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How Hyperbaric Oxygen Therapy can help Osteoradionecrosis patients

Cancer | Published: March 14th 2019, 12:51PM

Combining the Marx Protocol with surgery to help patients heal better


Hyperbaric oxygen therapy is approved by the FDA to treat many medical conditions. Additionally, HBOT is approved by Medicare to treat several conditions, including Osteoradionecrosis.


What is Osteoradionecrosis?

Osteoradionecrosis (meaning ‘bone death due to radiation’) is caused by radiation therapy to the bone. It can occur in patients who have had radiation therapy for head and neck cancers.

Osteoradionecrosis may develop months or years after radiation therapy and usually occurs in the lower jaw, also known as the mandible. It can occur spontaneously or as a result of tissue injury, most commonly when the patient undergoes a dental procedure (such as having a tooth pulled) or other surgery involving the jawbone.

Symptoms include mouth pain, jaw swelling and difficulty opening the mouth fully.

Treatment options include antibiotics, if there is an infection in the bone, and in some cases surgery may be necessary.[1]


How can hyperbaric oxygen therapy help Osteoradionecrosis patients?

Hyperbaric oxygen therapy works by increasing the amount of oxygen in the affected tissues to improve the chance of successful healing.

In the case of Osteoradionecrosis, hyperbaric oxygen therapy is often used before and after surgery to help with healing and to reduce the risk of complications. HBOT can also help reduce the swelling, discomfort and pain often associated with Osteoradionecrosis.


Hyperbaric oxygen therapy to prevent Osteoradionecrosis

Hyperbaric oxygen therapy can also be administered to prevent the condition from occurring in the first place.

Many dentists request HBOT as a mandatory requirement for at-risk patients before tooth extractions and other dental procedures.


What is the Marx Protocol?

Dr. Robert Marx, DDS is credited with developing an internationally recognized hyperbaric protocol, known as the Marx Protocol, for the treatment of Osteoradionecrosis.

As a world-renowned oral and maxillofacial surgeon specializing in benign and malignant tumor surgery and reconstructive surgery, Dr. Marx found that adding hyperbaric treatment pre- and post-surgery helped significantly improve outcomes for his Osteoradionecrosis patients.

Dr. Marx found that Osteoradionecrosis patients who had hyperbaric oxygen therapy before and after surgery showed:

  • Less post-surgical complications
  • Enhanced wound healing via the inhibition of growth or reproduction of bacteria
  • Enhanced wound healing through stimulation of vascular growth in the diseased bone and mucosa.

Since the publication of his research, the Marx Protocol has become a recognized standard for treating Osteoradionecrosis. There are many recent scientific studies that support his findings.

One study in particular, authored by Frans J Cronjé, MBChB(UP), MSc of Stellenbosch University found that “more than 95 per cent of patients can be successfully cured of their disease with predictable, functional and aesthetically acceptable outcomes.”[2]

Overall, patients who undergo the Marx Protocol expedite their healing and reduce or eliminate the pain of Osteoradionecrosis. It can also be used to prevent the condition from occurring in the first place after tooth extractions and other dental procedures in at-risk patients.


How we treat patients with Osteoradionecrosis

At Hyperbaric Healing Treatment Center, we use the Marx protocol to help our Osteoradionecrosis patients heal.

We’re honored to work with Dr. Robert Marx himself to assist in the healing of his Osteoradionecrosis patients from the Department of University of Miami Health System.



If you’d like to learn more about how hyperbaric oxygen therapy can help with Osteoradionecrosis, feel free to contact our office. Our qualified team will be happy to discuss any questions you may have.

For more information about how hyperbaric oxygen therapy can help with other medical conditions, you can visit our research library.


Ready to schedule an appointment? Call our office at (407) 530-0710 or get in touch on our Contact page.



1 – Canadian Cancer Society

2 – Journal of the South African Dental Association: “A Review of the Marx Protocols: Prevention and Management of Osteoradionecrosis by Combining Surgery and Hyperbaric Oxygen Therapy”

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