Bacterial Colonization of the Condyle in Patients with Advanced Mandibular Osteoradionecrosis: Analysis of Hemimandibulectomy Specimens

Author:

Takeda Daisuke1,Hashikawa Kazunobu2,Shigeoka Manabu13ORCID,Kanzawa Maki4,Yatagai Nanae1,Arimoto Satomi1,Kusumoto Junya1,Hasegawa Takumi1ORCID,Terashi Hiroto5,Akashi Masaya1ORCID

Affiliation:

1. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

2. Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

3. Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan

4. Division of Diagnostic Pathology, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan

5. Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

Abstract

Advanced mandibular osteoradionecrosis (ORN) sometimes requires extended resection (e.g., hemimandibulectomy). Bacterial infection contributes to ORN pathogenesis. To control infection and determine the extent of debridement required, an understanding of bacterial spread within sites of mandibular ORN is important. The current study used a histopathological approach to assess bacterial colonization in the mandibular condyle and elucidate possible paths of bacterial spread towards the mandibular condyle. Four hemimandibulectomy specimens were selected. Areas of bone destruction were macroscopically assessed and confirmed using hematoxylin and eosin staining. Bacterial presence within mandibular condyle was confirmed with Gram staining. Bone exposure was observed in the molar area in all specimens. Macroscopic bone destruction was apparent especially near the medial side of the cortical wall. Gram staining revealed bacterial colonization of the mandibular condyle in three of the four specimens. In conclusion, bacteria tended to spread posteriorly and through the medial side of the mandibular cortical wall. In patients with advanced ORN, the potential for bacterial colonization of the mandibular condyle should be considered during treatment.

Funder

Grant-in-Aid for Scientific Research

Publisher

Hindawi Limited

Subject

General Dentistry

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