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Hyperbaric oxygen therapy as an adjunct treatment of periodontitis, MRONJ, and ONJ: a systematic literature review

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Abstract

Objective

To review the available prospective literature on hyperbaric oxygen (HBO) therapy for periodontal conditions.

Materials and methods

A comprehensive electronic and manual search was performed to identify clinical studies on adult patients who underwent hyperbaric oxygen therapy for periodontal treatments. A systematic literature search was conducted in PubMed, Cochrane, and Dentistry Oral Sciences Source databases.

Results

Fourteen articles were included in the final literature review, of which five were RCTs and 11 were prospective clinical studies. Four studies discussed HBO as an adjunct to nonsurgical treatment of periodontitis, eight reported on HBO and osteoradionecrosis, and one examined HBO in bisphosphonate-related necrosis of the jaws.

Conclusions

HBO has shown superior efficacy compared to antibiotics as a prophylactic measure in preventing osteoradionecrosis (ORN) in patients with a history of high mandibular irradiation. Clinicians should consider referring such patients for HBO therapy before and after tooth extractions. However, for the surgical excision of existing ORN lesions, HBO therapy does not yield significant benefits but does not negatively impact outcomes either. Regarding the treatment of periodontitis patients, the variability among studies prevents definitive conclusions. HBO therapy as an adjunct to SRP in periodontitis treatment produces mixed results.

Clinical relevance

This study’s clinical relevance lies in its exploration of the potential benefits of HBO for periodontal conditions. Also, it provides clinicians with insights into when and how to integrate HBO therapy into their treatment approaches, particularly for patients with a history of irradiation and those undergoing complex dental procedures.

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Authors and Affiliations

  1. Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, 1011 N University Avenue, Ann Arbor, MI, 48109-1078, USA

    Teresa Heck, Danyal Lohana, Dhiraj Mallela, Obada Mandil, Lu Sun, Pramiti Saxena, Ann M. Decker & Hom-Lay Wang

  2. Department of Periodontics, Case Western Reserve University School of Dental Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USA

    Obada Mandil

Authors
  1. Teresa Heck
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  2. Danyal Lohana
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Contributions

T.H. was involved in the conception and design of the study, extraction of data, analysis and interpretation of data, initial and final drafting of the work, and final approval of the version to be published and was accountable for all aspects of the work. D.L. was involved in the initial and final drafting of the work, extraction of data, and final approval of the version to be published, and was accountable for all aspects of the work. D.M. was involved in the initial and final drafting of the work, extraction of data, and final approval of the version to be published, and was accountable for all aspects of the work. O.M. was involved in the initial and final drafting of the work, extraction of data, final approval of the version to be published, and was accountable for all aspects of the work. L.S. was involved in the initial and final drafting of the work, extraction of data, and final approval of the version to be published, and was accountable for all aspects of the work. P.S. was involved in the initial and final drafting of the work, extraction of data, and final approval of the version to be published, and was accountable for all aspects of the work. A.D. was involved in the design of the study and final review of the work, and was accountable for all aspects of the work. H–L.W. was involved in design of the study, critical review of the draft of the manuscript, final review, and approval of the work and was accountable for all aspects.

Corresponding author

Correspondence to Hom-Lay Wang.

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The authors declare no competing interests.

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Not applicable since the study is a systematic review.

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Not applicable since there were no human subjects involved; the study exempts from requiring patient consent.

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Heck, T., Lohana, D., Mallela, D. et al. Hyperbaric oxygen therapy as an adjunct treatment of periodontitis, MRONJ, and ONJ: a systematic literature review. Clin Oral Invest 28, 77 (2024). https://doi.org/10.1007/s00784-023-05410-7

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