{"title":"Treatment Approaches in Cases of Mandibular Osteoradionecrosis: A systematic meta-analysis.","authors":"Dr Nida Geçkil","doi":"10.1016/j.jormas.2025.102316","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Osteoradionecrosis (ORN) refers to necrotic bone that remains unhealed for a minimum of 3 months following radiotherapy in an irradiated region. The aim of this systematic meta-analysis was to evaluate the efficacy of hyperbaric oxygen therapy and surgery alone or in combination in the treatment of patients with ORN.</p><p><strong>Methods: </strong>A systematic review and analysis of literature were performed to ascertain the role of surgery and HBO in the treatment of ORN. In May 2024 we updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, Issue 1), MEDLINE, EMBASE, DORCTIHM and reference lists of articles.</p><p><strong>Results: </strong>Among patients who underwent both HBO and surgery, the success rate of the treatment was 69% (95% Confidence Interval [CI]: 0.47-0.85, df = 9). Patients who solely received HBO had a success rate of 38% (CI: 0.20-0.61, df = 4), while those who only had surgery had a success rate of 36% (CI: 0.19-0.58, df = 3). The statistical analysis showed no significant difference in the results between patients who received only hyperbaric oxygen therapy or surgical treatment (z=0.139, p=0.889). The analysis indicated significant disparities in treatment success rates among patients receiving a combination of HBO and surgery compared to those treated solely with HBO or surgery alone (z = 2.428, p = 0.015 for HBO vs HBO+surgery, z = 2.655, p = 0.008 for surgery vs HBO+surgery).</p><p><strong>Conclusion: </strong>The findings of this study indicate that the combination of HBO and surgery is a more effective approach for managing ORN, with better results observed when treatments are combined rather than used individually.</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102316"},"PeriodicalIF":2.2000,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Stomatology Oral and Maxillofacial Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jormas.2025.102316","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Dentistry","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Osteoradionecrosis (ORN) refers to necrotic bone that remains unhealed for a minimum of 3 months following radiotherapy in an irradiated region. The aim of this systematic meta-analysis was to evaluate the efficacy of hyperbaric oxygen therapy and surgery alone or in combination in the treatment of patients with ORN.
Methods: A systematic review and analysis of literature were performed to ascertain the role of surgery and HBO in the treatment of ORN. In May 2024 we updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, Issue 1), MEDLINE, EMBASE, DORCTIHM and reference lists of articles.
Results: Among patients who underwent both HBO and surgery, the success rate of the treatment was 69% (95% Confidence Interval [CI]: 0.47-0.85, df = 9). Patients who solely received HBO had a success rate of 38% (CI: 0.20-0.61, df = 4), while those who only had surgery had a success rate of 36% (CI: 0.19-0.58, df = 3). The statistical analysis showed no significant difference in the results between patients who received only hyperbaric oxygen therapy or surgical treatment (z=0.139, p=0.889). The analysis indicated significant disparities in treatment success rates among patients receiving a combination of HBO and surgery compared to those treated solely with HBO or surgery alone (z = 2.428, p = 0.015 for HBO vs HBO+surgery, z = 2.655, p = 0.008 for surgery vs HBO+surgery).
Conclusion: The findings of this study indicate that the combination of HBO and surgery is a more effective approach for managing ORN, with better results observed when treatments are combined rather than used individually.
期刊介绍：
J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics.
Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses.
All manuscripts submitted to the journal are subjected to peer review by international experts, and must:
Be written in excellent English, clear and easy to understand, precise and concise;
Bring new, interesting, valid information - and improve clinical care or guide future research;
Be solely the work of the author(s) stated;
Not have been previously published elsewhere and not be under consideration by another journal;
Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed.
Under no circumstances does the journal guarantee publication before the editorial board makes its final decision.
The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.
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