Management of bisphosphonate-associated osteonecrosis: pentoxifylline and tocopherol in addition to antimicrobial therapy. An initial case series.

BACKGROUND Studies of the use of pentoxifylline and α-tocopherol in osteoradionecrosis of the jaw have suggested their efficacy in this condition. We report an initial case series of pentoxifylline and α-tocopherol for patients with bisphosphonate-associated osteonecrosis (BON). METHODS Six cases referred for management of BON were provided pentoxifylline and α-tocopherol in addition to antimicrobial therapy, and followed for a mean of 10 months. RESULTS A 74% decrease in area of bony exposure and symptom control was achieved in these cases. DISCUSSION Pentoxifylline with α-tocopherol may represent a strategy for management of BON. Controlled trials in cases of BON appear warranted.