拔牙术前应用己酮可可碱和生育酚能否预防放射性骨坏死？系统评价。
Can the prophylactic use of pentoxifylline and tocopherol before dental extractions prevent osteoradionecrosis? A systematic review.
机构信息
Oral Diagnosis Department, Piracicaba Dental School University of Campinas, Piracicaba, Brazil.
Department of Oral Medicine, School of Dentistry, University of São Paulo, São Paulo, Brazil.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2023 Jul;136(1):33-41. doi: 10.1016/j.oooo.2023.01.005. Epub 2023 Jan 20.
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.
目的
本系统评价旨在确定在用五氧化二磷和生育酚（PENTO）方案预防头颈部放疗后拔牙的患者中，是否能有效降低放射性骨坏死（ORN）的风险。
方法
我们检索了 PubMed、SCOPUS、LILACS、EMBASE、Web of Science 和 Cochrane 数据库，截至 2022 年 8 月。我们仅考虑了纳入了头颈部癌症患者，并在放疗后使用 PENTO 预防拔牙的研究。
结果
在确定的 642 项研究中，有 4 项符合纳入标准。在纳入的研究中，387 例患者在接受 PENTO 预防拔牙时共拔除了 1871 颗牙齿。纳入研究中的 PENTO 方案间隔时间不同。总体而言，共有 12 例（3.1%）患者发生 ORN，而在个别牙齿水平分析中，ORN 的发生率为 0.9%。
结论
目前尚无足够的证据支持在拔牙前使用 PENTO 方案预防 ORN。
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