Scanning and transmission electron microscopy demonstrates bacteria in osteoradionecrosis

Fourteen deep medullar specimens from resected radionecrotic mandibles were studied. Microorganisms were detected in 9 of the 14 samples (64%). The bacteria seen included rods, spirochetes and cocci, with rods being the predominant cells. One sample also contained yeasts (blastoconida and pseudohyphae). The data from this study strongly suggest an association between microorganisms and osteoradionecrosis. This may call for a revision of its presumed pathophysiology, including the possibility of an infectious etiology.