IADR Abstract Archives
Pentoclo combination for the treatment of osteoradionecrosis of the jaw: a systematic review.
Objectives: to evaluate the effictiveness and the safety of the combination of pentoxifylline, tocopherol or vitamin E, and clodronate in treating osteoradionecrosis (ORN) of the jaw via a systematic review.
to present the indications and limits of this combination as a conservative treatment of maxillary and mandibular ORN.
Methods: We performed a detailed search on the following electronic databases: medline/pubmed, cochrane library, google scholar, using the combination of these [MESH] words: "osteoradionecrosis" AND "pentoxifylline" AND"Tocopherol" or "vitamin E" AND "clodronate".
Articles published in french or english in the last 15 years have been retained however duplicated articles, non human studies were exclused.
Full text papers, and papers with clear abstracts have been carefully read to extract the necessary data for our review.
Data were collected according to well-defined grid including the following: design, year, sample size, treatment, follow up period, results and references.
Results: the initial search identified 42 articles, after elimination of duplicated articles and non human studies 25 articles were retained,only 20 met the inclusion criteria. There are 6 litterature reviews, 2 case reports, 4 retrospective case series study,7 prospective trial, 1 systematic review.
the average treatment administered was 400 mg twice a day of pentoxifylline and 1000 UI/ day of tocopherol, some studies added clodronate 1600 mg/day 5/7 days. Most of the authors preconised one month of antibodies, anti-inflammatory and antifungal treatment before pentoclo to minimise the inflammatoy phase.
Some patients had benefited from other treatment options during the pentoclo treatment.
the average healing process took 3 to 13 months and more than half of the patients achieved clinical improvement or total recovery.
Conclusions: This therapy has shown a favorable safety profile, efficacy and low cost especially in mild and moderate stages of ORN
Pentoxifylline and tocopherol are synergetics and have antioxidants and antifibrotic activities that reverse the radiation induced fibrosis ( a recent concept of ORN ethiopathogeny), in the most serious cases clodronate is added to pentoxifylline and tocopherol to insure bone formation.
a blind randomised trial is necessary to confirm these results.
to present the indications and limits of this combination as a conservative treatment of maxillary and mandibular ORN.
Methods: We performed a detailed search on the following electronic databases: medline/pubmed, cochrane library, google scholar, using the combination of these [MESH] words: "osteoradionecrosis" AND "pentoxifylline" AND"Tocopherol" or "vitamin E" AND "clodronate".
Articles published in french or english in the last 15 years have been retained however duplicated articles, non human studies were exclused.
Full text papers, and papers with clear abstracts have been carefully read to extract the necessary data for our review.
Data were collected according to well-defined grid including the following: design, year, sample size, treatment, follow up period, results and references.
Results: the initial search identified 42 articles, after elimination of duplicated articles and non human studies 25 articles were retained,only 20 met the inclusion criteria. There are 6 litterature reviews, 2 case reports, 4 retrospective case series study,7 prospective trial, 1 systematic review.
the average treatment administered was 400 mg twice a day of pentoxifylline and 1000 UI/ day of tocopherol, some studies added clodronate 1600 mg/day 5/7 days. Most of the authors preconised one month of antibodies, anti-inflammatory and antifungal treatment before pentoclo to minimise the inflammatoy phase.
Some patients had benefited from other treatment options during the pentoclo treatment.
the average healing process took 3 to 13 months and more than half of the patients achieved clinical improvement or total recovery.
Conclusions: This therapy has shown a favorable safety profile, efficacy and low cost especially in mild and moderate stages of ORN
Pentoxifylline and tocopherol are synergetics and have antioxidants and antifibrotic activities that reverse the radiation induced fibrosis ( a recent concept of ORN ethiopathogeny), in the most serious cases clodronate is added to pentoxifylline and tocopherol to insure bone formation.
a blind randomised trial is necessary to confirm these results.