{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:56:40Z","timestamp":1792789000050,"version":"4.5.0"},"reference-count":83,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T00:00:00Z","timestamp":1739577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"HUN-REN-SU, Human Microbiota Study Group","award":["0272"],"award-info":[{"award-number":["0272"]}]},{"name":"HUN-REN-SU, Human Microbiota Study Group","award":["AOK-KA-2019\/48"],"award-info":[{"award-number":["AOK-KA-2019\/48"]}]},{"name":"Internal Scientific Grant of Pecs University Medical School","award":["0272"],"award-info":[{"award-number":["0272"]}]},{"name":"Internal Scientific Grant of Pecs University Medical School","award":["AOK-KA-2019\/48"],"award-info":[{"award-number":["AOK-KA-2019\/48"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Medication-related osteonecrosis of the jaw (MRONJ) is a common adverse event following antiresorptive treatment, leading to chronic inflammation and exposed, necrotic bone surfaces in the jawbone. There is an increasing recognition of the role of compositional changes in the colonizing members of the oral microbiota implicated in triggering and\/or maintaining MRONJ. The aim of our study was to characterize the culturable and non-culturable microbiota\u2014with particular focus on Actinomyces spp. and Actinomyces-like organisms (ALOs)\u2014from surgically removed bone samples of MRONJ patients and healthy control subjects. Methods: n = 35 patients (median age: 70 years) in various stages of MRONJ, with a history of receiving oral or intravenous antiresorptive treatment were included in the study. The controls (n = 35; median age: 35 years) consisted of otherwise healthy individuals undergoing tooth extraction. Traditional, quantitative, aerobic, and anaerobic culture, and Actinomyces-specific PCR was performed for all bone samples from patients and controls, while microbiome analyses\u2014based on 16S rRNA sequencing\u2014were carried out in 5-5 randomly selected samples. Mann\u2013Whitney U test, Wilcoxon rank sum test (alpha diversity), and PERMANOVA analysis (beta diversity) were performed. Results: In MRONJ samples, 185 anaerobic isolates, corresponding to 65 different species were identified (vs. 72 isolates, corresponding to 27 different species in the control group). The detection of Actinomyces spp. and ALOs was more common in MRONJ bone samples, based on traditional culture (65.7% vs. 17.1%; p &lt; 0.001) and PCR (82.9% vs. 37.1%; p &lt; 0.001), respectively. The isolation of Fusobacterium spp. (22 vs. 7; p = 0.001), Prevotella spp. (22 vs. 6; p = 0.034), and Gram-positive anaerobic cocci (GPAC) (30 vs. 9; p = 0.016) was significantly more common in MRONJ patient samples. The microbiota of the controls\u2019 bone samples were characterized by a considerable dominance of Streptococcus spp. and Veillonella spp, while the bacterial abundance rates were substantially more heterogeneous in MRONJ bone samples. Notable differences were not observed among the samples related to the abundance of Actinomyces in the bone microbiota. Conclusions: According to the \u201cinfection hypothesis\u201d, alterations in the oral microbiome\u2014with Actinomyces and ALOs being the most relevant\u2014may play a key role in the development, aggravation, and progression of MRONJ. The timely detection of Actinomyces in necrotic bone is crucial, as it has important therapeutic implications.<\/jats:p>","DOI":"10.3390\/antibiotics14020203","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T04:40:25Z","timestamp":1739767225000},"page":"203","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Microbiological Background of Medication-Related Osteonecrosis of the Jaw (MRONJ): Clinical Evidence Based on Traditional Culture and Molecular Biological Detection Methods"],"prefix":"10.3390","volume":"14","author":[{"given":"Zsanett","family":"K\u00f6v\u00e9r","sequence":"first","affiliation":[{"name":"Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of P\u00e9cs, T\u00fcz\u00e9r u. 1., 7623 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1270-0365","authenticated-orcid":false,"given":"M\u00e1ri\u00f3","family":"Gajd\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8687-7430","authenticated-orcid":false,"given":"Be\u00e1ta","family":"Polg\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Clinical Center, University of P\u00e9cs, Szigeti \u00fat 12., 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00f3ra","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Semmelweis University, Nagyv\u00e1rad t\u00e9r 4., 1089 Budapest, Hungary"},{"name":"Department of Neurosurgery and Neurointervention, Semmelweis University, Amerikai \u00fat 57., 1085 Budapest, Hungary"},{"name":"HUN-REN-SU Human Microbiota Research Group, 1052 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edit","family":"Urb\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Clinical Center, University of P\u00e9cs, Szigeti \u00fat 12., 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.joms.2004.02.004","article-title":"Osteonecrosis of the jaws associated with the use of bisphosphonates: A review of 63 cases","volume":"62","author":"Ruggiero","year":"2004","journal-title":"J. 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