Hyperbaric oxygen therapy and mandibular osteoradionecrosis: a retrospective study and analysis of treatment outcomes.
BACKGROUND
Hyperbaric oxygen (HBO) therapy is recognized as an adjunctive treatment for osteoradionecrosis (ORN). It may also be used prophylactically in patients who require dental extractions and are at high risk for developing ORN. This article reviews the treatment outcomes of patients treated with HBO therapy at the Toronto General Hospital from 1985 to 1997.


METHODS
A total of 297 charts of patients treated with HBO were reviewed. Criteria assessed included age of patient, gender, original diagnosis, radiation dose, time between radiation treatment and onset of ORN, presence or absence of fracture, orocutaneous fistula, pain, history of a precipitating event triggering ORN, medical status, HBO therapy (total oxygen time, number of dives), method of treatment of ORN and follow-up period. Minimum patient follow-up time for inclusion in the study was 6 months.


RESULTS
Adequate information to meet the inclusion criteria was obtained for 75 patients. Group A (51 patients) had been treated for overt ORN with HBO alone, HBO with sequestrectomy, or HBO with sequestrectomy and reconstruction. Group B (24 patients at risk for developing ORN) had been treated with HBO prophylactically for dental extractions. In group A, only 3 patients (5.9%) failed to show improvement. In group B, only one patient (4.2%) had complications during healing.


CONCLUSIONS
Encouraging results were achieved when HBO was used in the 2 groups described above. This paper supports existing literature on the potential benefit of HBO as a prophylactic agent and adjunctive treatment of ORN.
David
L A
LA
University of Toronto, Toronto, Ontario, Canada.
Sàndor
G K
GK
Evans
A W
AW
Brown
D H
DH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016371:Cranial Irradiation / Q000009:adverse effects; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008336:Mandibular Diseases / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D012189:Retrospective Studies; D014081:Tooth Extraction; D016896:Treatment Outcome