Hyperbaric oxygen for osteonecrosis of the jaw – pro

OsteonecroIs a well known complication of several medical interventions, such as radiation and biphosphonates. Osteonecrosis of the jaw is a known complication on of several medical interventions, such as radiation and biphosphonates. It had been described with 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 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.

Bennett MH, Feldmeier J, Hampson N, Smee R, Milross C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD005005

Gesell, Laurie B. (Chair and editor) (2008). Hyperbaric Oxygen Therapy Indications. The Hyperbaric Oxygen Therapy Committee Report (12 ed.). Durham, NC: Undersea and Hyperbaric Medical Society. ISBN 0930406230.

Freiberger JJ. Utility of hyperbaric oxygen in treatment of bisphosphonate-related osteonecrosis of the jaws.J Oral Maxillofac Surg. 2009 May;67(5 Suppl):96-106.

Mustafa Erkan etal, Bisphosphonate-Related Osteonecrosis of the Jaw in Cancer Patients
and Hyperbaric Oxygen TherapyJOP. J Pancreas (Online) 2009 Sep 4; 10(5):579-580.

Van den Wyngaert T, Claeys T, Huizing MT, Vermorken JB, Fossion E.
Initial experience with conservative treatment in cancer patients with osteonecrosis of the jaw (ONJ) and predictors of outcome.Ann Oncol. 2009 Feb;20(2):331-6.


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