez-Ruiz M. Viruses, friends, and foes: the case of Torque Teno virus and the net state of immunosuppression. Transpl Infect Dis. 2022;24(2):e13778.","journal-title":"Transpl Infect Dis"},{"issue":"5","key":"4202_CR25","doi-asserted-by":"publisher","first-page":"982","DOI":"10.3390\/v14050982","volume":"14","author":"C Tommasi","year":"2022","unstructured":"Tommasi C, Breuer J. The biology of Varicella-Zoster virus replication in the skin. Viruses. 2022;14(5):982.","journal-title":"Viruses"},{"issue":"Suppl 1","key":"4202_CR26","first-page":"S1","volume":"44","author":"HD Robert","year":"2007","unstructured":"Robert HD, Robert WJ, Judith B, John WG, Myron JL, Miroslav B, et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007;44(Suppl 1):S1\u201326.","journal-title":"Clin Infect Dis"},{"issue":"11","key":"4202_CR27","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1086\/648075","volume":"49","author":"NH Naik","year":"2009","unstructured":"Naik NH, Russo TA. Bisphosphonate-related osteonecrosis of the jaw: the role of actinomyces. Clin Infect Dis. 2009;49(11):1729\u201332.","journal-title":"Clin Infect Dis"},{"issue":"1","key":"4202_CR28","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1093\/annonc\/mdn526","volume":"20","author":"CI Ripamonti","year":"2009","unstructured":"Ripamonti CI, Maniezzo M, Campa T, Fagnoni E, Brunelli C, Saibene G, et al. Decreased occurrence of osteonecrosis of the jaw after implementation of dental preventive measures in solid tumour patients with bone metastases treated with bisphosphonates. The experience of the National Cancer Institute of Milan. Ann Oncol. 2009;20(1):137\u201345.","journal-title":"Ann Oncol"},{"issue":"4","key":"4202_CR29","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s10006-011-0303-8","volume":"16","author":"P Lambade","year":"2012","unstructured":"Lambade P, Lambade D, Saha TK, Dolas RS, Pandilwar PK. Maxillary osteonecrosis and spontaneous teeth exfoliation following herpes zoster. Oral Maxillofac Surg. 2012;16(4):369\u201372.","journal-title":"Oral Maxillofac Surg"},{"issue":"5","key":"4202_CR30","doi-asserted-by":"publisher","first-page":"2143","DOI":"10.1007\/s00784-018-2655-z","volume":"23","author":"M Zirk","year":"2019","unstructured":"Zirk M, Wenzel C, Buller J, Z\u00f6ller JE, Zinser M, Peters F. Microbial diversity in infections of patients with medication-related osteonecrosis of the jaw. Clin Oral Investig. 2019;23(5):2143\u201351.","journal-title":"Clin Oral Investig"},{"key":"4202_CR31","doi-asserted-by":"publisher","first-page":"1073607","DOI":"10.3389\/fneur.2022.1073607","volume":"13","author":"M Yin","year":"2022","unstructured":"Yin M, Huang P, Yang S, Wang W. Ramsay Hunt syndrome and mandibular alveolar bone necrosis following herpes zoster: a case report and literature review. Front Neurol. 2022;13:1073607.","journal-title":"Front Neurol"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-04202-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-024-04202-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-04202-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T10:02:47Z","timestamp":1712052167000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-024-04202-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,2]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4202"],"URL":"https:\/\/doi.org\/10.1186\/s12903-024-04202-z","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,2]]},"assertion":[{"value":"25 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Guangdong Provincial Hospital of Chinese Medicine (G2023-06). The patient signed a written consent stating the approval for participation in this report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent has been obtained from the patient to publish this paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"409"}}