Stage I disease represents small, superficial, localized bone
resorption with cutaneous or mucosal dehiscence. Early stage
ORN is approached conservatively with local wound care (oral
rinses), HBO therapy for 20 dives,36 and antibiotic therapy to quell
the super-infection that is often present. If patients show definitive
improvement, an additional 10 dives of HBO is given to allow for
additional healing of the surrounding soft tissue. Patients that do
not show signs of healing undergo a trans-oral debridement and
additional HBO therapy. This approach of 20/10 differs from Marx’s
protocol where a 30/10 protocol is recommended.