Utility of hyperbaric oxygen in treatment of bisphosphonate-related osteonecrosis of the jaws. Freiberger JJ(1). Author information: (1)Center for Hyperbaric. The benefit of hyperbaric oxygen therapy for osteonecrosis of the femoral head is not proven. IQWiG publishes final report / Therapy should be applied only. Bisphosphonate-Related Osteonecrosis of the Jaw in Cancer Patients and Hyperbaric Oxygen Therapy, Mustafa Erkan, Oguz Bilgi, Mesut Mutluoglu, Gunalp.

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There is currently a complete lack of relevant studies.

Use of platelet-rich plasma in the management of oral biphosphonate-associated osteonecrosis of the jaw: The cumulative incidence of the disease has been reported to hyperbaroc between 0.

Pamidronate Aredia and zoledronate Zometa induced avascular necrosis of the jaws: It is currently not proven that patients with idiopathic osteonecrosis of the femoral head hypetbaric specific type of destruction of the hip joint need surgery less often, or experience less pain or increased mobility of the joint if they receive hyperbaric oxygen therapy HBOT in addition to conventional treatment.

Due to the complete lack of appropriate clinical trials, HBOT for osteonecrosis of the femoral head in adults should only be applied in a suitable clinical trial setting in order to obtain long-term reliable findings, according to the Osteonedrosis. The management of BRONJ remains an important clinical challenge in cancer patients and requires a multidisciplinary approach involving dentists, medical oncologists, oral and maxillofacial surgeons and others, if necessary [ 4 ].

A review of 60 cases and treatment proposals. Journal of the Pancreas, Smith et al. However, in patients who are planning to undergo oral surgery, the interruption of bisphosphonates for 3 months or longer is recommended [ 5 ]. Breadcrumb Press Press releases The benefit of hyperbaric oxygen therapy…. Hyperbaric oxygen therapy has been used in the treatment and prevention of osteoradionecrosis of the jaw for more than 30 years [ 7 ].

All Published work is licensed under a Creative Commons Attribution 4. According to the diagnostic criteria defined by the American Association of Oral and Maxillofacial Surgeons, BRONJ is diagnosed in patients with a history of current or previous treatment with a bisphosphonate, with an exposed bone in the maxillofacial region which has continued for more than eight weeks, and with no history of radiation therapy to the jaw [ 3 ].


Objections referring to the content of the preliminary report are discussed in the final report see pages and are fully presented in a separate document. J Oral MaxillofacSurg ; 65 7: Moreover, it is not an emergency therapy and patients are usually capable osteoncerosis giving informed consent. Comments could be submitted on this version up to 23 May Hyperbaric oxygen in addition to antibiotic therapy is effective for bisphosphonate-induced osteonecrosis of the jaw in a patient with multiple myeloma.

Hyperbaric oxygen therapy and osteonecrosis.

Visit for more related articles at JOP. As to the greater recognition of the relationship between the use of bisphosphonates and oral osteonecrosis, new cases with different malignancies have been diagnosed as oateonecrosis from BRONJ. Although this type of therapy has been tested for about 20 years, data only on about to patients have been published worldwide.

Red blood cells, which transport oxygen, are already nearly saturated under normal conditions and can carry little more oxygen. However, the comments submitted were considered.

American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. Can’t read the image? Osteonecrosis of the jaws due to bisphosphonate use. In osteonecrosis of the hip or femoral head, part of the bone of the femoral head dies off.

Hyperbaric oxygen therapy for osteonecrosis – project plan – NIPH

As the comments produced no queries that needed to be discussed, IQWiG dispensed with an oral scientific debate. J Can Dent Assoc. More information Contact persons for the press. Int J Hematol ; 84 4: However, the disease is relatively often associated with alcohol or nicotine abuse.

Journal of the Pancreas.

Hyperbaric oxygen therapy for osteonecrosis – project plan – project description

This is alleged to increase the oxygen supply to the body hy;erbaric and stop necrosis. In the advanced stage of disease, the femoral osteknecrosis can collapse, so that the hip joint needs to be either surgically stabilised or replaced by a prosthesis. Utility of hyperbaric oxygen in treatment of bisphosphonate-related osteonecrosis of the jaws.

There are two ongoing randomized controlled trials which are testing the effectiveness of adjunctive hyperbaric oxygen therapy in the management of BRONJ [ 12 ]. The difficulty in the treatment of patients with BRONJ is that surgical approaches such osteonecrosiis extensive debridement of the necrotic tissue, and covering the exposed bone with soft tissue flaps often fails and leads to additional exposed bone [ 236 ]. Hyperbaric oxygen therapy is a way of treatment which increases the oxygen content of the blood and, consequently, the amount of oxygen delivered to tissues.


By applying HBOTthe aim is to prevent tissue necrosis by increasing the oxygen supply. In recent years, many papers have been published which shed light on the pathogenesis and clinical course of the disease.

Utility of hyperbaric oxygen in treatment of bisphosphonate-related osteonecrosis of the jaws.

Although early results are encouraging, evidence-based conclusions could be made after the final results of these studies are published [ 12 ].

Int J Dent Hyg. By increasing the ambient pressure, the amount of oxygen in the blood can be substantially increased. As everybody knows, an ounce of prevention is worth a pound of cure; patients who are planning to receive bisphosphonate treatment should consult with a dentist in order to address potential problems before starting bisphosphonate treatment.

As with carbonic acid in an unopened carbonated water bottle, due to the increase in pressure more oxygen dissolves hypsrbaric the blood plasma. Since bisphosphonates remain in the bone for very long periods and some patients cannot survive without bisphosphonates, cessation of bisphosphonate treatment is not carried out in osteonecrosls patient.

They are widely used in the treatment of osteoporosis, skeletal lesions of multiple hyperbaic and bone metastasis of solid tumors.

It is a concern for some physicians that hyperbaric oxygen may have a cancer-promoting effect or may lead to metastatic growth [ 13 ]. The proposed rationale behind the beneficial effects of hyperbaric oxygen therapy in BRONJ is increased wound healing, reduction of edema and inflammation, stem cell mobilization and moderation of the suppression of bone turnover by bisphosphonates [ 12 ]. Hyperbaric oxygen and the cancer patient: It remains unclear why the evidence base is so poor: