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Updated: Aug 7, 2025
Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
Can the prophylactic use of pentoxifylline and tocopherol before dental extractions prevent osteoradionecrosis? A
Gustavo Luiz Alkmin Paiva1, Wladimir Gushiken de Campos2, André Caroli Rocha3
1Oral Diagnosis Department, Piracicaba Dental School University of Campinas, Piracicaba, Brazil.
Purpose:
This systematic review aimed to determine whether the pentoxifylline and tocopherol (PENTO) protocol effectively reduce the risk of osteoradionecrosis (ORN) in patients undergoing tooth extraction after head and neck radiotherapy.
Methods:
We searched PubMed, SCOPUS, LILACS, EMBASE, Web of Science, and Cochrane databases up to August 2022. We considered only studies that included patients diagnosed with head and neck cancer undergoing tooth extraction with PENTO prophylaxis after radiotherapy.
Results:
Of the 642 studies identified, 4 were included. Across the included studies, 387 patients had 1871 teeth extracted while on PENTO prophylaxis. The interval of the PENTO protocol differed among the studies included. Overall, a total of 12 (3.1%) patients had ORN, whereas at the individual tooth level analysis the ORN rate was 0.9%.
Conclusions:
Insufficient evidence exists to promote using the PENTO protocol before dental extractions to prevent ORN.
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