The efficacy of pentoxifylline/tocopherol combination in the treatment of osteoradionecrosis.

Background Osteoradionecrosis (ORN) is an unfortunate complication of radiation therapy to the head and neck. Treatment has historically centered around hyperbaric oxygen therapy and surgical removal of necrotic bone. Recently, a new theory on the pathogenesis of ORN has proposed treatment with pentoxifylline (PTX) and tocopherol/vitamin E. The aim of this retrospective analysis was to evaluate the effectiveness of pentoxifylline and tocopherol in the management of patients with ORN. Methods The hospital dentistry group managed 13 patients that presented to our service with exposed bone after cancercidal doses of radiation to the head and neck. The patients were prescribed PTX 400 mg bid and tocopherol 1,000 IU QD. Results Eleven of the 13 patients exhibited improvement and resolution. No adverse events were noted during treatment. Conclusion This medical modality of treating ORN appears safe and effective, inducing bone and mucosal healing.