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Hyperbaric Oxygen Therapy In Iradiated Maxillofacial Dental Implant

Medical information reviewed by: ALEX MUNTEANU, Kinetoterapeut
i.php?p=8. Terapia hiperabara in implant

Discover the hyperbaric medicine center opened in our clinic. Centrokinetic has the top-performing hyperbaric chamber in Bucharest, with multiple medical and anti-aging uses. The Baroks chamber has 5 seats, and operates at a constant pressure of 2.5 atmospheres, being fully automated and having protocols for each condition, and can be used individually for each patient. 

Hyperbaric oxygen therapy - benefits

Patients who use the clinic's hyperbaric therapy services benefit from:

  • The only medically accredited hyperbaric therapy chamber in Bucharest, which operates at 2.5 atmospheres (those for aesthetic use go to 1 atmosphere and have no medical benefits).
  • A safe medical procedure, without irradiation, without pain, without other side effects. 
  • The specialized medical team consists of recovery doctors, orthopedists, rheumatologists, neurologists, and neurosurgeons, meaning a multidisciplinary team specialized in all diseases that can be treated with hyperbaric therapy. 
  • Premium conditions at a fair price. Our clinic is recognized for the conditions offered and for the care of each patient. But we do not need to pay exorbitant prices to have access to quality medical services. At Centrokinetic you can find an affordable and fair price. But note that we do not have a contract with the National Health Insurance House (we do not offer state reimbursed services)

Centrokinetic is keeping contact with prestigious clinics and universities in Belgium, the Netherlands, France, and Greece to constantly update treatments to provide patients with the best medical solutions.

Dental implant failure

Detailed knowledge and a broad understanding of the etiological and risk factors for dental implant failure are needed to reduce its failure rate. In recent years, implants have been used more and more frequently in patients with maxillofacial oral cancer, so there are still not enough conclusive studies to show that these irradiated patients in the head and neck area are more at risk of losing dental implants. The reduced healing capacity of the tissues leads to osteoradionecrosis, necrotic development of the bones, and pathological fracture in response to tissue trauma; thus, with a reduced healing capacity and osteoradionecrosis in response to injury.

Hyperbaric oxygen treatment

Hyperbaric oxygen therapy (HBO) and its effectiveness is still a controversial topic. There are numerous studies reported for the effectiveness of HBO in the treatment of osteoradionecrosis of various bone tissues. In addition to its usefulness in treating osteoradionecrosis, this therapy can prevent it. The researchers conducted a randomized/prospective clinical trial using HBO and penicillin. This study showed that HBO reduced the development of osteoradionecrosis after tooth removal, which was statistically significant. HBO therapy can be performed in multiplayer or single-seater rooms. The patient is kept in a room with 100% pure oxygen under a pressure of 1.5–3 absolute atmospheres.

What are the effects of oxygen therapy on the body?

  • Decreases inflammation
  • Increases the body's oxygen saturation by 20-30%
  • Increases the body's immunity
  • Increases blood circulation and stimulates the formation of new capillaries
  • Decreases toxins in the body
  • Stimulates the production of new blood cells
  • Increases healing rate

How does hyperbaric therapy work?

HBO therapy increases oxygen pressure, collagen production, and fibroblastic activity creating a matrix for neovascularization. According to Johnsson, it also combats the negative effect of irradiation, stimulates osseointegration, and improves the survival rate of the implant.

This systematic review helps the maxillofacial surgeon understand the evidence, integrate valid information, and make a rational decision about using HBO therapy for patients. It will also help improve the survival of the dental implant and the quality of life of these patients, providing successful long-term rehabilitation.

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Objective 

The objective of this analysis was to compare implant failure rates for irradiated or previously irradiated patients in the head and neck region and following HBO therapy to irradiated patients who do not receive such therapy after a follow-up period of 1-2 years to 26 years old. 

Materials and methods

  • Types of studies: Randomized controlled trials (SCRs), prospective clinical trials, and retrospective trials.
  • Types of participants: Patients with maxillofacial implants who have undergone radiotherapy.
  • Types of intervention: HBO therapy compared to classic treatment, without HBO.
  • Comparison type: HBO group versus non-HBO group.
  • Types of measures for the result: Implant failure rates.

Search strategies

In April 2016, an electronic search was performed in clinical trials comparing implant failure rates (O) in irradiated maxillofacial (P) patients undergoing dental implant treatment or with additional HBO therapy (I) or without HBO (C) therapy, using the following databases: PubMed, Google Scholar, and the Cochrane Oral Health Group Testing Registry. The search strategy used a combination of controlled vocabulary and free text terms.

Manual research of journals related to dental implants, the reference list of identified studies, and relevant reviews on this topic were also scanned for possible further studies. In addition, online databases providing information on ongoing clinical trials (clintrials.gov; www.centerwatch.com/clinicaltrials; www.clinicalconnection.com; www.cochranelibrary.com) were also verified. 

Data collection and analysis

Selection of studies

The review process comprises two phases. In the first phase, the titles and abstracts of the search were initially examined by two authors for relevance, thus, the full text of the relevant abstract being obtained and accessed. Any disagreement was resolved by communication, the suggestion of the third author also being important. The manual search of the selected journals was also performed, as well as the reference search of the selected studies. The articles were obtained after the first stage of the review process using the following inclusion and exclusion criteria and were analyzed in the second phase, and the relevant and appropriate articles were kept for further processing and data extraction. Duplicates and articles with insufficient required data were excluded.

Inclusion criteria

Human clinical trials in patients with irradiated maxillofacial dental implant, including:
  • RCT
  • Prospective study
  • Retrospective study
  • Preliminary reports.
  • Exclusion criteria
  • Case studies
  • Technical reports
  • Animal studies
  • In vitro studies
  • Non-scientific journals and articles

i.php?p=2. Oxigenoterapia hiperbarica in

In general, RCS is the highest level of evidence. Although the development of recommendations based on the highest level of evidence is desirable, an adequate number of RCSs is not always available. Therefore, we have included several prospective and retrospective clinical trials with a preliminary report. The purpose of the report was to provide preliminary data collected from a long-term prospective investigation into the effects of HBO therapy on implant integration in the irradiated jaw. Data on the effects of different irradiation doses in the perioral region were collected by periodic clinical, radiological, and histological examinations.

Data extraction and management

Three authors independently extracted data from studies using standardized selection criteria developed for this review. We tried to contact the authors of the primary studies to request additional information when the data were missing or incomplete. The authors of the review flattened all the differences by consultation. The data was excluded until more information became available. 

The following data were included for each process.
  • Year of publication and country of origin
  • Details about participants, including demographic characteristics and inclusion criteria
  • Details about the type of intervention
  • Details of reported results, including evaluation method and time intervals.
  • Assessing the "risk of prejudice" of this study
  • The risk assessment was performed using the approach recommended by the Cochrane studies and was completed independently and in duplicate by two authors, as part of the data extraction process.

Search results for data collection

The search in the database resulted in 62 titles, of which 22 titles were removed by evaluating the titles. The evaluation of the abstracts was made for the other 40 articles, and 6 articles were eliminated based on the inclusion and exclusion criteria. Full-text data were obtained for the remaining 34 articles, of which 8 articles were eliminated due to insufficient data and 12 articles did not meet the study criteria. Finally, 14 articles were selected for the study.

Description of included studies

The data obtained according to the search strategy were classified and analyzed statistically. The effects of the intervention and the statistical analysis. The effect of the intervention was studied for all 14 selected studies, and the implant survival rate for each group was calculated statistically. 
i.php?p=5. Terapia hiperbara in ischemia

Conclusions

According to the above statistical analysis, the results show that HBO preventive therapy can reduce the risk of implant failure in irradiated patients, which may be due to improved vascularity, leading to a reduced risk of tissue damage and, therefore, HBO may be effective as a treatment protocol, while implant treatment is planned in patients who have experienced maxillofacial irradiation. 

However, some major factors, other than irradiation, that affect the survival rate of the implant in the irradiated bone were: the type of implant, the surgical procedures used, the time interval between radiotherapy and implant placement, and the radiation dose, which were not included in the meta-analysis due to insufficient data.

Therefore, further research is needed to identify the many reasons for failure and various factors that affect the success and failure rates of dental implants in patients who have undergone radiation therapy.

There is a definite need for more RCSs to determine the effectiveness of HBO in patients with maxillofacial dental implants. These studies should be of high quality and reported according to the recommendations of the consort's statement (www.consort-statement.org/). Each clinical center may have a limited number of patients and multicenter studies are likely to be required. 

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450897/

IN CASE YOU HAVEN'T ALREADY HEARD ABOUT US

Centrokinetic is the place where you will find clear answers and solutions for your motricity problems. The clinic is dedicated to osteoarticular diseases and is divided into the following specialized departments:

  • Orthopedics , a department composed of an extremely experienced team of orthopedic doctors, led by Dr. Andrei Ioan Bogdan, primary care physician in orthopedics-traumatology, with surgical activity at Medlife Orthopedic Hospital, specialized in sports traumatology and ankle and foot surgery. .
  • Pediatric orthopedics , where children's sports conditions are treated (ligament and meniscus injuries), spinal deformities (scoliosis, kyphosis, hyperlordosis) and those of the feet (hallux valgus, hallux rigidus, equine larynx, flat valgus, hollow foot).
  • Neurology , which has an ultra-performing department, where consultations, electroencephalograms (EEG) and electromyography (EMG) are performed. 
  • Medical recovery  for adults and  children , department specialized in the recovery of performance athletes, in spinal disorders, in the recovery of children with neurological and traumatic diseases. Our experience is extremely rich, treating over 5000 performance athletes.
  • Medical imaging , the clinic being equipped with ultrasound and MRI, high-performance devices dedicated to musculoskeletal disorders, and complemented by an experienced team of radiologists: Dr. Sorin Ghiea and Dr. Cosmin Pantu, specialized in musculoskeletal imaging.

Find the latest news by following the Facebook and YouTube accounts of the Centrokinetic clinic.  

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