Hyperbaric oxygen therapy for the treatment of moderate to severe periodontitis: a clinical pilot study

Undersea Hyperb Med. 2020 Fourth Quarter;47(4):571-580. doi: 10.22462/10.12.2020.6.


Objectives: To clinically and microbiologically evaluate the effects of hyperbaric oxygen (HBO2) therapy in addition to full-mouth ultrasonic subgingival debridement (FM-UD), in the initial treatment of chronic periodontitis.

Methods: Twenty patients presenting moderate to severe generalized forms of chronic periodontitis were included in a three-month randomized, parallel-group, single-blinded, prospective study. At baseline patients were randomly assigned to two treatment groups [Test Group (FM-UD+HBO2) and Control Group (FM-UD)]. Both groups were treated with an FM-UD session. Ten HBO2 sessions (one session per day for 10 days at a pressure of 2.5 ATA) were additionally administered to the Test Group. Soft tissues parameters [probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL) and visible plaque index (VPI)] were assessed at baseline (immediately before FM-UD treatment), after two weeks, after six weeks and at three months. For each patient, a site presenting PPD ≥ 6mm and positive BOP was selected as a qualifying site (QS), to be monitored clinically (at T0, T1, T2 and T3) and microbiologically (at T0, T1 and T3).

Results: There were no statistically significant differences between the two groups for any clinical parameter analyzed after three months, except for BOP, which was significantly (p < 0.05) reduced in the Test Group. Reductions in bacterial levels were detected in both groups after therapy. Faster bacterial recolonization occurred after three months in the Control Group.

Conclusion: HBO2 therapy in combination with FM-UD may represent an efficacious approach to the treatment of moderate to severe forms of periodontitis.

Keywords: hyperbaric oxygen therapy; periodontitis; ultrasonic debridement.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Chronic Periodontitis / microbiology
  • Chronic Periodontitis / therapy*
  • Combined Modality Therapy / methods
  • Female
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Male
  • Middle Aged
  • Periodontal Debridement / methods*
  • Pilot Projects
  • Porphyromonas gingivalis / isolation & purification
  • Prospective Studies
  • Single-Blind Method
  • Tannerella forsythia / isolation & purification
  • Treponema denticola / isolation & purification
  • Ultrasonic Therapy / methods
  • Young Adult