The Effectiveness of Hyperbaric Oxygen Therapy for Management Osteoradionecrosis in Jaw: A Meta-Analysis

Authors

  • Thanyaporn Leesomprasong, DDS. Institute of Dentistry, Department of Medical Services
  • Sasithorn Thaweedej, DDS., Dip, Thai Board of General Dentistry. Institute of Dentistry, Department of Medical Services

Keywords:

Osteoradionecrosis, Hyperbaric oxygenation, Jaw, Meta-analysis

Abstract

Background : Osteoradionecrosis of the jaw is a severe complication of radiotherapy in patients with head and neck cancer. However, there is insufficient empirical results to support the effect of hyperbaric oxygenation treatment.Objective : The purpose of this meta-analysis study was to collect data and evidence on the effect of hyperbaric oxygenation in management of osteoradionecrosis.Method : Systematically and meta-analysis study search for related article from the Cochrane Database of Systematic Reviews (CDSR), PubMed, Google scholar and manual search at Institute’s library.Result : Five articles were extracted. Risk ratio was calculated and pooled data at 95% confidence interval and random effect model was used (RR=1.17 (95% CI=0.975-1.404, p=0.92)). The result is high heterogeneity of data (I2=69.8%). Asymmetric funnel plot was found (Begg’s test p-value=0.624, Egger’s test p-value = 0.422) which stated an absence of publication bias or small study effect.Conclusions : The use of hyperbaric oxygenation for management of osteoradionecrosis has more healing chance compared to the unused group, statistically insignificant, but the evidence is inconclusive from high heterogeneity of data (I2 = 69.8%). However, the limitations in study design are result in few high-quality studies. Further study is still required in the future for a high-quality trial.

References

References

O’Dell K, Sinha U. Osteoradionecrosis. Oral Maxillofac Surg Clin North Am 2011;23:455-64.

Lyons A, Ghazali N. Osteoradionecrosis of the jaws: current understanding of its pathophysiology and treatment. Br J Oral Maxillofac Surg 2008;46:653-60.

Marx RE. Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg1983;41:283-8.

Marx RE. A new concept in the treatment of osteoradionecrosis.J Oral Maxillofac Surg 1983;41:351-7.

Delanian S, Lefaix JL. The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway.Radiother Oncol 2004;73:119-31.

Martos-Fernandez M, Saez-Barba M, Lopez-Lopez J, Estrugo-Devesa A, Balibrea-Del-Castillo JM, Bescos-Atin C.Pentoxifylline,tocopherol, and clodronate for the treatment of mandibular osteoradionecrosis: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2018;125:431-9.

Vudiniabola S, Pirone C, Williamson J, Goss AN. Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the facial bones. Int J Oral Maxillofac Surg 2000;29:435-8.

Jenwitheesuk K, Mahakkanukrauh A, Punjaruk W, Jenwitheesuk K, Chowchuen B, Jinaporntham S, et al. Efficacy of Adjunctive Hyperbaric Oxygen Therapy in Osteoradionecrosis. Biores Open Access 2018;7:145-9.

Pasquier D, Hoelscher T, Schmutz J, Dische S, Mathieu D,Baumann M, et al. Hyperbaric oxygen therapy in the treatment of radio-induced lesions in normal tissues: a literature review.Radiother Oncol 2004;72:1-13.

Hampson NB, Holm JR, Wreford-Brown CE, Feldmeier J.Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury. Cancer 2012;118:3860-8.

Marx RE, Johnson RP, Kline SN. Prevention of osteoradionecrosis:a randomized prospective clinical trial of hyperbaric oxygen versus penicillin. J Am Dent Assoc 1985;111:49-54.

Bennett MH, Feldmeier J, Hampson NB, Smee R, Milross C.Hyperbaric oxygen therapy for late radiation tissue injury.Cochrane Database Syst Rev 2016;4: CD005005.

Annane D, Depondt J, Aubert P, Villart M, Gehanno P, Gajdos P,et al. Hyperbaric oxygen therapy for radionecrosis of the jaw:a randomized, placebo-controlled, double-blind trial from the ORN96 study group. J Clinical Oncol 2004;22:4893-900.

Richard van Merkesteyn, Dirk Jan Bakker. Comment on “Hyperbaric oxygen therapy for radionecrosis of the jaw: a randomized, placebo-controlled,double-blind trial from the ORN96 Study Group”. J Clin Oncol 2005;23:4465-6.

Feldmeier JJ, Hampson NB. A systematic review of the literature reporting the application of hyperbaric oxygen prevention and treatment of delayed radiation injuries: an evidence based approach. Undersea 2002;29:4-30.

Lindell K. WM. Hyperbaric Oxygen Therapy Indications. 13th ed.Florida: Best Publishing Company; 2014.

Sims PG, Lieblich SE. Diagnosis and management of pathological condition. J Oral Maxillofac Surg 2017;75:e6.

HIggins J AD, Sterne J. Assessing risk of bias in included studies.In: Higgins J, Green S, editors Cochrane Handbook for Systematic Reviews of Interventions:The Cochrane Collaboration; 2009.

Vudiniabola S, Pirone C, Williamson J, Goss AN. Hyperbaric oxygen in the prevention of osteoradionecrosis of the jaws. Aust Dent J 1999;44:243-7.

Shaw RJ, Butterworth CJ, Silcocks P, Tesfaye BT, Bickerstaff M,Jackson R, et al. HOPON (Hyperbaric Oxygen for the Prevention of Osteoradionecrosis): A Randomized Controlled Trial of Hyperbaric Oxygen to Prevent Osteoradionecrosis of the Irradiated Mandible After Dentoalveolar Surgery. Int J Radiat Oncol Biol Phys 2019;104:530-9.

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Published

18-06-2021

How to Cite

1.
Leesomprasong T, Thaweedej S. The Effectiveness of Hyperbaric Oxygen Therapy for Management Osteoradionecrosis in Jaw: A Meta-Analysis. J DMS [Internet]. 2021 Jun. 18 [cited 2024 Nov. 22];46(1):99-106. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/251702

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Original Article