Retrospective audit of the use of the Marx Protocol for prophylactic hyperbaric oxygen therapy in managing patients requiring dental extractions following radiotherapy to the head and neck

N Z Dent J. 2009 Jun;105(2):47-50.


Objective: The study's primary objective was to review (for the years 2003 to 2006) the outcomes of using prophylactic hyperbaric oxygen therapy (HBOT) to prevent osteoradionecrosis (ORN) in a group of patients previously exposed to radiotherapy of the head and neck. A secondary objective was to evaluate any HBOT-associated vision changes.

Design: The study was a retrospective audit of the clinical outcomes of HBOT for the prevention of ORN following dental extractions in previously irradiated jaws.

Methods: Information was obtained from dental records held at Green Lane Clinical Centre (Auckland) and Oxygen Therapies Ltd (Quay Park Health, Auckland). Data included patient age, gender, site of tumour, radiation dose, time lapse between radiotherapy and tooth/teeth extracted, extraction procedures and the HBOTprotocol used. Follow-up data were obtained through a telephone interview using a standardised questionnaire.

Results: Of the 29 treated patients, 26 (90%) were available for follow-up. Of these, one failed to heal after dental extractions following the use of prophylactic HBOT, and only nine (34%) developed temporary vision changes.

Conclusion: The outcome of this audit suggests that it is appropriate to use prophylactic HBOT in association with dental extractions in patients who have previously had radiotherapy to the head and neck. Acute vision changes following the 30th HBOT were transient.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / radiotherapy
  • Cranial Irradiation / adverse effects*
  • Dental Audit
  • Female
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Hyperbaric Oxygenation / adverse effects
  • Hyperbaric Oxygenation / statistics & numerical data*
  • Male
  • Maxillary Diseases / etiology
  • Maxillary Diseases / prevention & control*
  • Middle Aged
  • Osteoradionecrosis / etiology
  • Osteoradionecrosis / prevention & control*
  • Preoperative Care
  • Retrospective Studies
  • Surveys and Questionnaires
  • Tooth Extraction*
  • Vision Disorders / etiology
  • Young Adult