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

Published:January 19, 2023DOI:https://doi.org/10.1016/j.oooo.2023.01.005
Can the prophylactic use of pentoxifylline and tocopherol prior to dental extractions prevent osteoradionecrosis? A systematic review
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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, four 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 osteoradionecrosis.

      Keywords

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      Article info

      Publication history

      Accepted: January 12, 2023
      Received in revised form: January 4, 2023
      Received: November 1, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Disclosures/Conflict of Interest:

      The authors declare that they have no conflict of interest.

      AUTHOR CONTRIBUTIONS:

      Each author participated sufficiently in the work to take public responsibility for appropriate portions of the content.

      Study conception and design:

      André Caroli Rocha, Gustavo Luiz Alkmin Paiva and Alan Roger dos Santos Silva

      Acquisition of data:

      Gustavo Luiz Alkmin Paiva (first reviewer), Wladimir Gushiken de Campos (second reviewer) and André Caroli Rocha (third reviewer)

      Drafting of manuscript:

      Gustavo Luiz Alkmin Paiva and Wladimir Gushiken de Campos

      Critical revision:

      Celso Augusto Lemos Júnior, André Caroli Rocha, Cesar Augusto Migliorati and Alan Roger dos Santos Silva

      This article was written at Piracicaba dental School (Oral Diagnosis department), University of Campinas, Piracicaba/São Paulo, Brazil.

      Funding sources:

      none

      Identification

      DOI: https://doi.org/10.1016/j.oooo.2023.01.005

      Copyright

      © 2023 Elsevier Inc. All rights reserved.

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