Cochrane · intervention · CD003603

Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants

Esposito, M, Worthington, HV · Cochrane Database of Systematic Reviews · 2013 · Cochrane Library

Oral Health Implants and prosthodontics3 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 1 · 14.3%Ungraded 5 · 71.4%Very low 1 · 14.3%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Patients who have had radiotherapy and who have missing teeth that require replacement with osseointegrated dental implants	26 patients included (13 HBO therapy, 13 no HBO therapy); 2 patients died during healing period (1 from each group); 3 additional patients in each group died one year after overdenture placement
Intervention	Hyperbaric oxygen (HBO) therapy	HBO therapy (n=13)
Comparison	No HBO therapy	No HBO therapy (n=13)
Outcomes	Prosthesis failure if secondary to implant failure; Implant failure: mobility and removal of stable implants dictated by progressive marginal bone loss; Radiographic marginal bone level changes on intraoral radiographs taken with a parallel technique; Preimplantation complications (eustachian tube dysfunction, tympanic membrane rupture, ear or sinus or tooth pain, pneumothorax, etc.); Postimplantation complications (mucosa ulceration, osteoradionecrosis, etc.); Patient satisfaction; Cost effectiveness	Prosthetic failures (n=24); Implant failures (n=24); Preimplantation complications (n=24); Postimplantation complications (n=24); Overall denture satisfaction (n=17)
Study designs	Randomised controlled trials	Randomised controlled trial (n=1)
Timing	Not specified	One year after delivery of the prosthesis

Search date: 2013-06. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE

Questions and results

Current version only

Hyperbaric oxygen (HBO) therapy vs No HBO therapy

Population: Patients who have had radiotherapy and who have missing teeth that require replacement with osseointegrated dental implants

CD003603.PUB3 (current) · 7 questions

Outcome	Effect	Evidence	Status / GRADE
Preimplantation complications same question in other reviews	Analysis 1.1 (Dichotomous outcomes: Preimplantation complications): Risk Ratio (M-H, Fixed, 95% CI), totals not selected; not estimable (no events in either arm).	1 study · 24 participants	Ungraded
Radiographic marginal bone level changes same question in other reviews	Radiographic bone level changes (but not used since extrapolated from oblique lateral radiographs).	1 study	Ungraded
Prosthetic failure 1 year after delivery of the prosthesis same question in other reviews	RR 3.00 [0.13, 67.06] Without HBO: low-risk population 10 per 1000; high-risk population 100 per 1000 vs With HBO: low-risk population 30…	1 study · 24 participants	Very low Downgraded: risk of bias, imprecision
Patient satisfaction (overall denture satisfaction) 1 year after delivery of the prosthesis same question in other reviews	Analysis 1.2 (Overall denture satisfaction): Mean Difference (IV, Fixed, 95% CI), totals not selected (value not displayed).	1 study · 17 participants	Ungraded
Cost effectiveness same question in other reviews	Cost effectiveness data were not presented but it was possible to extrapolate this.	0 studies	No studies
Implant failure 1 year after delivery of the prosthesis same question in other reviews	RR 2.5 [0.60, 10.46]	1 study · 24 participants	Ungraded
Postimplantation complications 1 year after delivery of the prosthesis same question in other reviews	RR 5.0 [0.27, 94.34]	1 study · 24 participants	Ungraded

Hyperbaric oxygen (HBO) therapy vs No HBO therapy

Population: Patients who have had radiotherapy and who have missing teeth that require replacement with osseointegrated dental implants

CD003603.PUB2 · 7 questions

Outcome	Effect	Evidence	Status / GRADE
Preimplantation complications	Analysis 1.3 (Preimplantation complications): Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0] (not estimable; no events in either arm).	1 study · 24 participants	Ungraded
Radiographic marginal bone level changes	Radiographic bone level changes: data presented, but not used since extrapolated from oblique lateral radiographs.	1 study	Ungraded
Cost effectiveness	Cost effectiveness: data not presented but possible to extrapolate.	0 studies	No studies
Implant failure 1 year after delivery of the prosthesis	RR 2.5 [0.60, 10.46]	1 study · 24 participants	Ungraded
Postimplantation complications 1 year after delivery of the prosthesis	RR 5.0 [0.27, 94.34]	1 study · 24 participants	Ungraded
Prosthetic failure 1 year after delivery of the prosthesis	RR 3.00 [0.13, 67.06]	1 study · 24 participants	Ungraded
Patient satisfaction (overall denture satisfaction) 1 year after delivery of the prosthesis	SMD -0.44 [-1.41, 0.53]	1 study · 17 participants	Ungraded

Hyperbaric oxygen (HBO) therapy vs No HBO therapy

Population: Patients who have had radiotherapy and who have missing teeth that require replacement with osseointegrated dental implants

CD003603 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR	No randomised controlled trials were identified. No data were available.	0 studies	No studies