Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental...

Area of Science:

• Oral surgery and implantology
• Radiotherapy oncology
• Hyperbaric medicine

Background:

• Dental implants are a reconstructive option for missing teeth, particularly beneficial for patients with head and neck cancer treated with radiotherapy.
• Hyperbaric oxygen therapy (HBO) is controversially advocated to enhance dental implant success rates in irradiated patients.

Purpose of the Study:

• To compare the success rates, morbidity, patient satisfaction, and cost-effectiveness of dental implant treatment with and without HBO in patients who have undergone radiotherapy.

Main Methods:

• A systematic review was conducted, searching multiple databases (Cochrane, MEDLINE, EMBASE) and handsearching journals for randomized controlled trials (RCTs).
• The search included unpublished and ongoing RCTs, with no language restrictions. The last search was performed in June 2007.
• Data extraction and quality assessment were performed independently by two reviewers, with results analyzed using random-effects models.

Main Results:

• Only one RCT involving 26 patients (13 in HBO group, 13 in control) met the inclusion criteria.
• While one patient in the HBO group developed osteoradionecrosis and lost all implants, there were no statistically significant differences in implant/prosthesis failures, complications, or patient satisfaction between groups.
• Four patients died in each group one year after implant loading.

Conclusions:

• Current limited evidence suggests that hyperbaric oxygen therapy (HBO) may not provide significant clinical benefits for dental implant success in irradiated patients.
• There is a clear need for more high-quality, multicentered randomized controlled trials (RCTs) to definitively ascertain the effectiveness of HBO in this patient population.
• Future trials should adhere to CONSORT guidelines for robust reporting and methodology.