title: Retrospective audit of the use of the Marx Protocol for prophylactic hyperbaric oxygen therapy in managing patients requiring dental extractions following radiotherapy to the head and neck.
abstract: OBJECTIVE
  The study's primary objective was to review (for the years 2003 to 2006) the outcomes of using prophylactic hyperbaric oxygen therapy (HBOT) to prevent osteoradionecrosis (ORN) in a group of patients previously exposed to radiotherapy of the head and neck. A secondary objective was to evaluate any HBOT-associated vision changes.
  
  
  METHODS
  The study was a retrospective audit of the clinical outcomes of HBOT for the prevention of ORN following dental extractions in previously irradiated jaws.
  
  
  METHODS
  Information was obtained from dental records held at Green Lane Clinical Centre (Auckland) and Oxygen Therapies Ltd (Quay Park Health, Auckland). Data included patient age, gender, site of tumour, radiation dose, time lapse between radiotherapy and tooth/teeth extracted, extraction procedures and the HBOTprotocol used. Follow-up data were obtained through a telephone interview using a standardised questionnaire.
  
  
  RESULTS
  Of the 29 treated patients, 26 (90%) were available for follow-up. Of these, one failed to heal after dental extractions following the use of prophylactic HBOT, and only nine (34%) developed temporary vision changes.
  
  
  CONCLUSIONS
  The outcome of this audit suggests that it is appropriate to use prophylactic HBOT in association with dental extractions in patients who have previously had radiotherapy to the head and neck. Acute vision changes following the 30th HBOT were transient.
authors.affiliation: Oral Health Regional Service, Green Lane Clinical Centre, Green Lane, Auckland, New Zealand.
authors.forename: Jasmeen
authors.initials: J
authors.lastname: Kaur
authors.forename: K David
authors.initials: KD
authors.lastname: Hay
authors.forename: Heather
authors.initials: H
authors.lastname: Macdonald
authors.forename: Alison M
authors.initials: AM
authors.lastname: Rich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D016371:Cranial Irradiation / Q000009:adverse effects*; D019230:Dental Audit; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008439:Maxillary Diseases / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014081:Tooth Extraction; D014786:Vision Disorders / Q000209:etiology; D055815:Young Adult