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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Hyperbaric oxygen therapy hypsrbaric been used in the treatment and prevention of osteoradionecrosis of the jaw for more than 30 years [ 7 ]. More information Contact persons for the press. 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.

American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws.

Quintessence Publishing Co Inc; J Oral MaxillofacSurg ; 65 7: 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.

The final report was sent to the contracting agency, the German Federal Joint Committee, on 8 August As with carbonic acid in an unopened carbonated water bottle, due to the increase in pressure more oxygen dissolves into the blood plasma. 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. Although early results are encouraging, evidence-based conclusions could be made after the final results of these studies are published [ 12 ].

By increasing the ambient pressure, the amount of oxygen in the blood can be substantially increased. A review of bisphosphonate-associated osteonecrosis of the jaws and its management. The Institute therefore recommends osteoneceosis HBOT in these patients only within the ostdonecrosis of clinical trials. Utility of hyperbaric oxygen in treatment of bisphosphonate-related osteonecrosis of the jaws.

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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 benefit of hyperbaric oxygen therapy for osteonecrosis of the femoral head is not proven

A review of 60 cases and treatment proposals. Comments could be submitted on this version up to 23 May Osteonecrosis of the jaws due to bisphosphonate use. According hylerbaric 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 oxygen, are already nearly saturated under normal conditions and can carry little more oxygen.

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. 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 hypperbaric the cancer patient: All Published work is licensed under a Creative Commons Attribution 4. Oral and intravenous bisphosphonate-induced osteonecrosis of the jaws.

Therefore, patients in the control groups would by no means be arbitrarily deprived of an allegedly better treatment alternative.

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

There is currently a complete lack of relevant studies. IQWiG received 2 comments, which did not, however, contradict the general conclusions of the preliminary report.


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.

Bisphosphonates are osteinecrosis inhibitors of osteoclastic bone resorption and one of the most frequently prescribed drugs. After the paper by Marx et al.

Hyperbaric oxygen therapy and osteonecrosis.

Overall, we believe that a multidisciplinary approach is fundamental for achieving a favorable outcome in patients with BRONJ. J Can Dent Assoc. It remains unclear why the evidence base is so poor: Additional relevant publications that had not already been identified by IQWiG were not reported, either.

In the March issue of JOP. Breadcrumb Press Press releases The benefit of hyperbaric oxygen therapy…. Can’t read the image? 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 ].

Select your language of interest to view the total content in your interested language. 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.

We 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. The cause of the idiopathic form of disease is unknown, unlike the cause of secondary or traumatic osteoencrosis of the femoral head. It is a concern for some physicians that hyperbaric oxygen may have a cancer-promoting effect or may lead to metastatic growth [ 13 ].