title: Hyperbaric oxygen and dental extractions in irradiated patients: short- and long-term outcomes.
abstract: OBJECTIVE
  Mandibular osteoradionecrosis (ORN) can occur in patients post-radiation therapy. This study assessed the incidence of ORN in the setting of adjunctive hyperbaric oxygen therapy (HBO2) and sought to identify risk factors that may predispose to its development.
  
  
  METHODS
  A retrospective chart review was completed on patients with a history of radiation therapy to the head and neck who underwent HBO2 prior to and immediately following dental extractions between January 1, 1995, and December 31, 2005, in the hyperbaric medicine unit.
  
  
  RESULTS
  The incidence of ORN in 40 patients immediately following completion of HBO was 0%. Available follow-up longer than six months after completion of HBO2 on 19 of these patients showed an incidence of ORN increased to 15.8%. None of the considered risk factors for development of ORN reach statistical significance.
  
  
  CONCLUSIONS
  The incidence of ORN at the completion of HBO2 was less than previously reported incidences between 1.5%-4.2%. However, long-term follow-up indicated a much higher incidence of 15.8%. The difference in incidence of ORN immediately upon completion of HBO2 approximately two weeks after dental extractions compared to that at least six months later identifies a need for more long-term follow-up of these patients following their dental extractions.
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: John B
authors.initials: JB
authors.lastname: McCabe
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Faruqi
authors.forename: Jawad N
authors.initials: JN
authors.lastname: Kassem
authors.forename: Monica
authors.initials: M
authors.lastname: Morgan
authors.forename: Gary
authors.initials: G
authors.lastname: Schopfer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods; D015994:Incidence; D007571:Jaw Diseases / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009910:Oral Hygiene; D010025:Osteoradionecrosis / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D014081:Tooth Extraction; D016896:Treatment Outcome; D055815:Young Adult