Pentoxifylline, tocopherol, and clodronate for the treatment of mandibular osteoradionecrosis: a systematic review.

Objective: The purpose of this study was to evaluate the healing benefit provided by the antioxidant and antifibrotic properties of pentoxifylline-tocopherol or pentoxifylline-tocopherol-clodronate in combination therapy for osteoradionecrosis.

Study Design: We searched for relevant reports in PubMed by using a combination of "osteoradionecrosis" and the following keywords: "pentoxifillyne," "tocopherol," "vitamin E," or "clodronate." We considered articles in English or Spanish, with no limitations on the publication date.

Results: The combination of pentoxifylline plus tocopherol with or without clodronate was found to be effective for the treatment of mandibular osteoradionecrosis, although data were generally scarce and mostly came from retrospective case series.

Conclusions: This drug therapy is well tolerated and could be promising for the treatment of mandibular osteoradionecrosis, but prospective randomized controlled clinical trials are needed for further clarification.