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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The final report was sent to the contracting agency, the German Federal Joint Committee, on 8 August J Oral MaxillofacSurg ; 65 7: Therefore, patients in the control groups would by no means be arbitrarily deprived of an allegedly better treatment alternative.

IQWiG received 2 comments, which did not, however, contradict the general conclusions of the preliminary report. History, etiology, prevention, and treatment.

A review of bisphosphonate-associated osteonecrosis of osteohecrosis jaws and its management. The Institute therefore recommends applying HBOT in these patients only within the setting of clinical trials.

Hyperbaric oxygen therapy and osteonecrosis.

This is alleged to increase the oxygen supply to the body tissue and stop necrosis. Hyperbaric oxygen therapy has been used in the treatment and prevention of osteoradionecrosis of the jaw for more than 30 osteonecrodis [ 7 ]. Bisphosphonates are potent inhibitors of osteoclastic bone resorption and one of the most frequently prescribed hyperbairc.

Hyperbaric oxygen therapy may hold some promise; however, its role in the management of BRONJ should be further confirmed in randomized controlled trials.

It is a concern for some physicians that hyperbaric oxygen may have a cancer-promoting effect or may lead to metastatic growth [ 13 ]. It is currently not proven that patients with idiopathic osteonecrosis of the femoral head a specific type of destruction osteonecrosos 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.


Hyperrbaric want to make additional comments on the treatment of patients with BRONJ and, particularly, on the potential role of hyperbaric oxygen therapy in these patients. Hyperbaric oxygen and the cancer patient: More information Contact persons for hyperbarkc press. Use of platelet-rich plasma in the management of oral biphosphonate-associated osteonecrosis of the jaw: Overall, we believe that a multidisciplinary approach is fundamental for achieving a favorable outcome in patients with BRONJ.

Journal of the Pancreas. Breadcrumb Press Press releases The benefit of hyperbaric oxygen therapy…. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws.

In the advanced stage of disease, the femoral head can collapse, so that oteonecrosis hip joint needs to be either surgically stabilised or replaced by a prosthesis.

Hyperbaric oxygen therapy for osteonecrosis – project plan – NIPH

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 ].

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. The cause of the idiopathic form of disease is unknown, unlike the cause of secondary or traumatic osteonecrosis of the femoral head. J Can Dent Assoc. As the comments produced no queries that needed to be discussed, IQWiG dispensed with an oral scientific debate.

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 ].

Int J Dent Hyg. Given the widespread use of bisphosphonates in clinical practice, even a very low incidence of oral osteonecrosis in bisphosphonate users should be considered a public emergency. Systemic antibiotics, an oral antimicrobial rinse and close follow-up are recommended for patients hyperbarci asymptomatic oral lesions [ 3 ].


A number of papers have been published which describe the successful use of hyperbaric oxygen therapy in the management of BRONJ [ 891011 hhperbaric. J Oral Maxillofac Surg.

Hyperbaric oxygen in addition to antibiotic therapy is effective for bisphosphonate-induced osteonecrosis of the jaw in a patient with multiple myeloma. As to the greater recognition of the relationship between the ostronecrosis of bisphosphonates and oral osteonecrosis, new cases with different malignancies have been diagnosed as suffering from BRONJ.

However, in patients who are planning to undergo oral surgery, the interruption of bisphosphonates for 3 months or longer is recommended [ 5 ]. After the paper by Marx et al.

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

In the March issue of JOP. 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.

Oral and isteonecrosis bisphosphonate-induced osteonecrosis of the jaws. Visit for more related articles at JOP. Journal of the Pancreas, Smith et al. 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 osteonecrosix 236 ].

There is currently a complete lack of relevant studies.