se of Pentoxyphylline and Tocopherol prior to Tooth Extractions in Oncological patients submitted to treatment with Agents Bone Modifiers

Bone modifying agents (antiresorptives) have the function of reducing excessive bone resorption by decreasing the activity and/or number of osteoclasts. Among them, the class of bisphosphonates and denosumab stand out, both of which are associated with the development of drug-related osteonecrosis of the jaw (MRONJ), especially when bone tissue is manipulated. Given the need to perform tooth extraction in patients undergoing such medications, the greatest concern is the risk of MRONJ. The association of pentoxifylline and tocopherol has been shown to be beneficial in the treatment of MRONJ and its prophylactic use has been shown in osteoradionecrosis, however, there is a paucity of studies in MRONJ. In light of this problem, the aim of this study is to evaluate the prophylactic effect of pentoxifylline and tocopherol on MRONJ in patients undergoing tooth extraction in the face of treatment with bone-modifying agents. The research will be developed by a single researcher at the dental clinic of the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), from April 2021 to February 2022. Patients will be screened through the daily medication schedule of the IMIP oncology outpatient clinic and through internal referral, for 05 months. Patients who meet the established eligibility criteria will participate in the research. Prior to performing the tooth extraction, a prophylactic drug protocol for MRONJ will be prescribed. The patient will be reassessed for a period of 01 week, 01 month and 03 months after the extraction. The data collected will be recorded in a specific form, which will later be tabulated in a Microsoft Excel 2016 spreadsheet and subjected to statistical analysis.