Hyperbaric Use in Oral Surgery

Hyperbaric oxygen therapy (HBOT) is a medical treatment that involves inhaling pure oxygen in a pressurized chamber. In the context of oral surgery, HBOT has been shown to have several benefits, including:

1. Accelerated wound healing: HBOT promotes angiogenesis, fibroblast proliferation, and collagen synthesis, leading to faster and more effective wound closure.

2. Reduced risk of infection: HBOT enhances the bactericidal abilities of white blood cells, making it more effective in preventing and treating infections.

3. Improved tissue oxygenation: HBOT increases tissue oxygen levels, which is essential for proper wound healing and tissue repair.

4. Enhanced bone regeneration: HBOT stimulates osteoclast and osteoblast activity, promoting bone regeneration and re-absorption of dead bone.

Indications for HBOT in Oral Surgery

1. Oral surgery after radiation therapy: HBOT has been shown to improve wound healing and reduce complications in patients undergoing oral surgery after radiation therapy.

2. Osteoradionecrosis: HBOT can help promote healing and reduce pain in patients with osteoradionecrosis, a condition characterized by necrosis of the jaw bone following radiation therapy.

3. Dental implants: HBOT can improve the success rate of dental implants by promoting bone regeneration and reducing the risk of infection.

4. Gingivitis and periodontitis: HBOT can help treat chronic infections and promote healing in patients with gingivitis and periodontitis.

HBOT has been shown to:

1. Alter the oral microbiome: Studies suggest that HBOT can influence the oral microbiome by modulating the growth and activity of certain microorganisms. For example, one study found that HBOT increased the population of beneficial bacteria, such as Lactobacillus and Bifidobacterium, in the oral cavity (1).

2. Reduce pathogenic bacteria: HBOT has been shown to decrease the presence of pathogenic bacteria, such as Porphyromonas gingivalis and Fusobacterium nucleatum, which are associated with periodontal disease (2).

3. Improve oral hygiene: HBOT has been linked to improved oral hygiene, as it can enhance the body’s natural defenses against infection and inflammation (3).

Clinical Studies and Case Reports

Several studies and case reports have demonstrated the effectiveness of HBOT in oral surgery. For example:

• A study published in the Journal of Oral and Maxillofacial Surgery found that HBOT improved wound healing and reduced complications in patients undergoing oral surgery after radiation therapy.

• A case report published in the Journal of Hyperbaric Medicine described the successful use of HBOT in treating a patient with osteoradionecrosis and promoting healing of a dental implant.

A quote from the canadian dental association:

“Short-term effects of HBO therapy include vasoconstriction, reduction of edema, phagocytosis activation and an anti-inflammatory effect. Long-term effects include stimulation of collagen production by fibroblasts, osteoneogenesis and, most important, neovascularization.3,13 The induced angiogenesis becomes detectable after 8 sessions. At 20 sessions, it reaches a plateau at 80-85% of non-irradiated tissue vascularity. The changes induced by HBO therapy on the tissue's oxygen pressure appear to be largely permanent, as, 3 years after completion of HBO treatment, oxygen pressure in the tissue has been observed to be 90% of what it was at the end of the treatment.”

Conclusion

Hyperbaric oxygen therapy is a valuable adjunctive treatment in oral surgery, particularly in cases where patients have undergone radiation therapy or have compromised wound healing. Its benefits include accelerated wound healing, reduced risk of infection, improved tissue oxygenation, and enhanced bone regeneration. While more research is needed to fully understand its effects, the existing evidence suggests that HBOT can improve outcomes in oral surgery patients.

Clinical utility of hyperbaric oxygen therapy in dentistry

The role of hyperbaric oxygen therapy within oral and maxillofacial surgery

Hyperbaric Oxygen Therapy for Head and Neck Irradiated Patients with Special Attention to Oral and Maxillofacial Treatments

Hyperbaric Oxygen Preconditioning Can Reduce Postabdominoplasty Complications: A Retrospective Cohort Study