Hyperbaric oxygen therapy for the treatment of moderate to severe periodontitis: a clinical pilot study

Abstract

Objectives: To clinically and microbiologically evaluate the effects of hyperbaric oxygen (HBO2) therapy in addition to full-mouth ultrasonic subgingival debridement (FM-UD), in the initial treatment of chronic periodontitis. Methods: Twenty patients presenting moderate to severe generalized forms of chronic periodontitis were included in a three-month randomized, parallel-group, single-blinded, prospective study. At baseline patients were randomly assigned to two treatment groups [Test Group (FM-UD+HBO2) and Control Group (FM-UD)]. Both groups were treated with an FM-UD session. Ten HBO2 sessions (one session per day for 10 days at a pressure of 2.5 ATA) were additionally administered to the Test Group. Soft tissues parameters [probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL) and visible plaque index (VPI)] were assessed at baseline (immediately before FM-UD treatment), after two weeks, after six weeks and at three months. For each patient, a site presenting PPD ≥ 6mm and positive BOP was selected as a qualifying site (QS), to be monitored clinically (at T0, T1, T2 and T3) and microbiologically (at T0, T1 and T3). Results: There were no statistically significant differences between the two groups for any clinical parameter analyzed after three months, except for BOP, which was significantly (p < 0.05) reduced in the Test Group. Reductions in bacterial levels were detected in both groups after therapy. Faster bacterial recolonization occurred after three months in the Control Group. Conclusion: HBO2 therapy in combination with FM-UD may represent an efficacious approach to the treatment of moderate to severe forms of periodontitis.

Eficacia de la terapia de oxígeno hiperbárico en periodontitis: Una revisión sistemática

“…En cuanto al cegamiento de los pacientes y de los investigadores se aprecia alto riesgo de sesgo en todos los artículos, esto es debido a que los pacientes que fueron incluidos en los diferentes grupos conocían completamente cual era la intervención que se les realizaría. Igualmente, se presenta el sesgo de notificación selectiva de los resultados hay un alto riesgo [13,14,16] y riesgo medio de sesgo [15,17]. Y finalmente, el sesgo de desgaste en el estudio de Chen TL [13] con presencia de alto riesgo ya que se examinaron únicamente a los participantes que terminaron el ensayo; los demás ensayos clínicos tienen un bajo riesgo en este sesgo (véase tabla 3).…”

“…Diez sesiones de HBO2 (una sesión por día durante 10 días a una presión de 2,5 ATA) se administraron adicionalmente al grupo de prueba. Los resultados mostraron que la terapia con oxigenoterapia hiperbárica en combinación con FM-UD puede representar un enfoque eficaz para el tratamiento de formas moderadas a severas de periodontitis, ya que mejora el sangrado al sondaje que se redujo significativamente en el grupo experimental (p<0,05) y se redujeron de forma significativa los niveles de bacterias [16].…”

A Narrative Review on Means to Promote Oxygenation and Angiogenesis in Oral Wound Healing

“…In treating periodontitis, hyperbaric oxygen therapy (HBOT) seems to improve clinical parameters and reduce subgingival anaerobic growth, making it a promising adjuvant in combination with standard procedures such as scaling and root planning. In a recent study, HBOT in addition to full-mouth ultrasonic subgingival debridement was administered over 10 days for the treatment of generalized severe periodontitis [ 64 ]. This modality was shown to be effective at reducing bleeding on probing and resulted in slower bacterial recolonization when compared to the control group.…”