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Positive effect of pentoxifylline on medication-related osteonecrosis of the jaw

J Li1, W Wang1

  • 1Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University, Kunming 650106, China.

Journal of Stomatology, Oral and Maxillofacial Surgery
|December 22, 2019
PubMed

Insights

Medication-related osteonecrosis of the jaw (MRONJ) involves microcirculatory issues and cellular toxicity. Pentoxifylline (PTX) may improve MRONJ by enhancing blood flow, similar to its effects on osteoradionecrosis of the jaw (ORN).

Area of Science:

  • Oral and Maxillofacial Surgery
  • Pharmacology
  • Biomedical Engineering

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) pathophysiology involves microcirculatory dysfunction, direct cellular toxicity, bacterial infection, and immune dysfunction.
  • Transforming growth factor-beta (TGF-β1) pathway dysregulation is implicated in MRONJ.
  • MRONJ and osteoradionecrosis of the jaw (ORN) share histological similarities.

Purpose of the Study:

  • To explore the potential therapeutic mechanisms of drugs targeting microcirculation and signaling pathways in MRONJ.
  • To investigate the efficacy of pentoxifylline (PTX) and anti-fibrotic drugs in managing MRONJ, drawing parallels with ORN treatment.

Main Methods:

  • Comparative analysis of MRONJ and ORN pathophysiology.
  • Review of existing literature on the effects of PTX and anti-fibrotic agents on microcirculation and bone healing.
  • Discussion of the role of TGF-β1/BMP signaling in osteonecrosis.

Main Results:

  • Improving blood flow, enhancing blood supply, and regulating TGF-β1/BMP signaling are key to managing osteonecrosis of the jaw.
  • Pentoxifylline (PTX), a non-selective phosphodiesterase inhibitor (PED), significantly improves ORN microcirculation.
  • Anti-fibrotic drugs show potential preventive and therapeutic effects on MRONJ, similar to PTX's effects on ORN.

Conclusions:

  • PTX and anti-fibrotic drugs may offer therapeutic benefits for MRONJ by improving microcirculation and modulating key signaling pathways.
  • Further research is required to determine the efficacy of PTX in treating and preventing phosphorous necrosis of the jaw (PNJ).
Keywords:
Bisphosphonates(BPs)Medication-related osteonecrosis of the jaw (MRONJ)Pentoxifylline (PTX)Phosphorous necrosis of the jaw(PNJ)TGF-β1

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