Effect of hyperbaric oxygen on bone healing after enucleation of mandibular cysts: a modified case control study

Mandibular cysts may require enucleation, resulting in large cavities compromising mandibular strength and functions. We investigated the effects of hyperbaric oxygen therapy (HBOT) on healing after enucleation of mandibular cysts.

Fourteen healthy individuals in whom no modifiers of wound healing were present received a median of 20 post-operative HBOT. The rate of filling of the defect was derived from the number of pixels in the residual cavity after transformation of the area of the lesion in orthopantomograms taken immediately after surgery and at six months postoperatively. Modifications in bone density, detected on panoramic radiographs, were defined through a gray scale of 256 tonalities. The radiolucency of a healthy tooth was used as a reference to control for differences between radiographs taken at different times in the same patient. Both the rate of filling and changes in bone density were compared with corresponding data from a previous study of 27 healthy subjects who healed spontaneously without HBOT.

At six months postoperatively, the HBO-treated group showed 55 ± 9% reduction in the size of the residual cavity and 55 ± 17% increase in bone density compared to immediate postoperative values. Corresponding values in the control study were 12 ± 4% and 37 ± 23%, respectively. These differences were significant (t = -16.95; P = 1.21E-11 [x 10-11] for the reduction in cavity size and t = -2.39; P = 0.029 for bone density).

HBOT merits a place as a useful adjunct in the surgical management of defects of the mandible.