Purine Derivatives in the Management of Antiresorptive Drug-Related Osteonecrosis of the Jaw

Purinic derivatives has recently attracted attention as a potential therapeutic agent, with preliminary evidence suggesting its utility in the management of osteonecrosis of the jaw. work aims at providing an update of the current literature, shedding light on the purinic derivatives treatment for patients who received intravenous antiresorptive drugs and developed osteonecrosis of the jaw. A retrospective study was conducted at the Oral and Maxillofacial Surgery Department of ”Prof. Dr. Dan Theodorescu” Clinical Hospital in Bucharest, Romania, involving 160 consecutive patients diagnosed with refractory, established antiresorptive drug-related osteonecrosis of the jaw between 2022 and 2024. A study group of 23 consecutive patients was selected to receive adjunctive therapy with pentoxifylline (800 mg/day) and vitamin E (1000 IU/day) for six months, while the remaining 137 patients who were not eligible for pentoxifylline tretament formed the control group. Bone healing outcomes were assessed based on the extent of exposed necrotic bone. The study results indicate the fact that 100% of patients in the study group experienced symptomatic improvement, despite a higher prevalence of stage III medication-related osteonecrosis of the jaw, provides strong evidence supporting the therapeutic efficacy observed in this sample population. Post-hoc power analysis showed that the study was strongly powered to detect the observed differences, supporting the reliability of the results. Treatment with purine derivatives demonstrates significant therapeutic potential in the management of antiresorptive drug-related osteonecrosis of the jaw and should be considered as complementary to the standard therapy, particularly in advanced stages of the disease.