Preventive Effect of Phosphodiesterase Inhibitor Pentoxifylline against Medication-Related Osteonecrosis of the Jaw: An Animal Study

Publication date: Available online 26 April 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Gül Merve Yalcin-Ulker, Alev Cumbul, Gonca Duygu-Capar, Ünal Uslu, Kemal Sencift
PurposeThe aim of this experimental study is to investigate the prophylactic effect of pentoxifylline (PTX) on medication- related osteonecrosis of the jaw (MRONJ).MethodsFemale Sprague-Dawley rats (n=33) received zoledronic acid (ZA) for 8 weeks to create osteonecrosis model. The left mandibular second molar teeth were extracted and the recovery period lasted 8 weeks before sacrification. PTX was intraperitoneally administered to prevent MRONJ. The specimens were histopathologically and histomorphometrically evaluated.ResultsHistomorphometrically, between control group and group ZA there was no statistically significant difference in total bone volume (p=0.999); but statistically significant difference in bone ratio in the extraction sockets (p<0.001). A comparison of the bone ratio of ZA group with ZA/PTX group (PTX administered after extraction) showed no statistically significant difference (p=0.69); but statistically significant difference with the ZA/PTX/PTX group (PTX administered before and after extraction) (p=0.008). Histopathologically, between control and ZA groups, there were statistically significant differences for inflammation (p=0.013), vascularization (p=0.022), hemorrhage (p=0.025) and regeneration (p=0.008). Between ZA and ZA/PTX groups, there were no statistically significant differences for inflammation (p=0.536), vascularization (p=0.642), hemorrhage (p=0.765) and regeneration (p=0.127). Between ZA and ZA/PTX/PTX groups, there were statistically significant difference for inflammation (p=0.017), vascularization (p=0.04), hemorrhage (p=0.044) and regeneration (p=0.04).ConclusionIn this experimental model for MRONJ, it might be concluded that although PTX, given after tooth extraction, improves new bone formation that positively affects bone healing, but it is not prophylactic. However, PTX, given before tooth extraction is prophylactic. In conclusion, PTX might affect healing in a positive way via optimizing inflammatory response.



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