Hyperbaric Oxygen Therapy for Medication-Related Osteonecrosis of the Jaw: Retrospective Study

Medication-related osteonecrosis of the jaw (MRONJ) is a complication associated with the use of different drugs, including bisphosphonates. Hyperbaric oxygen (HBO₂) treatment might be effective in this condition through multiple mechanisms, although evidence in the literature remains limited.

A single-institutional retrospective study included patients who underwent HBO₂ treatment for MRONJ in our Unit. Data were collected at baseline and after treatment. The primary outcome was clinical response to HBO₂ treatment. Descriptive analysis was followed by paired samples tests comparing variables before and after treatment. Univariate analyses were made to investigate possible predictors of clinical response and relapse rate. Statistical analysis was performed using SPSS® (p < 0.05).

Eighteen patients were included, mostly female, with a mean age of 60.6 ± 13.5 years. Clinical response was observed in most patients (61.1%), with a significant decrease in MRONJ stage severity. There was a significant decrease in pain intensity, number of oral lesions, area of bone exposure, and orofacial inflammatory signs. Five patients relapsed after treatment, with a median time until relapse of 2.0 months. No significant predictors of clinical improvement or relapse rate were found in the univariate analysis.

Clinical improvement was present in most patients, as demonstrated by improvement in disease stage. Our findings support the hypothesis that HBO₂ treatment is beneficial as an adjunct in treating MRONJ related to bisphosphonates. However, larger studies are necessary to confirm these findings.