Title: Current trends in the management of osteoradionecrosis with pentoxifylline and tocopherol
Abstract:
Osteoradionecrosis (ORN) is a devastating complication of radiotherapy, and outcomes in alteration of the appearance and function of the oral cavity and jaw that creates substantial deterioration in patient quality of life. Osteoradionecrosis can be spontaneous but primarily related to hypovascular, hypocellular, and hypoxic conditions that exist in bone. Mandibular ORN is more common when compared to maxilla. ORN incidence ranges from 2% to 22% and, in the 70% of cases, ORN occur within 3 years after radiation therapy. Several factors in the literature are interrelated with the risk of developing ORN. These include total radiation dose,
dental extractions, poor oral hygiene, tobacco, alcohol use, tumor size, location and staging. In addition to antibiotics, treatment options for osteoradionecrosis includes surgical approaches, hyperbaric oxygen therapy, and combined therapy with pentoxifylline and tocopherol, among this combined therapy with pentoxifylline and tocopherol have been newly introduced. The combined use of pentoxifylline with tocopherol (vitamin E) has been justified by a synergistic antioxidant effect. These are easily available and safe drugs. Researches have shown that this combination noticeably minimizes the chronic damages of radiation therapy. Therefore, the purpose of this paper is to discuss the definition and classifications of ORN, clinical symptoms and diagnosis, pathogenesis and risk factors, basic information on pentoxifylline and tocopherol and current reports of pentoxifylline and tocopherol combined therapy.
Audience Take Away Notes:-
- Numerous factors in the literature are associated with the risk of developing ORN. These include total radiation dose, poor oral hygiene, alcohol, tobacco use, dental extractions, tumor size, location and staging. They can be divided into three main groups :-
1. Treatment-related factors
2. Patient-related factors
3. Tumor-related factors - Osteoradionecrosis (ORN) of the jaw is one of the most severe and debilitating complicationsoftheheadandneckradiotherapy(RT).ORNincidencerangesfrom2%to 22% and, in the 70% of cases, ORN occur within 3 years after RT. The most frequent trigger event is the dental extraction.
- The purpose of this paper is to discuss the clinical symptoms and diagnosis, pathogenesis andriskfactors,basicinformationonpentoxifyllineandtocopherolandcurrentreportsof pentoxifylline and tocopherol combined therapy.
- The combined use of pentoxifylline with tocopherol (vitamin E) has been justified by a synergistic antioxidant effect. These are easily available and safe drugs.
