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Tocopherol + pentoxifylline is a combination therapy being investigated by the University of Catania as a topical gel for the prevention and treatment of medication-related osteonecrosis of the jaw (MRONJ). Pentoxifylline is a methylxanthine derivative that improves peripheral blood flow by increasing erythrocyte flexibility and reducing blood viscosity; it also possesses anti-fibrotic and anti-inflammatory properties by inhibiting phosphodiesterases and reducing the production of tumor necrosis factor-alpha (TNF-alpha). Tocopherol (Vitamin E) is a potent antioxidant that neutralizes reactive oxygen species and works synergistically with pentoxifylline to mitigate tissue damage, reduce fibrosis, and promote healing in necrotic bone environments. This specific topical formulation is designed for local application to MRONJ-related lesions or post-extraction sockets in patients receiving antiresorptive medications.
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