Oral and Maxillofacial Indications

Purpose of Maxillofacial Surgical Indications

The jaw and oral region presents unique biological challenges for healing: bone tissue in direct contact with the oral microbiome, extensive vascularization that may be disrupted following radiotherapy or certain medications, and continuous mechanical stress from chewing.

In this demanding environment, healing and restoration of bone structures require optimal biological conditions, and inadequate oxygenation is often a major limiting factor.

Hyperbaric oxygen chamber therapy has become established in maxillofacial surgery as one of the most reliable complementary interventions for conditions associated with hypoxia in irradiated or vascularly compromised bone.

By restoring oxygenation, it restores the tissue to the biological conditions it needs to heal, integrate implants, or combat infections, always as a complement to surgical and dental care.

Key Characteristics of the Treatment

In the maxillofacial field, hyperbaric oxygen chamber therapy acts on three main levels. First, it directly improves oxygenation of bone tissue by increasing dissolved oxygen in the plasma, allowing it to reach even areas with inadequate blood supply.

It then induces neoangiogenesis through VEGF, which restores the vascular infrastructure of the affected tissue over the long term. Finally, it activates osteoblasts to promote increased bone regeneration and exerts a bactericidal effect against anaerobic pathogens that are often involved in jaw infections.

The synergy of these three effects makes hyperbaric oxygen particularly useful in situations where jaw tissue has diminished biological capacity—for example, following radiotherapy or chronic infection—and requires substantial biological support to meet therapeutic demands.

Scientific Evidence

Maxillofacial surgery is one of the fields with the strongest scientific evidence supporting the use of hyperbaric oxygen. Osteoradionecrosis of the jaw is an approved indication by the UHMS and ECHM, with a high level of supporting evidence based on established randomized studies.

For other indications—such as implants in irradiated jaws, jaw osteomyelitis, and periodontitis—the scientific evidence is steadily increasing.

In all cases, treatment is administered in close collaboration with the maxillofacial surgeon or specialized dentist, as a complement to surgical management and not as a substitute for it.