Original Article Oral and Maxillofacial Surgery|Articles in Press

The use of liquid formulation pentoxifylline and vitamin E in both established and as a prophylaxis for dental extractions ‘at risk’ of osteoradionecrosis

Published:February 24, 2023DOI:



      Osteoradionecrosis (ORN) of the jaws remains one of the most debilitating complications of radiotherapy (RT) in head and neck cancer (HNC) patients. Liquid pentoxifylline and vitamin E (PVe) presents an alternative formulation to tablets for patients presenting with dysphagia or enteric feeding


      The purpose of this study was to assess the clinical outcomes for the use of a liquid formulation of PVe for both established ORN and as a prophylaxis to avoid its occurrence following dental extractions. A secondary objective was to determine patient-reported side effects in relation to the liquid formulation of PVe

      Study design

      Clinical records of 111 HNC patients who were prescribed liquid PVe were reviewed retrospectively (66 with established ORN and 45 as a prophylaxis prior to an invasive dental procedure)


      In established ORN, 44% healed and 41% were stable. In the prophylaxis group, 96% of surgical sites healed completely with 4% (n = 2) developing ORN.Most patients (89%) were able to tolerate liquid PVe. Of the 11% (n =12) who were unable to tolerate this regime, the most common reported side effect was gastric irritation (n=5/12) while dizziness, malaise and bleeding was reported by no more than one patient


      This retrospective review suggests that liquid PVe is efficacious for both established ORN and as a prophylaxis. Side effects reported were similar to those recognised for the tablet formulation.
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