Periodontal Treatment Associated With Hyperbaric Oxygen Therapy

Materials and Methods: In 20 patients diagnosed with severe generalized chronic periodontitis (pockets>7mm) with bleeding on probing, SRP was rendered in all pockets. Additionally, five consecutive hyperbaric sessions were administered in 10 patients after random allocation (SRP+HBOT). Clinical parameters were assessed at baseline up to 6 months: plaque index (PI), bleeding on probing, probing depth, clinical attachment level and BANA test.

Results: SRP+HBOT resulted in greater probing reduction and attachment gain than SRP alone 3 months after treatment (p<0.001). The BANA test was negative after 1 week only for sites in the SRP+HBOT group (p<0.05). However SRP+HBOT failed to show a significant difference from SRP group after 3 months were all BANA sites became negative (p>0.05).

Conclusion: These preliminary data suggest that hyperbaric oxygen therapy had a short-term beneficial effect on pocket reduction and bacterial elimination, and may be considered a potential therapy option to improve the clinical outcomes of scaling in severe cases of chronic periodontitis.

Inclusion criteria

• This preliminary (pilot) study was designed with twenty subjects (12 men, 8 women, mean age 37.3 years) selected from a pool of 360 patients referred to the Periodontal Clinic of the School of Dentistry at Bahian Science Foundation (FBDC, Bahia, Brazil).
• The patients had an initial diagnosis of severe generalized chronic periodontitis (AAP 1999).

Exclusion criteria

• Patients were excluded according to the following criteria:

• smoking
• pregnancy or lactation
• antibiotics or periodontal treatment within the last 6 months
• a diagnosis of aggressive periodontitis
• trauma from occlusion or endodontic lesions
• According to an accurate clinical examination performed by a hyperbaric medical doctor (MD), the HBOT contra-indications (Iazzeti & Mantovani 1998) served as exclusion criteria.
• The only absolute contraindication to hyperbaric oxygen therapy was from patients with untreated pneumothorax
• Relative contraindications were considered:

• upper respiratory infections
• high fevers
• emphysema with CO2 retention
• historic of thoracic surgery
• malignant disease and middle ear barotrauma
• Patients taking or have recently taken the following drugs:

• doxorubicin (Adriamycin®)
• disulfiram (Antabuse®)
• Cis-platinum and mafenide acetate (Sulfamylon®).