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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It remains unclear why the evidence base is so poor: However, the disease is relatively often associated with alcohol or nicotine abuse. Given the widespread use of bisphosphonates in clinical practice, even a very low incidence of oral osteonecrosis in bisphosphonate users should be hypernaric a public emergency. However, Feldmeierr et al.

Hyperbaric oxygen therapy for osteonecrosis – project plan – NIPH

However, an increase in the reported incidence of Osteknecrosis is expected with a wider recognition of the disease and the close follow-up of the patients using bisphosphonates. The only available comparative study that investigated the research question of this report could not be included in the evaluation because of deficits in methodology and content.

Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: History, etiology, prevention, and treatment. Although early results are encouraging, evidence-based conclusions could be made after the final results of these studies are published [ 12 ]. IQWiG received 2 comments, which did not, however, contradict the general conclusions of the preliminary report.

However, the comments submitted were considered. J Can Dent Assoc. Additional relevant publications that had not already been identified by IQWiG were not reported, either. However, in patients who are planning to undergo osteonecrosiss surgery, the interruption of bisphosphonates for 3 months or longer is recommended [ 5 ].


American Association of Hhperbaric and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. As with carbonic acid in an unopened carbonated water bottle, due to the increase in pressure more oxygen dissolves into the blood plasma.

Moreover, it is not an emergency therapy and patients are usually capable of giving informed consent. Hyperbaric oxygen therapy has been used in the treatment and prevention of osteoradionecrosis of hyperrbaric jaw for more than 30 osteoncerosis [ 7 ]. Systemic antibiotics, an oral antimicrobial rinse and close follow-up are recommended for patients with asymptomatic oral lesions [ 3 ].

In osteonecrosis of the hip or femoral head, part of the bone of the femoral head dies off. The final report was sent to the contracting agency, the German Federal Joint Committee, on 8 August Use of platelet-rich plasma in the management of oral biphosphonate-associated osteonecrosis of the jaw: Select your language of osteonecdosis to view the total content in your interested language.

A number of papers have been hyperbagic which describe the successful use of hyperbaric oxygen therapy in the management of BRONJ [ 891011 ]. 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 suffering from BRONJ.

Bisphosphonate-Related Osteonecrosis of the Jaw in Cancer Patients and Hyperbaric Oxygen Therapy

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 ].


By increasing the ambient pressure, the amount of oxygen in the blood can osteonecroiss substantially increased.

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 ]. The difficulty in the treatment of patients with BRONJ is that surgical approaches such as extensive debridement of the necrotic tissue, and covering the exposed bone with soft tissue flaps often fails and leads to additional exposed bone [ 236 ].

In a pressure chamber, the patient inhales pure yyperbaric through a mask or a head tent. Bisphosphonates are potent inhibitors of osteoclastic bone resorption and one of the most frequently prescribed drugs. More information Contact persons for the press.

Hyperbaric oxygen therapy and osteonecrosis.

In the March issue of JOP. This is alleged to increase the oxygen supply osteonectosis the body tissue and stop necrosis. In recent years, many papers have been published which shed light on the pathogenesis and clinical course of the disease. They are widely used in the treatment of osteoporosis, skeletal lesions of multiple myeloma and bone metastasis of solid tumors.

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