PDF(Pubmed)
Abstract：
Medication-related osteonecrosis of the jaws (MRONJ) is a challenging situation in clinics. Previous studies have shown that pentoxifylline combined with tocopherol proved to be beneficial in patients with osteoradionecrosis, due to their antioxidant and antifibrotic properties. The aim of this randomized study was to evaluate the effect of pentoxifylline and tocopherol in patients that had developed MRONJ after tooth extractions. The study population consisted of 202 Stage I MRONJ female patients with an average age of 66.4 ± 8.3 years, who were divided into two groups. The test group (n = 108) received a pharmacological protocol with pentoxifylline and tocopherol (2 months pre-operatively and 6 months post-operatively). The control group (n = 94) had sequestrectomy operations without any pharmacological preparation. The main outcomes were clinical healing of the mucosa after 1 month, and clinical and radiographic healing of the bone lesion at 6 months. In the test group all patients had mucosal healing and there was only one relapse within 6 months. In the control group, in 17% of the patients the mucosa did not heal, 71% of the patients relapsed within two months, and 7% developed infectious complications (such as abscess or phlegmon). After 6 months, the control group patients with persisting issues were prescribed pentoxifylline and tocopherol, as in the test group. At a subsequent follow-up, all those patients healed completely. Patients were monitored for a period of 7.8 ± 0.3 years, during which no relapse or additional problems were reported. As a conclusion, pentoxifylline and tocopherol protocol seems to be beneficial in the management of MRONJ patients.
摘要：
药物相关的颌骨坏死（MRONJ）在临床上是一个具有挑战性的情况。以前的研究表明，己酮可可碱联合生育酚被证明对骨坏死患者有益，由于它们的抗氧化和抗纤维化特性。这项随机研究的目的是评估己酮可可碱和生育酚在拔牙后发生MRONJ的患者中的作用。研究人群包括202名I期MRONJ女性患者，平均年龄为66.4±8.3岁，他们被分成两组。测试组（n=108）接受了己酮可可碱和生育酚的药理学方案（术前2个月和术后6个月）。对照组（n=94）在没有任何药物准备的情况下进行了永久切除术。主要结果为1个月后粘膜的临床愈合，以及6个月时骨病变的临床和影像学愈合。在测试组中，所有患者的粘膜均愈合，并且在6个月内只有一次复发。在对照组中，在17％的患者中，粘膜没有愈合，71%的患者在两个月内复发，7%出现感染性并发症(如脓肿或痰)。六个月后,有持续问题的对照组患者服用己酮可可碱和生育酚，在测试组中。在随后的后续行动中，所有这些病人都完全痊愈了.对患者进行了7.8±0.3年的监测，在此期间没有报告复发或其他问题。作为结论,己酮可可碱和生育酚方案似乎对MRONJ患者的治疗有益。
