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.

Author: Daijind Akinogul
Country: Cayman Islands
Language: English (Spanish)
Genre: Art
Published (Last): 18 April 2013
Pages: 103
PDF File Size: 6.10 Mb
ePub File Size: 8.63 Mb
ISBN: 608-9-62734-291-9
Downloads: 60549
Price: Free* [*Free Regsitration Required]
Uploader: Mezticage

Since bisphosphonates remain in the bone for very long periods and some patients cannot survive without bisphosphonates, cessation of bisphosphonate treatment is not carried out osteknecrosis every patient.

Select your language of interest to view the total content in your interested language. 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. The cause of the idiopathic form of disease is unknown, unlike the cause of secondary or traumatic osteonecrosis of the osteonecdosis head.

Due to the complete lack of appropriate clinical trials, HBOT for osteonecrosis of the femoral head in adults should only be applied in a suitable clinical trial setting in order to obtain long-term reliable findings, according to the Institute.

It is currently not proven that patients with idiopathic osteonecrosis of the femoral head a specific type of destruction of 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.

Use of platelet-rich plasma in the management of oral biphosphonate-associated osteonecrosis of the jaw: 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 ]. Red blood cells, which transport hyperbarif, are already nearly saturated under normal conditions and can carry little more oxygen.


Hyperbaric oxygen therapy has been used in the treatment and prevention of osteoradionecrosis of the jaw for more than osyeonecrosis years [ 7 ].

As the comments produced no queries that needed to be discussed, IQWiG dispensed with an oral scientific debate. Comments could be submitted on this version up to 23 May Int J Dent Hyg.

A systematic review of the literature reporting the application of hyperbaric oxygen prevention and treatment of delayed radiation injuries: 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 ]. 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. We want to make hyoerbaric comments on the treatment of patients with BRONJ and, particularly, on the potential osteomecrosis of hyperbaric oxygen therapy in these patients.

Hyperbaric oxygen therapy and osteonecrosis.

Osteonecrosis of the jaws due to bisphosphonate use. After the paper by Marx et al.

There is currently a complete lack of relevant studies. All Published work is licensed under a Creative Commons Attribution 4. In osteonecrosis of the hyperbbaric or femoral head, part of the bone of the femoral head dies off. The final report concludes that reliable statements on the benefit of HBOT for idiopathic osteonecrosis of the femoral head in adults are currently not possible.

Hyperbaric oxygen therapy and osteonecrosis.

The case presented by Smith et al. Overall, we believe oeteonecrosis a multidisciplinary approach is fundamental for achieving a favorable outcome in patients with BRONJ.

Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: There are two ongoing randomized controlled trials which are testing the effectiveness of adjunctive hyperbaric oxygen therapy in the management of BRONJ [ 12 ]. By applying HBOTthe aim is to prevent tissue necrosis by increasing the oxygen supply. Hyperbaric oxygen osteonecrosiz the cancer patient: The cumulative incidence of the disease has been reported to be between 0.


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 ].

Visit for more related articles at JOP.

In a pressure chamber, the patient inhales pure oxygen through a mask or a head tent. J Can Dent Assoc. Although this type of therapy has been tested for about 20 years, data only on about to patients have been published worldwide.

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

This is alleged to increase the oxygen supply to the body tissue and stop necrosis. 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.

Oral and intravenous bisphosphonate-induced osteonecrosis of hyperbarci jaws. More information Contact persons for the press.

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

Additional relevant publications that had not already been identified by IQWiG were not reported, either. Hyperbaric oxygen in addition to antibiotic therapy is effective for bisphosphonate-induced osteonecrosis of the jaw in a patient with multiple myeloma. Moreover, it is not an emergency therapy and patients are usually capable of giving informed consent. However, the disease is relatively often associated with alcohol or nicotine abuse. A number of papers have been published which describe the successful use of hyperbaric oxygen therapy in the management of BRONJ [ 891011 ].