Arqueros-Lemus M, Mariño-Recabarren D, Niklander S, Martínez-Flores R, Moraga V. Pentoxifylline and tocopherol for the treatment of osteoradionecrosis of the jaws. A systematic review. Med Oral Patol Oral Cir Bucal. 2023 May 1;28 (3):e293-300.

doi:10.4317/medoral.25729

https://dx.doi.org/doi:10.4317/medoral.25729


1. Marx RE. Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg. 1983;41:283-8.

https://doi.org/10.1016/0278-2391(83)90294-X

PMid:6572704 

2. Chronopoulos A, Zarra T, Ehrenfeld M, Otto S. Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings. A concise review. Int Dent J. 2018;68:22-30.

https://doi.org/10.1111/idj.12318

PMid:28649774 PMCid:PMC9378891

3. Maesschalck T, Dulguerov N, Caparrotti F, Scolozzi P, Picardi C, Mach N, et al. Comparison of the incidence of osteoradionecrosis with conventional radiotherapy and intensity-modulated radiotherapy. Head Neck. 2016;38:1695-702.

https://doi.org/10.1002/hed.24505

PMid:27240700 

4. Nabil S, Samman N. Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review. Int J Oral Maxillofac Surg. 2011;40:229-43.

https://doi.org/10.1016/j.ijom.2010.10.005

PMid:21115324 

5. D'Souza J, Lowe D, Rogers SN. Changing trends and the role of medical management on the outcome of patients treated for osteoradionecrosis of the mandible: experience from a regional head and neck unit. Br J Oral Maxillofac Surg. 2014;52:356-62.

https://doi.org/10.1016/j.bjoms.2014.01.003

PMid:24480621 

6. Kolokythas A, Rasmussen JT, Reardon J, Feng C. Management of osteoradionecrosis of the jaws with pentoxifylline-tocopherol: a systematic review of the literature and meta-analysis. Int J Oral Maxillofac Surg. 2019;48:173-80.

https://doi.org/10.1016/j.ijom.2018.08.007

PMid:30205911 

7. Lyons A, Osher J, Warner E, Kumar R, Brennan PA. Osteoradionecrosis-a review of current concepts in defining the extent of the disease and a new classification proposal. Br J Oral Maxillofac Surg. 2014;52:392-5.

https://doi.org/10.1016/j.bjoms.2014.02.017

PMid:24725905 

8. Meyer I. Infectious diseases of the jaws. J Oral Surg. 1970;28:17-26.

PMid:5262227

9. Delanian S. Late complications of radiotherapy. Physiopathological aspects of radiation-induced fibrosis. Bull Cancer Radiother. 1995;82:88-93.

https://doi.org/10.1016/0924-4212(96)80033-8

Pmid:7546899

10. Shokri T, Wang W, Vincent A, Cohn JE, Kadakia S, Ducic Y. Osteoradionecrosis of the Maxilla: Conservative Management and Reconstructive Considerations. Semin Plast Surg. 2020;34:106-13.

https://doi.org/10.1055/s-0040-1709144

PMid:32390778 PMCid:PMC7202910

11. Patel V, Gadiwalla Y, Sassoon I, Sproat C, Kwok J, McGurk M. Use of pentoxifylline and tocopherol in the management of osteoradionecrosis. Br J Oral Maxillofac Surg. 2016;54:342-5.

https://doi.org/10.1016/j.bjoms.2015.11.027

PMid:26794083 

12. Delanian S, Chatel C, Porcher R, Depondt J, Lefaix JL. Complete restoration of refractory mandibular osteoradionecrosis by prolonged treatment with a pentoxifylline-tocopherol-clodronate combination (PENTOCLO): a phase II trial. Int J Radiat Oncol Biol Phys. 2011;80:832-9.

https://doi.org/10.1016/j.ijrobp.2010.03.029

PMid:20638190 

13. Hato H, Sakata KI, Sato J, Satoh A, Hayashi T, Kitagawa Y. Clinical study of treatment methods and associated factors in mandibular osteoradionecrosis. J Oral Sci. 2021;63:289-91.

https://doi.org/10.2334/josnusd.21-0154

PMid:34092776 

14. Delanian S, Depondt J, Lefaix JL. Major healing of refractory mandible osteoradionecrosis after treatment combining pentoxifylline and tocopherol: a phase II trial. Head Neck. 2005;27:114-23.

https://doi.org/10.1002/hed.20121

PMid:15641107 

15. Delanian S, Lefaix JL. Mature bone radionecrosis: from recent physiopathological knowledge to an innovative therapeutic action. Cancer Radiother. 2002;6:1-9.

https://doi.org/10.1016/S1278-3218(01)00142-1

PMid:11899674 

16. Dissard A, P Dang N, Barthelemy I, Delbet C, Puechmaille M, Depeyre A, et al. Efficacy of pentoxifylline-tocopherol-clodronate in mandibular osteoradionecrosis. Laryngoscope. 2020;130:E559-66.

https://doi.org/10.1002/lary.28399

PMid:31747060 

17. Bohn JC, Schussel JL, Stramandinoli-Zanicotti RT, Sassi LM. Tissue repair in osteoradionecrosis using pentoxifylline and tocopherol-report of three cases. Oral Maxillofac Surg. 2016;20:97-101.

https://doi.org/10.1007/s10006-015-0522-5

PMid:26251132 

18. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10:89.

https://doi.org/10.1186/s13643-021-01626-4

PMid:33781348 PMCid:PMC8008539

19. Lo CKL, Mertz D, Loeb M. Newcastle-Ottawa Scale: comparing reviewers' to authors' assessments. BMC Med Res Methodol. 2014;14:45.

https://doi.org/10.1186/1471-2288-14-45

PMid:24690082 PMCid:PMC4021422

20. Revilla-León M, Gómez-Polo M, Vyas S, Barmak AB, Özcan M, Att W, et al. Artificial intelligence applications in restorative dentistry: A systematic review. J Prosthet Dent. 2022;128:867-75.

https://doi.org/10.1016/j.prosdent.2021.02.010

PMid:33840515 

21. Munn Z, Barker TH, Moola S, Tufanaru C, Stern C, McArthur A, et al. E. Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evid Synth. 2020;18:2127-33.

https://doi.org/10.11124/JBISRIR-D-19-00099

PMid:33038125 

22. Robard L, Louis MY, Blanchard D, Babin E, Delanian S. Medical treatment of osteoradionecrosis of the mandible by PENTOCLO: preliminary results. Eur Ann Otorhinolaryngol Head Neck Dis. 2014;131:333-8.

https://doi.org/10.1016/j.anorl.2013.11.006

PMid:24993781 

23. Hayashi M, Pellecer M, Chung E, Sung E. The efficacy of pentoxifylline/tocopherol combination in the treatment of osteoradionecrosis. Spec Care Dentist. 2015;35:268-71.

https://doi.org/10.1111/scd.12124

PMid:26084886 

24. McLeod NM, Pratt CA, Mellor TK, Brennan PA. Pentoxifylline and tocopherol in the management of patients with osteoradionecrosis, the Portsmouth experience. Br J Oral Maxillofac Surg. 2012;50:41-4.

https://doi.org/10.1016/j.bjoms.2010.11.017

PMid:21247671 

25. Patel S, Patel N, Sassoon I, Patel V. The use of pentoxifylline, tocopherol and clodronate in the management of osteoradionecrosis of the jaws. Radiother Oncol. 2021;156:209-16.

https://doi.org/10.1016/j.radonc.2020.12.027

PMid:33385466 

26. Dos Anjos RS, de Pádua GN, de Hollanda RO, Guerios LA, Tavares AA, Patel P, et al. Pentoxifylline, tocopherol, and sequestrectomy are effective for the management of advanced osteoradionecrosis of the jaws-a case series. Support Care Cancer. 2021;29:3311-7.

https://doi.org/10.1007/s00520-020-05847-6

PMid:33106977 

27. Lyons AJ, Brennan PA. Pentoxifylline - a review of its use in osteoradionecrosis. Br J Oral Maxillofac Surg. 2017;55:230-4.

https://doi.org/10.1016/j.bjoms.2016.12.006

PMid:28034471 

28. Chiao TB, Lee AJ. Role of pentoxifylline and vitamin E in attenuation of radiation-induced fibrosis. Ann Pharmacother. 2005;39:516-22.

https://doi.org/10.1345/aph.1E186

PMid:15701781 

29. Dhanda J, Pasquier D, Newman L, Shaw R. Current Concepts in Osteoradionecrosis after Head and Neck Radiotherapy. Clin Oncol (R Coll Radiol). 2016;28:459-66.

https://doi.org/10.1016/j.clon.2016.03.002

PMid:27038708 

30. Annane D, Depondt J, Aubert P, Villart M, Géhanno P, Gajdos P, et al. Hyperbaric oxygen therapy for radionecrosis of the jaw: a randomized, placebo-controlled, double-blind trial from the ORN96 study group. J Clin Oncol. 2004;22:4893-900.

https://doi.org/10.1200/JCO.2004.09.006

PMid:15520052 

31. Zhang Z, Xiao W, Jia J, Chen Y, Zong C, Zhao L, et al. The effect of combined application of pentoxifylline and vitamin E for the treatment of osteoradionecrosis of the jaws: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020;129:207-14.

https://doi.org/10.1016/j.oooo.2019.08.005

PMid:32029419 

32. McCloskey E, Paterson AH, Powles T, Kanis JA. Clodronate. Bone. 2021;143:115715.

https://doi.org/10.1016/j.bone.2020.115715

PMid:33127577