title: Professional attitudes in regard to hyperbaric oxygen therapy for dental extractions in irradiated patients: a comparison of two specialties.
abstract: OBJECTIVE
  Mandibular osteoradionecrosis (ORN) is a serious complication of radiation therapy. The current use of hyperbaric oxygen therapy (HBO2) to prevent ORN when dental extractions are performed has been called into question. We sought to determine the current acceptability and confidence in this treatment by practitioners from two different specialties.
  
  
  METHODS
  We surveyed both hyperbaric medicine physicians and radiation oncologists regarding their views on the use of HBO2 for the prevention of ORN. Separate web-based anonymous surveys were sent via email invitation. These two groups were compared, including statistical analysis using the chi-square test when appropriate.
  
  
  RESULTS
  175 radiation oncologists and 118 hyperbaric medicine physicians participated. Among those not recommending HBO2, lack of evidence was cited by 52% of radiation oncologists and 38% of hyperbaric medicine physicians (chi2 = 5.0, p = 0.03, 95%, CI 1.9% to 25.6%). A majority of radiation oncologists (79%) and hyperbaric medicine physicians (85%) believe it is important that a new randomized controlled trial (RCT) is conducted (chi2 = 1.3, p = NS).
  
  
  CONCLUSIONS
  While HBO2 has been used for decades, recent tissue-sparing radiation techniques and advanced surgical techniques are now calling into question the continued use of HBO2 for ORN prevention. Our results demonstrate that there is overwhelming support among responding practitioners for a new RCT.
authors.affiliation: Dept. of Emergency Medicine, Division of Hyperbaric Medicine, SUNY Upstate Medical University, Syracuse, NY, USA. heyboerm@upstate.edu
authors.forename: Marvin
authors.initials: M
authors.lastname: Heyboer
authors.forename: Susan M
authors.initials: SM
authors.lastname: Wojcik
authors.forename: William D
authors.initials: WD
authors.lastname: Grant
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Faruqi
authors.forename: Monica
authors.initials: M
authors.lastname: Morgan
authors.forename: Seung S
authors.initials: SS
authors.lastname: Hahn
mesh_terms: D001291:Attitude of Health Personnel; D019317:Evidence-Based Medicine; D019538:Health Care Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000523:psychology* / Q000706:statistics & numerical data; D008336:Mandibular Diseases / Q000517:prevention & control*; D010025:Osteoradionecrosis / Q000517:prevention & control*; D010810:Physical and Rehabilitation Medicine / Q000706:statistics & numerical data; D018787:Radiation Oncology / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D014081:Tooth Extraction