Description

Aguiar ARR, Noversa R, Queiroz I, Gaio-Lima C, Barata P, Camacho Ó. Hyperbaric Oxygen Therapy

for Medication-Related Osteonecrosis of the Jaw: Retrospective Study. Undersea Hyperb Med. 2026

Third Quarter; 53(3):495-504.

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a complication associated with

the use of different drugs, including bisphosphonates. Hyperbaric oxygen (HBO2) treatment might be

effective in this condition through multiple mechanisms, although evidence in the literature remains

limited.

Methods: A single-institutional retrospective study included patients who underwent HBO2 treatment

for MRONJ in our Unit. Data were collected at baseline and after treatment . The primary outcome

was clinical response to HBO2 treatment . Descriptive analysis was followed by paired samples tests

comparing variables before and after treatment . Univariate analyses were made to investigate possible

predictors of clinical response and relapse rate. Statistical analysis was performed using SPSS® (p < 0.05).

Results: Eighteen patients were included, mostly female, with a mean age of 60.6 ± 13.5 years. Clinical

response was observed in most patients (61.1%), with a significant decrease in MRONJ stage severity.

There was a significant decrease in pain intensity, number of oral lesions, area of bone exposure, and

orofacial inflammatory signs. Five patients relapsed after treatment , with a median time until relapse of

2.0 months. No significant predictors of clinical improvement or relapse rate were found in the univariate

analysis.

Discussion: Clinical improvement was present in most patients, as demonstrated by improvement in

disease stage. Our findings support the hypothesis that HBO2 treatment is beneficial as an adjunct in

treating MRONJ related to bisphosphonates. However, larger studies are necessary to confirm these

findings.

Keywords: bisphosphonate-associated osteonecrosis of the jaw; drug-related adverse reactions;

hyperbaric oxygen treatment; jaw diseases