Management of bisphosphonate-associated osteonecrosis: pentoxifylline and tocopherol in addition to antimicrobial therapy. An initial case series.
BACKGROUND
Studies of the use of pentoxifylline and α-tocopherol in osteoradionecrosis of the jaw have suggested their efficacy in this condition. We report an initial case series of pentoxifylline and α-tocopherol for patients with bisphosphonate-associated osteonecrosis (BON).


METHODS
Six cases referred for management of BON were provided pentoxifylline and α-tocopherol in addition to antimicrobial therapy, and followed for a mean of 10 months.


RESULTS
A 74% decrease in area of bony exposure and symptom control was achieved in these cases.


CONCLUSIONS
Pentoxifylline with α-tocopherol may represent a strategy for management of BON. Controlled trials in cases of BON appear warranted.
Epstein
Matthew S
MS
University of Washington, Seattle, WA, USA.
Wicknick
Fredrick W
FW
Epstein
Joel B
JB
Berenson
James R
JR
Gorsky
Meir
M
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002710:Chlorhexidine / Q000627:therapeutic use; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D007571:Jaw Diseases / Q000139:chemically induced / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D010020:Osteonecrosis / Q000139:chemically induced / Q000188:drug therapy*; D010431:Pentoxifylline / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000627:therapeutic use*
D000891:Anti-Infective Agents, Local; D000975:Antioxidants; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D016166:Free Radical Scavengers; D009067:Mouthwashes; D010726:Phosphodiesterase Inhibitors; D024502:alpha-Tocopherol; D002710:Chlorhexidine; D010431:Pentoxifylline