METHODS: A comprehensive electronic and manual search was performed to identify clinical studies on adult patients who underwent hyperbaric oxygen therapy for periodontal treatments. A systematic literature search was conducted in PubMed, Cochrane, and Dentistry Oral Sciences Source databases.
RESULTS: Fourteen articles were included in the final literature review, of which five were RCTs and 11 were prospective clinical studies. Four studies discussed HBO as an adjunct to nonsurgical treatment of periodontitis, eight reported on HBO and osteoradionecrosis, and one examined HBO in bisphosphonate-related necrosis of the jaws.
CONCLUSIONS: HBO has shown superior efficacy compared to antibiotics as a prophylactic measure in preventing osteoradionecrosis (ORN) in patients with a history of high mandibular irradiation. Clinicians should consider referring such patients for HBO therapy before and after tooth extractions. However, for the surgical excision of existing ORN lesions, HBO therapy does not yield significant benefits but does not negatively impact outcomes either. Regarding the treatment of periodontitis patients, the variability among studies prevents definitive conclusions. HBO therapy as an adjunct to SRP in periodontitis treatment produces mixed results.
CONCLUSIONS: This study\'s clinical relevance lies in its exploration of the potential benefits of HBO for periodontal conditions. Also, it provides clinicians with insights into when and how to integrate HBO therapy into their treatment approaches, particularly for patients with a history of irradiation and those undergoing complex dental procedures.
方法:进行了全面的电子和人工搜索,以确定接受高压氧治疗的成年患者牙周治疗的临床研究。在PubMed进行了系统的文献检索,科克伦,和牙科口腔科学源数据库。
结果:最终文献综述包括14篇文章,其中5项为RCT,11项为前瞻性临床研究.四项研究讨论了HBO作为牙周炎非手术治疗的辅助手段,八例报告了HBO和骨坏死,一个人检查了双膦酸盐相关的颌骨坏死中的HBO。
结论:与抗生素相比,HBO作为一种预防措施,在有高下颌骨照射史的患者中,在预防放射性骨坏死(ORN)方面显示出更好的疗效。临床医生应考虑在拔牙前后将此类患者转诊为HBO治疗。然而,用于手术切除现有的ORN病变,HBO治疗不会产生显著的益处,但也不会对结果产生负面影响。关于牙周炎患者的治疗,研究之间的可变性阻碍了明确的结论。HBO疗法作为牙周炎治疗中SRP的辅助手段产生了不同的结果。
结论:本研究的临床相关性在于探索HBO对牙周疾病的潜在益处。此外,它为临床医生提供了关于何时以及如何将HBO疗法整合到他们的治疗方法中的见解,特别是对于有放疗史和接受复杂牙科手术的患者。