Nogueira-Filho
Some evidence that adjunctive HBOT improves outcome in severe chronic periodontitis at three months.
| 1. No difference at three months in the plaque index or proportion of sites bleeding on probing. 2. Significantly improved mean probing depth and clinical attachment level at three months |
Citation: Nogueira-Filho GR, Rosa BT, David-Neto JR. 3. Effects of hyperbaric oxygen therapy on the treatment of severe cases of periodontitis. UHM 2010;37(2):107-113.
Lead author's name and fax: Getulio Nogueira-Filho nogueira@cc.umanitoba.ca Three-part Clinical Question: For patients with severe periodontitis, does the adjunctive use of hyperbaric oxygen compared to standard therapy with scaling and root planing only, result in any improvement in outcome?
Search Terms: periodonitis, chronic severe; hyperbaric oxygen
The Study: Single-blinded concealed randomised controlled trial with intention-to-treat.
The Study Patients: Adult patients with severe, generalised, chronic periodontitis diagnosed with more than 30% of sites affected Control group (N = 10; 10 analysed): Standard treatment for periodontitis including scaling and root planing at five visits up to three months. Experimental group (N = 10 ; 10 analysed): As above, plus twice daily HBOT for five days. Each session 72 minutes at 2.4ATA breathing 100% oxygen.
The Evidence:
| Outcome | Standard Group | HBO Group | Difference | 95% CI | ||
| Mean | SD | Mean | SD | ^ | ^ | |
| Probing depth (mm) at 3 months | 5.5 | 1.1 | 3.7 | 1.3 | 1.8 | 0.64 to 2.9 |
| Clinical attachment level (mm) at 3 months | 5.7 | 1.5 | 3.8 | 1.4 | 1.9 | 0.57 to 3.3 |
| Non-Event Outcomes | Time to outcome/s | Control group | Experimental group | P-value |
| Plaque index (PI) | 3 months | 45.2% | 32.2% | >0.05 |
| Bleeding on probing (BoP) | 3 months | 28.3% | 18.7% | >0.05 |
Comments:
1. Pilot study only, no sample size calculations made. Only 20 of 360 patients were eligible - most did not meet the inclusion criteria.
2. The clinical importance of these findings is not clear. The plaque index has not been explained.
3. Improvements in probing depth and clinical attachment level may reflect improved fibroblast activity and bacterial killing.
4. This trial only measured short-term effects and more work is necessary.
Appraised by: Mike Bennett, Prince of Wales Hospital ; Monday, 14 July 2014 Email: m.bennett@unsw.edu.au
Kill or Update By: July 2017
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