Effect of Hyperbaric Oxygen on Non-Grafted and Grafted Calvarial Critical-sized Defects

Objectives: The purpose of this study was to evaluate whether the effects of hyperbaric oxygen (HBO) therapy could alter the critical size defect (CSD) diameter and to evaluate the effect of HBO on the repair of CSD in the presence and absence of a non-vascularized autogenous bone graft (ABG). Study Design: Twenty rabbits were divided in two groups of ten animals each. CSD were created in the parietal bones bilaterally. Defects were critical-sized, 15 mm on one side and supracritical-sized, 18 mm on the contralateral side. Group 1 received a 90-min HBO treatment sessions at 2.4 absolute atmospheric pressure (ATA) for 90 minutes per day for 20 days. Group 2 served as a normobaric roomair control (NBO). Additional ten animals were divided into 2 groups of 5 animals each. Bilateral CSD were created. ABG were allocated to one side of each calvarium. Group 1 received HBO treatments. Group 2 served as NBO. After sacrifice, data were collected including qualitative assessment, radiographic analysis, Micro CT bone analysis and histomorphometric analysis. ANOVA and paired sample t test were used for statistical analysis. Results: Both radiographic analysis and histomorphometric analysis demonstrated more new bone in the HBO CSD (p<.001). Micro CT analysis indicated a higher bone mineral content (BMC) in ABG CSD (p<.05). Histologically, complete bridging of the defect was observed in ABG defects. Histomorphometric analysis showed that HBO treatment increased new bone and marrow and reduced fibrous tissue in the defects (p<.01 for all). Conclusion: Bone regeneration was significantly greater in the HBO animals regardless of the defect size. HBO may have changed the accepted diameter of CSD to more than 18 mm. HBO enhances bony healing in non-grafted CSD.MAS