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Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: a case series.

Publication ,  Journal Article
Freiberger, JJ; Padilla-Burgos, R; Chhoeu, AH; Kraft, KH; Boneta, O; Moon, RE; Piantadosi, CA
Published in: J Oral Maxillofac Surg
July 2007

PURPOSE: Bisphosphonate (BP)-associated osteonecrosis of the jaw (ONJ) is an emerging problem with few therapeutic options. Our pilot study of BP-ONJ investigated a possible role for hyperbaric oxygen (HBO(2)) therapy. PATIENTS AND METHODS: A total of 16 patients, ranging in age from 43 to 78 years, with BP-ONJ were treated with adjunctive HBO(2) between July 2003 and April 2006. Staging was based on the size and number of oral lesions. Clinical response after treatment and at distant follow-up; the odds of remission, stabilization, or relapse; and time to failure analysis were calculated. RESULTS: The median time on BP therapy before appearance of ONJ symptoms was 18 months, and that from symptom onset to HBO(2) therapy was 12 months. Fourteen of 16 patients (87.5%) improved in stage. The size and number of ONJ lesions were decreased after HBO(2) therapy (P < .001 and P = .008, respectively; Wilcoxon signed-rank test). Immediately after HBO(2) therapy, 7 of 16 patients (44%) were in remission and 8 (50%) had stabilized; however, stabilization without remission was sustained in only 2 patients. At follow-up, 10 of the patients (62.5%) were still in remission or had stabilized. The 7 patients who continued on BP treatment during HBO(2) therapy had a shorter time to failure (8.5 months; 95% confidence interval [CI] = 7.1 to 9.8) than those who discontinued the drug (20.1 months; 95% CI = 17.5 to 23.9; P = .006 by the log-rank test). Clinical response was not associated with cancer type or malignancy remission status. CONCLUSIONS: Adjunctive HBO(2) therapy may benefit patients with BP-ONJ; however, the outcome is improved with cessation of BP administration.

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Published In

J Oral Maxillofac Surg

DOI

ISSN

0278-2391

Publication Date

July 2007

Volume

65

Issue

7

Start / End Page

1321 / 1327

Location

United States

Related Subject Headings

  • Remission Induction
  • Osteonecrosis
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Logistic Models
  • Kaplan-Meier Estimate
  • Jaw Diseases
  • Hyperbaric Oxygenation
  • Humans
 

Citation

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Freiberger, J. J., Padilla-Burgos, R., Chhoeu, A. H., Kraft, K. H., Boneta, O., Moon, R. E., & Piantadosi, C. A. (2007). Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: a case series. J Oral Maxillofac Surg, 65(7), 1321–1327. https://doi.org/10.1016/j.joms.2007.03.019
Freiberger, John J., Rebecca Padilla-Burgos, Austin H. Chhoeu, Kevin H. Kraft, Otto Boneta, R. E. Moon, and C. A. Piantadosi. “Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: a case series.J Oral Maxillofac Surg 65, no. 7 (July 2007): 1321–27. https://doi.org/10.1016/j.joms.2007.03.019.
Freiberger JJ, Padilla-Burgos R, Chhoeu AH, Kraft KH, Boneta O, Moon RE, et al. Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: a case series. J Oral Maxillofac Surg. 2007 Jul;65(7):1321–7.
Freiberger, John J., et al. “Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: a case series.J Oral Maxillofac Surg, vol. 65, no. 7, July 2007, pp. 1321–27. Pubmed, doi:10.1016/j.joms.2007.03.019.
Freiberger JJ, Padilla-Burgos R, Chhoeu AH, Kraft KH, Boneta O, Moon RE, Piantadosi CA. Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: a case series. J Oral Maxillofac Surg. 2007 Jul;65(7):1321–1327.
Journal cover image

Published In

J Oral Maxillofac Surg

DOI

ISSN

0278-2391

Publication Date

July 2007

Volume

65

Issue

7

Start / End Page

1321 / 1327

Location

United States

Related Subject Headings

  • Remission Induction
  • Osteonecrosis
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Logistic Models
  • Kaplan-Meier Estimate
  • Jaw Diseases
  • Hyperbaric Oxygenation
  • Humans