Hyperbaric oxygen for osteonecrosis of the jaw

Osteonecrosis, death of bone tissues,  is a well known complication that can occur in different bones. Osteonecrosis of the jaw is a known complication on of several medical interventions, such as radiation and biphosphonates. It had been initially described with the biphosphonate Fosomax but began to be seen more frequently with the intravenous biphosphonates, such as Zometa. Conservative treatment is successful in approximately 50% of patients and consists of local rinses, antibiotics, and cessation of biphosphonates. Unfortunately some patients evidence progressive necrosis despite therapy and almost a half fail to completely heal. For this reason there is a great deal of interest in hyperbaric oxygen, as a therapy that has shown effectiveness front nonhealing wounds of various types as well as for osteonecrosis caused by radiation. Unfortunately, for osteonecrosis after biphosphonate use, the supporting evidence remains case reports and case series A  2006 American Association of Oral and Maxillofacial Surgeons Position Paper on Bisphosphonate-Related Osteonecrosis of the Jaws failed to recommend this therapy because of the lack of evidence.

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