A retrospective evaluation of the efficacy of pentoxifylline and tocopherol medical therapy in the treatment of medication-related advanced osteonecrosis of the jaws

Objective: There is no standardized protocol for the treatment of medication-related osteonecrosis of the jaws (MRONJ). These patients are admitted to clinics with decreased quality of life, impaired oral functions, worsening social relations, pain and infection and may consider euthanasia. There are studies in the literature reporting favorable outcomes of pentoxifylline and tocopherol (PENTO) medical treatment for MRONJ patients. The aim of this thesis was to retrospectively evaluate the efficacy of PENTO medical therapy supporting in the treatment of medication-related advanced (American Association of Oral and Maxillofacial Surgeons- AAOMS Stage II- III) osteonecrosis of the jaws. Method: Patients diagnosed with AAOMS Stage II-III MRONJ were started on PENTO medical treatment after relevant consultations. Clinical and radiologic records were obtained. Pre-operative and post-operative records of the treated patients were evaluated clinically and radiologically. Results: Primary healing was observed in most patients and secondary healing in some. Lesions remained stable in three patients. No recurrent lesions were observed during the follow-up period. Conclusion: The obtained results indicate that the proposed approach can be considered in the treatment protocol of MRONJ that is for the benefit of patients. This study may serve as a basis for future controlled clinical trials with larger samples and aid in reaching a consensus in the ideal management of MRONJ. Key words: osteonecrosis, MRONJ, pentoxifylline, tocopherol, PENTO