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: Mezigami Tejinn
Country: Sierra Leone
Language: English (Spanish)
Genre: Health and Food
Published (Last): 1 November 2017
Pages: 471
PDF File Size: 4.61 Mb
ePub File Size: 3.86 Mb
ISBN: 921-6-22918-723-3
Downloads: 21971
Price: Free* [*Free Regsitration Required]
Uploader: Mozilkree

The case presented by Smith et al. Bisphosphonates are potent inhibitors of osteoclastic bone resorption and one of the most frequently prescribed drugs.

In recent years, many papers have been published which shed light on the pathogenesis and clinical course of the disease.

Hyperbaric oxygen therapy may hold some promise; however, its role in the management of BRONJ hyperbarci be further confirmed in randomized controlled trials. Int J Hematol ; 84 4: However, the comments submitted were considered.

As everybody knows, an ounce of prevention is worth a pound of cure; patients who are planning to receive bisphosphonate treatment should consult hyperharic a dentist in order to address potential problems before starting bisphosphonate treatment. This is alleged to increase the oxygen supply to the body tissue and stop necrosis. However, the disease is relatively often associated with alcohol or nicotine abuse.

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. Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: 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.

J Oral MaxillofacSurg ; 65 7: All Published work is licensed under a Creative Commons Attribution 4. In the March issue of JOP.

Hyperbaric oxygen in addition to antibiotic therapy is effective for bisphosphonate-induced osteonecrosis of the jaw in a patient with multiple myeloma. Osteonecrosis of the jaws due to bisphosphonate use. Int J Dent Hyerbaric. Use of platelet-rich plasma in the management of oral biphosphonate-associated osteonecrosis of the jaw: Hyperbaric oxygen and the cancer patient: American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws.


The proposed rationale behind the beneficial effects of hyperbaric oxygen therapy in BRONJ is increased wound healing, reduction of edema and inflammation, stem cell mobilization and moderation of the suppression of bone turnover by bisphosphonates [ 12 ]. 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 in every patient. The cumulative incidence of the disease has been reported to be between 0.

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 osteonecrosix region which has continued for more than eight weeks, and with no history of radiation therapy to the jaw [ 3 ]. Systemic antibiotics, an oral antimicrobial rinse and close follow-up are recommended for patients with asymptomatic oral lesions [ 3 ].

Visit for more hyperbaeic articles at JOP. Objections from ethics committees against direct clinical comparisons are also not to be expected, as HBOT has already been used for a long time and no dramatic effects are to be expected.

Hyperbaric oxygen therapy for osteonecrosis – project plan – NIPH

Although this type of therapy has been tested osteonecrosks about 20 years, data only on about to patients have been published worldwide. Select your language of interest to view the total content in your interested language. Hyperbaric oxygen therapy has been used in the treatment and prevention of osteoradionecrosis of the jaw for more than 30 years [ 7 ].

The final report concludes that reliable statements on the benefit of HBOT for idiopathic osteonecrosis of the femoral head osteoncerosis adults are currently not possible.

As with carbonic acid in an unopened carbonated water bottle, due to the increase in pressure more oxygen dissolves into the blood plasma. Therefore, patients in the control groups would by no hypfrbaric be arbitrarily deprived of an allegedly better treatment alternative. Given the jyperbaric use of bisphosphonates in clinical practice, even a very low incidence of oral osteonecrosis in bisphosphonate users should be considered a public emergency.


Additional relevant publications that had not already been identified by IQWiG were not reported, either. 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.

In a pressure chamber, the patient inhales pure oxygen through a mask or a head tent. Pamidronate Aredia and zoledronate Zometa induced avascular necrosis of the jaws: By increasing the ambient pressure, the amount of oxygen in the blood can be substantially increased. Hyperbaric oxygen therapy is a way of treatment which increases the oxygen content of the blood and, consequently, the amount of oxygen delivered to tissues.

Objections referring to the content of the preliminary report are discussed in the final report see pages and are fully presented in a separate document.

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

More information Contact persons for the hyperbariic. However, an increase in the reported incidence of BRONJ is expected with a wider recognition of the disease and the close follow-up of the patients using bisphosphonates. A review of bisphosphonate-associated osteonecrosis of the jaws and its management. In the advanced stage of disease, the femoral head can collapse, so that the hip joint needs to be either surgically stabilised or replaced by a prosthesis.

The Institute therefore recommends applying HBOT in these patients only within the setting of clinical trials.