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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This is alleged to increase the oxygen supply to the body tissue and stop necrosis. 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. Red blood cells, which transport oxygen, are already nearly saturated under normal conditions and can carry little more oxygen.

After the paper by Marx et al. It is a concern for some physicians that hyperbaric oxygen may have a cancer-promoting effect or may lead to metastatic growth [ 13 ]. As the comments produced no queries that needed to be discussed, IQWiG dispensed with an oral scientific debate. Bisphosphonates are potent inhibitors of osteoclastic bone resorption and one of the most frequently prescribed drugs.

Hyperbaric oxygen therapy for osteonecrosis – project plan – project description

A number of papers have been published which describe the successful use of hyperbaric oxygen hhyperbaric in the management of BRONJ [ 891011 ]. Hyperbaric oxygen in addition to antibiotic therapy is effective for bisphosphonate-induced osteonecrosis of the jaw in a patient with multiple myeloma. Use of platelet-rich plasma in the management of oral biphosphonate-associated osteonecrosis of the jaw: A review of 60 cases and treatment proposals.

There is currently a complete lack of relevant studies. Although osteoncrosis results are encouraging, evidence-based conclusions could be made after the final results of these studies are published [ 12 ]. A review of bisphosphonate-associated osteonecrosis of the jaws and its management. The uyperbaric of the idiopathic form of disease is unknown, unlike the cause of secondary or traumatic osteonecrosis of the femoral head.


Int J Dent Hyg.

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

Journal of the Pancreas. In the March issue of JOP. 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.


It is currently not proven that patients with idiopathic osteonecrosis of the osteonecross head a specific type hypervaric 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. All Published work is licensed under a Creative Commons Attribution 4. By increasing the ambient pressure, the amount of oxygen in the blood can be substantially increased.

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

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

Therefore, patients in the control groups would ostoenecrosis no ostfonecrosis be arbitrarily deprived of an allegedly better treatment alternative. Oral and intravenous bisphosphonate-induced osteonecrosis of the jaws.

Hyperbaric oxygen treatment and bisphosphonate-induced 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 ]. The cumulative incidence of the disease has been reported to be between 0.


As everybody knows, an ounce of prevention is worth a pound of cure; patients who are oosteonecrosis to receive bisphosphonate treatment should consult with a dentist in order to address potential problems before starting bisphosphonate treatment.

However, the comments submitted were considered. J Oral MaxillofacSurg ; 65 7: J Oral Maxillofac Surg.

History, etiology, prevention, and treatment. Can’t read the image? More information Contact persons for the press.

Utility of hyperbaric oxygen in treatment of bisphosphonate-related osteonecrosis of the jaws. Osteonecrosis of the jaws due to bisphosphonate use. Additional relevant publications that had not already been identified by IQWiG were not reported, either. However, the disease is relatively often associated with alcohol or nicotine abuse. Pamidronate Aredia and zoledronate Zometa induced avascular necrosis of the jaws: 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.

Hyperbaric oxygen therapy and osteonecrosis.

Moreover, it is not an emergency therapy and patients are usually capable of giving informed consent. They are widely used in the treatment of osteoporosis, skeletal lesions of multiple myeloma and bone metastasis of solid tumors.

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. Hyperbaric oxygen therapy has been used in the treatment and prevention of osteoradionecrosis of the jaw for more than 30 years [ 7 ].