Evaluation of the clinical effect of hyperbaric oxygen therapy (HBOT) adjunctively to scaling and root planing (SRP) in the treatment of severe case of chronic periodontitis.

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®).