Adjunctive hyperbaric oxygen in irradiated patients requiring dental extractions: outcomes and complications.
OBJECTIVE
This study assessed complications of hyperbaric oxygen (HBO) therapy, potential predictors of poor outcome, and treatment outcomes in irradiated patients undergoing dental extractions.


METHODS
This was a prospective, descriptive study of 40 consecutive patients treated with HBO before and after dental extractions in an irradiated field. All patients had radiation caries; none had osteoradionecrosis (ORN). All were prescribed a protocol of 20 pre-extraction and 10 postextraction HBO treatments at 2.4 ATA for 90 minutes. Potential risk factors for poor healing and risk factors for complications were identified. All complications were recorded. Extraction site healing was evaluated at the conclusion of HBO therapy, at 1 month, and 1 year later.


RESULTS
There were no serious complications. There was no correlation between preidentified risk factors and poor healing. At 1 year, 98.5% of all extraction sites were healed. Patients who did not heal were an average of 8 years since radiation, compared with 3.3 years for those who healed (P <.001).


CONCLUSIONS
Use of HBO is associated with a very low incidence of ORN at 1-year follow-up. However, the time since radiation has a positive correlation with risk for ORN.
Chavez
J A
JA
Division of Oral and Maxillofacial Surgery, University of Minnesota, Minneapolis, MN, USA.
Adkinson
C D
CD
D000328:Adult; D000368:Aged; D001469:Barotrauma / Q000209:etiology; D000075202:Contraindications; D016371:Cranial Irradiation / Q000009:adverse effects*; D003731:Dental Caries / Q000209:etiology / Q000601:surgery; D004432:Ear, Middle / Q000293:injuries; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000209:etiology* / Q000517:prevention & control; D010033:Otitis Media / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014081:Tooth Extraction / Q000009:adverse effects*; D016896:Treatment Outcome; D014945:Wound Healing