Background and objectives : Since the first description of bisphosphonates related osteonecrosis of the jaw (BRONJ) made in 2003 there has been an increased number of cases described in the literature and it remains a difficult condition to treat. In the last few years the challenge has been to improve healing in BRONJ, and different adjunctive treatments have been advocated; hyperbaric oxygen (HBO2) has generated good results and an improvement of the quality of life in different case reports and series. We aim to validate these results. The objective of this study is to evaluate the beneficial effects of HBO2, as an adjunctive therapy, in the treatment of BRONJ, comparing our results with a thorough literature review.
Methods : We analyzed 15 patients with BRONJ treated with HBO2 as an adjunctive therapy between January 2006 and January 2013 and compared them with 15 patients with BRONJ that had not received HBO2. We retrospectively studied gender, age, and localization of osteonecrosis, bisphosphonates indication, the number of HBO2 treatment, and the clinical and radiological behaviour of osteonecrosis when adjunctive therapy with HBO2 was used.
Results : We observed a clinical improvement in the group of patients who presented with BRONJ when treated with HBO2 as an adjunctive therapy. The clinical outcome was statistically significant in the group of patients treated with HBO2 when we compared lesion stage and osteonecrosis stabilization; 2 patients had complete remission and the rest had long term satisfactory outcome.
Conclusions : HBO2 as an adjunctive therapy benefits patients with BRONJ and this supports the results of other studies where HBO2 has shown potential benefits and should be considered as part of the routine treatment of BRONJ.
Key words: bisphosphonates; osteonecrosis; hyperbaric oxygen