Can the prophylactic use of pentoxifylline and tocopherol before dental extractions prevent osteoradionecrosis? A systematic review.

Gustavo Luiz Alkmin Paiva, Wladimir Gushiken de Campos, André Caroli Rocha, Celso Augusto Lemos Júnior, Cesar Augusto Migliorati, Alan Roger Dos Santos Silva

Journal: Oral surgery, oral medicine, oral pathology and oral radiology 2023;136(1):33-41

PMID: 36882364

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Abstract

PURPOSE

This systematic review aimed to determine whether the pentoxifylline and tocopherol (PENTO) protocol effectively reduce the risk of osteoradionecrosis (ORN) in patients undergoing tooth extraction after head and neck radiotherapy.

METHODS

We searched PubMed, SCOPUS, LILACS, EMBASE, Web of Science, and Cochrane databases up to August 2022. We considered only studies that included patients diagnosed with head and neck cancer undergoing tooth extraction with PENTO prophylaxis after radiotherapy.

RESULTS

Of the 642 studies identified, 4 were included. Across the included studies, 387 patients had 1871 teeth extracted while on PENTO prophylaxis. The interval of the PENTO protocol differed among the studies included. Overall, a total of 12 (3.1%) patients had ORN, whereas at the individual tooth level analysis the ORN rate was 0.9%.

CONCLUSIONS

Insufficient evidence exists to promote using the PENTO protocol before dental extractions to prevent ORN.

Address: Oral Diagnosis Department, Piracicaba Dental School University of Campinas, Piracicaba, Brazil.; Department of Oral Medicine, School of Dentistry, University of São Paulo, São Paulo, Brazil.; Department of Oral and Maxillofacial Surgery, Clinics Hospital, University of São Paulo, São Paulo, Brazil.; Department of Oral & Maxillofacial Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA.; Oral Diagnosis Department, Piracicaba Dental School University of Campinas, Piracicaba, Brazil. Electronic address: [email protected].

DOI: 10.1016/j.oooo.2023.01.005

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MeSH Terms: Humans, Tocopherols, Pentoxifylline, Osteoradionecrosis, Head and Neck Neoplasms, Tooth Extraction, Retrospective Studies