Alternating Triamcinolone and Platelet-Rich Plasma Therapy for Oral Submucous Fibrosis

NCT ID: NCT07277998

Last Updated: 2025-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-03-31

Study Completion Date

2026-09-30

Brief Summary

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Oral Submucous Fibrosis (OSF) is a chronic, progressive, potentially malignant disorder characterized by mucosal stiffness, trismus, and burning sensation. This interventional clinical trial evaluates the therapeutic effectiveness of alternating weekly intralesional Triamcinolone Acetonide (TA) and Platelet-Rich Plasma (PRP) injections compared to standard Triamcinolone therapy alone. The purpose is to determine whether sequential anti-inflammatory (TA) and regenerative (PRP) stimulation can produce superior clinical improvement in mouth opening, burning sensation, and mucosal flexibility compared to corticosteroid therapy alone.

Detailed Description

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Oral Submucous Fibrosis (OSF) is a chronic, irreversible fibro-elastic disorder of the oral mucosa associated with restricted mouth opening, burning sensation, impaired mastication, and decreased quality of life. Traditional management approaches include intralesional corticosteroids, physiotherapy, antioxidants, and more recently, regenerative therapies such as Platelet-Rich Plasma (PRP).

Triamcinolone Acetonide (TA) provides anti-inflammatory and anti-fibrotic effects by suppressing fibroblast activity and collagen deposition. PRP, an autologous concentrate of platelets and growth factors, has demonstrated potential in promoting angiogenesis, collagen remodeling, and mucosal regeneration. Alternating TA and PRP may theoretically combine the immediate anti-inflammatory benefits of TA with the long-term regenerative benefits of PRP, resulting in more effective improvement of OSF symptoms.

This study consists of two arms. In the control arm, participants will receive weekly intralesional Triamcinolone injections for 6 weeks. In the experimental arm, participants will receive Triamcinolone in Week 1, PRP in Week 2, followed by alternating TA and PRP injections for a total of 6 weeks. All participants will be instructed to perform standardized jaw physiotherapy exercises during the study period.

Primary outcomes include change in interincisal mouth opening (millimeters) and reduction in burning sensation using a Visual Analog Scale (VAS). Secondary outcomes include mucosal flexibility score, cheek rigidity grading, functional improvement during mastication and speech, and patient satisfaction.

This clinical trial aims to generate high-quality comparative evidence regarding whether an alternating TA-PRP protocol offers superior therapeutic outcomes compared to conventional corticosteroid therapy alone, thereby supporting advancement of regenerative treatment protocols for OSF within oral and maxillofacial clinical practice.

Conditions

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Oral Submucous Fibrosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two-arm parallel assignment comparing alternating-week Triamcinolone + PRP therapy vs standard single-agent therapy
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Alternating Triamcinolone + PRP Therapy

Patients will receive alternating-week intralesional Triamcinolone (10 mg/mL) and Platelet-Rich Plasma therapy. Triamcinolone is given in Week 1, PRP in Week 2, and alternated weekly for a total of 6-8 sessions.

Group Type ACTIVE_COMPARATOR

Platelet-Rich Plasma (PRP) Injections

Intervention Type BIOLOGICAL

Autologous Platelet-rich plasma (PRP) injected intralesionally at standard volume for Oral submucous fibrosis (OSF) treatment, administered every alternate week.

Triamcinolone Acetonide

Intervention Type DRUG

Triamcinolone acetonide 10 mg/mL administered intralesionally once weekly.

Triamcinolone Alone Therapy

Patients will receive intralesional Triamcinolone acetonide (10 mg/mL) once weekly for 6-8 sessions as standard therapy.

Group Type ACTIVE_COMPARATOR

Triamcinolone Acetonide

Intervention Type DRUG

Triamcinolone acetonide 10 mg/mL administered intralesionally once weekly.

Interventions

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Platelet-Rich Plasma (PRP) Injections

Autologous Platelet-rich plasma (PRP) injected intralesionally at standard volume for Oral submucous fibrosis (OSF) treatment, administered every alternate week.

Intervention Type BIOLOGICAL

Triamcinolone Acetonide

Triamcinolone acetonide 10 mg/mL administered intralesionally once weekly.

Intervention Type DRUG

Other Intervention Names

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PRP TA

Eligibility Criteria

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Inclusion Criteria

Clinically diagnosed Oral Submucous Fibrosis (OSF), Stage II-IV using Haider et al. classification.

Age 18-65 years. Mouth opening ≤ 30 mm. Persistent burning sensation (VAS ≥ 3). Able and willing to comply with weekly therapy sessions. Provided written informed consent.

Exclusion Criteria

Previous treatment with PRP, Platelet-rich Fibrin (PRF), corticosteroid, or combination therapy in the last 6 months.

Systemic diseases affecting wound healing (e.g., uncontrolled diabetes, severe anemia).

Current steroid therapy or immunosuppressive therapy.

Oral lesions suspicious for malignancy or recurrent Oral Squamous cell carcinoma (OSCC).

Bleeding disorders or platelet count \<150,000.

Pregnant or breastfeeding women.

Known allergy to local anesthetics or triamcinolone.

Patients unwilling to stop areca nut/tobacco habits.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Karachi Medical and Dental College

OTHER

Sponsor Role lead

Responsible Party

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Madiha Khan

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sufyan Ahmed, BDS, FCPS

Role: STUDY_CHAIR

Karachi Medical and Dental College

Locations

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Abbasi Shaheed Hospital

Karachi, Sindh, Pakistan

Site Status

Countries

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Pakistan

Central Contacts

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Madiha Khan, BDS, MS

Role: CONTACT

+923350-250691

Aisha Faraz, BDS, MS

Role: CONTACT

+92333096619

Facility Contacts

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Madiha Khan, BDS, MS

Role: primary

+923350250691

Aisha Faraz, BDS, MS

Role: backup

+923333096619

References

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Khan M, Ahmed S, Faraz A, Ali Z, Khan S, Iqbal M. Comparison Between Treatment of Oral Submucous Fibrosis with Intralesional Triamcinolone Injection Versus Platelet-Rich Plasma. Journal of Population Therapeutics and Clinical Pharmacology. 2025;32(4):166-172.

Reference Type RESULT

Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of Platelet-Rich Plasma and regenerative potential in tissue healing. Am J Sports Med. 2009;37(11):2259-2272. PMID: 19088268.

Reference Type RESULT

Tilakaratne WM, Klinikowski MF. Intralesional corticosteroid injection as a treatment modality for oral submucous fibrosis. J Oral Pathol Med. 2016;45(3):162-168. PMID: 27422421.

Reference Type RESULT

Saraf K, Gaur A, Thomas R. Efficacy of Platelet-Rich Plasma injections in Oral Submucous Fibrosis: A Prospective Clinical Study. Dent Res Dent Clin Dent Prospects. 2021;15(4):275-280. PMID: 34912641.

Reference Type RESULT

OSF Singh S, Misra N. Comparative evaluation of intralesional platelet-rich plasma and intralesional corticosteroid in management of oral submucous fibrosis. J Oral Maxillofac Pathol. 2020;24(1):121-126. PMID: 33584414.

Reference Type RESULT

Ali H, Ahmed S, Raza SH. Effect of intralesional injection of triamcinolone acetonide in oral submucous fibrosis. Journal of Surgery Pakistan. 2019;24(4):181-185.

Reference Type RESULT

Haider SM, Merchant A, Fida M. Clinical grading of oral submucous fibrosis: A practical classification for patient severity assessment. Journal of Pakistan Dental Association. 2016;25(4):147-152.

Reference Type RESULT

Related Links

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https://www.jptcp.com/index.php/jptcp/article/view/10065

Published comparative study on PRP and TA therapy for Oral Submucous Fibrosis by the Principal Investigator.

https://pubmed.ncbi.nlm.nih.gov/10783440/

Institutionally developed OSF clinical grading system used in this trial.

https://www.jsp.org.pk/index.php/jsp/article/view/170?utm_source=chatgpt.com

Steroid-based management study of Oral Submucous Fibrosis conducted at the same institution.

Other Identifiers

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KMDC/OMFS/OSF-CombTherapy/2025

Identifier Type: OTHER

Identifier Source: secondary_id

MK_OSF_ALTTA_PRP_2025

Identifier Type: -

Identifier Source: org_study_id

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