Esposito

Little evidence available to assess the effect of hyperbaric oxygen therapy for dental implants into irradiated tissue

Clinical bottom line: 1. Only one small study found, so no meta-analysis possible.  2. HBOT may not offer any appreciable clinical benefits.

 

Citation/s: 1. Esposito M, Worthington HV. Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants. Cochrane Database of Systematic Reviews 2013, Issue 9. Art No.: CD003603. DOI: 10.1002/14651858.CD003603.pub3

2. Esposito M, Grusovin MG, Patel S, Worthington HV, Coulthard P. Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD003603

Lead author's name and fax: Marco Esposito, Cochrane Oral Health Group, espositomarco@hotmail.com

Three-part Clinical Question:For previously irradiated patients requiring dental implants, does HBOT therapy around the time of implant, compared to no specific intervention, result in an increase in successful implantation rate or a reduction in adverse outcomes?

Search Terms: Radiotherapy; dental implants

The Review:

Data Sources: : Cochrane Library, Medline, Embase, Authors of the review also wrote to RCT author, oral implant manufacturers, personal contacts and an internet discussion group (implantology@yahoogroups.com)

Study Selection: All RCTs enrolling patients having osseointegrated dental implants into an irradiated area and which compare HBOT to no HBOT.

Data Extraction: Data independently extracted by two reviewers. Any dispute adjudicated by third reviewer. Extracted patient details, type of intervention and outcomes of interest.

The Evidence:

Outcome	Time to Outcome	Typical Control Event Rate	Typical Odds Ratio	Relative Risk Reduction	NNT
Prosthetic failure	1 year	0	3.00
95% CI:			0.13 to 67.06
Implant failures	1 year	0.167	2.50	-100%	-6
95% CIs:			0.60 to 10.46		17 to -2
Postimplantation complications	1 year	0	5.0
95% CIs:			0.27 to 94.34

 

Comments:

1. Only 24 randomized patients contributed to this review from a single small study.

2. The outcome assessors were not blinded so this domain was assessed as high risk of bias

3. One patient who lost all implants was excluded from the analysis so this domain was assessed as at unclear risk of bias.

4. This SR has added little information but helps to define a more definitive study.

5. This is one of a series of systematic reviews of interventions for these patients

Appraised by:Vincenzo Zanon c/o Servizio OTI - Istituto Clinico Città di Brescia degli Istituti Ospedalieri Bresciani, SpA - GSD 15, Via Gualla -- 25128 Brescia ITALY Fax: +39-030-37.10.357; Sat, July 09th 2016

Email: vincenzo.zanon@gmail.com

Kill or Update By: December 2020