title: Prophylactic use of pentoxifylline and tocopherol in patients who require dental extractions after radiotherapy for cancer of the head and neck.
abstract: Osteoradionecrosis (ORN) is a complication seen intermittently in patients who have had radiotherapy to the head and neck, and results of treatment with pentoxifylline and tocopherol (PVe) have been encouraging. As a consequence, some argue that this should be used prophylactically to lower the risk of ORN after dental extractions in this group. We retrospectively analysed data on 390 dental extractions in 82 patients who had had radiotherapy for cancer of the head and neck. Each had been given PVe prophylactically. Only one patient (1.2%) developed ORN (rate/tooth 0.26%). Patients had taken PVe for a mean (SD) of 11 (23) weeks preoperatively and 13.6 (18) weeks postoperatively. The incidence we found was lower than that normally associated with dental extractions in irradiated patients (7%).
authors.affiliation: Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Vinod.Patel@hotmail.co.uk.
authors.forename: Vinod
authors.initials: V
authors.lastname: Patel
authors.affiliation: Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: yusuf.gadiwalla@nhs.net.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Gadiwalla
authors.affiliation: Department of Informatics, King's College London, Strand, London WC2R 2LS. Electronic address: isabel.sassoon@kcl.ac.uk.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sassoon
authors.affiliation: Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Chris.Sproat@gstt.nhs.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Sproat
authors.affiliation: Oral Surgery Dept, Floor 23, Guys Dental Hospital, London Bridge, London, SE1 9RT. Electronic address: Jerry.Kwok@gstt.nhs.uk.
authors.forename: Jerry
authors.initials: J
authors.lastname: Kwok
authors.affiliation: Department of Oral and Maxillofacial Surgery, Atrium 3, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT. Electronic address: Mark.mcgurk@kcl.ac.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: McGurk
mesh_terms: D006258:Head and Neck Neoplasms / Q000150:complications / Q000532:radiotherapy*; D006801:Humans; D009333:Neck; D010025:Osteoradionecrosis / Q000188:drug therapy*; D010431:Pentoxifylline / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011878:Radiotherapy; D024505:Tocopherols / Q000627:therapeutic use*; D014081:Tooth Extraction
chemical_list: D010975:Platelet Aggregation Inhibitors; D024505:Tocopherols; D010431:Pentoxifylline
keywords: Dental extractions; Osteoradionecrosis; Pentoxifylline; Tocopherol