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The effects of pentoxifylline and tocopherol in jaw osteomyelitis

대한구강악안면외과학회지 2020년 46권 1호 p.19 ~ 27
서미현 ( Seo Mi-Hyun ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery

어미영 ( Eo Mi-Young ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
명훈 ( Myoung Hoon ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
김성민 ( Kim Soung-Min ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
이종호 ( Lee Jong-Ho ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery

Abstract


Objectives: Pentoxifylline (PTX) is a methylxanthine derivative that has been implicated in the pathogenesis of peripheral vessel disease and intermittent lameness. The purpose of this study was to investigate the effect of PTX and tocopherol in patients diagnosed with osteoradionecrosis (ORN), bisphosphonate-related osteonecrosis of the jaw (BRONJ), and chronic osteomyelitis using digital panoramic radiographs.

Materials and Methods: This study was performed in 25 patients who were prescribed PTX and tocopherol for treatment of ORN, BRONJ, and chronic osteomyelitis between January 2014 and May 2018 in Seoul National University Dental Hospital. Radiographic densities of the dental panorama were compared prior to starting PTX and tocopherol, at 3 months, and at 6 months after prescription. Radiographic densities were measured using Adobe Photoshop CS6 (Adobe System Inc., USA). Blood sample tests showing the degree of inflammation at the initial visit were considered the baseline and compared with results after 3 to 6 months. Statistical analysis was performed using the Mann?Whitney test and repeated measurement ANOVA using IBM SPSS 23.0 (IBM Corp., USA).

Results: Eight patients were diagnosed with ORN, nine patients with BRONJ, and the other 8 patients with chronic osteomyelitis. Ten of the 25 patients were men, average age was 66.32±14.39 years, and average duration of medication was 151.8±80.65 days (range, 56-315 days). Statistically significant increases were observed in the changes between 3 and 6 months after prescription (P<0.05). There was no significant difference between ORN, BRONJ, and chronic osteomyelitis. Only erythrocyte sedimentation rate (ESR) was statistically significantly lower than before treatment (P<0.05) among the white blood cell (WBC), ESR, and absolute neutrophil count (ANC).

Conclusion: Long-term use of PTX and tocopherol can be an auxiliary method in the treatment of ORN, BRONJ, or chronic osteomyelitis in jaw.

키워드

Pentoxifylline; Tocopherols; Panoramic radiography; Osteomyelitis
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