Tratamento e prevenção da osteorradionecrose e osteonecrose dos maxilares induzida por medicamentos: implementação do protocolo pento/pentoclo

Abstract

Osteoradionecrosis of the jaw (ORN) and medication-related osteonecrosis of the jaw (MRONJ) are serious complications associated with head and neck radiotherapy and the use of antiresorptive drugs or angiogenesis inhibitors, respectively. Recently, based on the understanding of the pathophysiology of ORN and MRONJ, the use of drug protocols such as PENTOCLO (pentoxifylline, tocopherol, and clodronate) and PENTO (pentoxifylline and tocopherol) for the treatment and prevention of these conditions has been proposed. The aim of this study was to perform a narrative review of the literature on the use of the PENTO/PENTOCLO protocol in the treatment and prevention of ORN and MRONJ. Retrospective, prospective, randomized clinical studies and case series reports published between 2010 and 2023 were included. The databases used for the search were PubMed, SciELO, Elsevier, and Biblioteca Virtual em Saúde, focusing on articles in English and Portuguese. Simple literature reviews and case reports were excluded. It is concluded that the PENTO/PENTOCLO protocol appears as a promising option, characterized by its simplicity and accessibility in treatment. Despite the positive preliminary results, it is essential to carry out additional studies, especially multicenter ones, for the definitive validation of the protocol and its large-scale implementation in health services.