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Hansen T, Kunkel M et al. J Oral Pathol Med 2006; 35: 155–160

Osseous metastases may cause severe pain and pathological fractures, and biphosphonates are used to inhibit osteolysis. A complication of this treatment is osteonecrosis occurring almost exclusively in the jaw, and the present study compared 8 patients with this condition and 10 with jaw osteoradionecrosis following radiotherapy for tumours. In all cases, biopsies were taken.

In most cases in both groups, inflammatory infiltrates were found, along with medullary space fibrosis. There was minimal obliteration of blood vessels, and in all cases in both groups, Actinomyces was found, commonly at sites of eroded necrotic bone. In one case, fungal spores were also present. There were also some possible differences between the groups. The authors discuss their findings, and consider that Actinomyces may be involved in the chronic, non-healing processes which are present.