Hyperbaric oxygen and postradiation osteonecrosis of the mandible

The clinical and dental records of 26 patients with the clinical diagnosis of postradiation osteonecrosis (PRON) managed with hyperbaric oxygen (HBO) were reviewed to determine the efficacy of HBO. 19 patients were male and 7 were female; age at the first HBO session ranged from 28 to 80 years (median 57.5 years). All but 8 patients reviewed had some form of surgical management; 7 had mandibulectomy for PRON. As part of management, a total of 9-84 HBO sessions (median 35 sessions) was administered. 18 of the 26 patients ultimately achieved persistent mucosal and cutaneous coverage 1-84 months (median 24 months) after the first HBO session. 13 of the 26 patients met strict criteria for resolution of their disease; fully 21 of 26 patients had improved PRON status following HBO therapy. HBO treatment as part of a comprehensive management plan is safe and effective in the management of PRON.