Efficacy Of Platelet Rich Fibrin (PRF) In Neurosensory Disturbance Among Patients With Mandibular Body Fractures

NCT ID: NCT07319650

Last Updated: 2026-01-06

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

2026-01-31

Study Completion Date

2027-02-28

Brief Summary

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Mandibular body fractures frequently result in inferior alveolar nerve (IAN) and mental nerve injuries which ultimately leads to paresthesia of chin and lower lip area. The objective of this study is to evaluate the efficacy of platelet rich fibrin (PRF) application to mental nerve during open reduction and internal fixation (ORIF) of patients having neurosensory disturbance (NSD) following mandibular body fracture involving mental foramen. The PRF application to mental nerve in mandibular body fractures will not only aid in hard and soft tissue healing but also prove to be a game changer for a holistic healing of a patient rather than separate surgical procedures for nerve repair such as microsurgery, grafting, tissue glues, laser.

Alternate Hypothesis HA= The application of PRF to the mental nerve during open reduction and internal fixation of mandibular body fractures involving the mental foramen significantly improves neurosensory recovery compared to cases where PRF is not applied.

Null Hypothesis HO= The application of PRF to the mental nerve during open reduction and internal fixation of mandibular body fractures involving the mental foramen does not significantly improve neurosensory recovery compared to cases where PRF is not applied.

Detailed Description

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Oral and Maxillofacial surgical procedures such as maxillofacial trauma treatments,TMJ surgeries, cyst enucleation, tumor resection, orthognathic surgeries may result in nerve injuries. Bilateral sagittal split osteotomy can result in damage to IAN nerve. Mandibular fractures can result in damage to IAN/ mental nerve as result of trauma. The frequency of temporary IAN injury is 0.5-5%, whereas permanent injury is \<1% and can result in numbness or paresthesia in lower lip and chin area .

The use of PRF may provide a beneficial effect in virtue because it contains several growth factors and may enhance epineurium fibroblast regeneration. PRF has better efficacy than PRP and normal saline (control) in functional nerve recovery (Khojasteh et al.,2016). The use of PRF placement in mandibular body fractures will not only aid in hard and soft tissue healing but also prove to be a game changer for a holistic healing of a patient (Preponement et al.,2013) rather than separate surgical procedures for nerve repair such as microsurgery, grafting, tissue glues, laser.

Limited studies have been done regarding the role of PRF in neurosensory disturbance following mandibular body fractures. The most recent study conducted by Tabrizi et al.(2024) who studied the role of PRF in neurosensory recovery following mandibular body fractures. In this study PRF was placed on IAN between fracture segments. This study had several limitations such as low sample size and there was no direct application of PRF to mental nerve, which may be a factor in NSD. The actual sample size was lower i.e 25 patients as compared to their calculated sample size i.e 30, because 5 patients did not return for follow-up. Our study will provide more significant data related to efficacy of PRF application to mental nerve in patients having neurosensory disturbance following mandibular body fracture involving mental foramen. The PRF application to mental nerve in mandibular body fractures will not only aid in hard and soft tissue healing but also prove to be a game changer for a holistic healing of a patient rather than separate surgical procedures for nerve repair such as microsurgery, grafting, tissue glues, laser.

Conditions

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Neurosensory Disturbance Mandibular Body Fractures

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Experimental Group= The group in which PRF will be placed over mental nerve during open reduction and internal fixation of patients with mandibular body fractures.

Control Group= The group in which PRF will not be placed over mental nerve during open reduction and internal fixation of patients with mandibular body fractures.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Case Group

The group in which PRF will be placed over mental nerve during open reduction and internal fixation of patients with mandibular body fractures involving mental foramen.

Group Type EXPERIMENTAL

Platelets rich Fibrin

Intervention Type OTHER

PRF is the second generation autologous platelet concentrate that is obtained from patient's own blood in simple and cost effective manner. PRF is comprised of three main specifications. First, the existence of platelets and their active growth factors i.e. platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor (TGF), insulin-like growth factor (IGF) and epidermal growth factor (EGF). Second, the role of leukocytes and cytokines i.e. TNF alpha, IL-6 and IL-1ɓ in anti-inflammatory response and immune modulation. Third, the fibrin meshwork where these platelets, cytokines and growth factors are embedded and subsequently released after a short period

Control Group

The group in which PRF will not be placed over mental nerve during open reduction and internal fixation of patients with mandibular body fractures.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Platelets rich Fibrin

PRF is the second generation autologous platelet concentrate that is obtained from patient's own blood in simple and cost effective manner. PRF is comprised of three main specifications. First, the existence of platelets and their active growth factors i.e. platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor (TGF), insulin-like growth factor (IGF) and epidermal growth factor (EGF). Second, the role of leukocytes and cytokines i.e. TNF alpha, IL-6 and IL-1ɓ in anti-inflammatory response and immune modulation. Third, the fibrin meshwork where these platelets, cytokines and growth factors are embedded and subsequently released after a short period

Intervention Type OTHER

Other Intervention Names

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PRF

Eligibility Criteria

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Inclusion Criteria

* Patients having neurosensory disturbance following mandibular body fracture involving mental foramen and pre-operative TPD discrimination score '0' or '1' will be selected in this study ( as per operational definition). TPD discrimination will be recorded; Preoperatively Immediately post operatively After 6 months

Age 15-40years, Both Gender ASA\_1

Exclusion Criteria

* Comminuted mandibular fractures Previously treated cases of fractures Patients with history of neurological disorders Comorbid patients
Minimum Eligible Age

15 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Health Sciences Lahore

OTHER

Sponsor Role lead

Responsible Party

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Muhammad umair shakir

Postgraduate Resident (MDS) Oral & Maxillofacial Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dr Gulraiz Zulfiqar, FCPS(OMFS)

Role: STUDY_DIRECTOR

Associate professor and Head of Department Oral & Maxillofacial Surgery, Allama Iqbal Medical College/ Jinnah Hospital Lahore

Locations

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Allama Iqbal Medical College/ Jinnah Hospital Lahore

Lahore, Punjab Province, Pakistan

Site Status

Countries

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Pakistan

Central Contacts

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Muhammad Umair Shakir, PGR MDS (OMFS)

Role: CONTACT

+92 3127916610

Facility Contacts

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Dr Gulraiz Zulfiqar, FCPS (OMFS)

Role: primary

+92 321 4559970

References

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Yadav S, Sachdeva A, Verma A.2011. Inferior alveolar nerve damage following removal of mandibular third molar teeth. Journal of Innovative Dentistry, 1:1-4.

Reference Type BACKGROUND

Wu CL, Lee SS, Tsai CH, Lu KH, Zhao JH, Chang YC. Platelet-rich fibrin increases cell attachment, proliferation and collagen-related protein expression of human osteoblasts. Aust Dent J. 2012 Jun;57(2):207-12. doi: 10.1111/j.1834-7819.2012.01686.x.

Reference Type BACKGROUND
PMID: 22624763 (View on PubMed)

Thurmüller P, Dodson TB, Kaban LB.2001. Nerve injuries associated with facial trauma: natural history, management, and outcomes of repair. Oral Maxillofac Surg Clin,13:283-293.

Reference Type BACKGROUND

SUNDERLAND S. A classification of peripheral nerve injuries producing loss of function. Brain. 1951 Dec;74(4):491-516. doi: 10.1093/brain/74.4.491. No abstract available.

Reference Type BACKGROUND
PMID: 14895767 (View on PubMed)

Reza Tabrizi, DMD1, Hamidreza Moslemi, DMD2, Shervin Shafiei, DMD1,Ramtin Dastgir, DDS3 and Zachary S. Peacock, DMD, MD.2024.FACS4Craniomaxillofacial Trauma &Reconstruction , Vol. 0(0) 1-7

Reference Type BACKGROUND

Tabrizi R, Pourdanesh F, Jafari S, Behnia P. Can platelet-rich fibrin accelerate neurosensory recovery following sagittal split osteotomy? A double-blind, split-mouth, randomized clinical trial. Int J Oral Maxillofac Surg. 2018 Aug;47(8):1011-1014. doi: 10.1016/j.ijom.2018.04.010. Epub 2018 May 4.

Reference Type BACKGROUND
PMID: 30954205 (View on PubMed)

Padmaraj Hegde, Bhadrinath Sai Swaroop, Tripthi Shetty.2021.Department of Oral and Maxillofacial Surgery, NITTE University, AB Shetty Memorial Institute of Dental Sciences 575018, Mangalore, INDIA Nat. Volatiles & Essent. Oils,8(5):10566-10571

Reference Type BACKGROUND

Libersa P, Savignat M, Tonnel A. Neurosensory disturbances of the inferior alveolar nerve: a retrospective study of complaints in a 10-year period. J Oral Maxillofac Surg. 2007 Aug;65(8):1486-9. doi: 10.1016/j.joms.2007.03.023.

Reference Type BACKGROUND
PMID: 17656272 (View on PubMed)

Khojasteh A, Hosseinpour S, Nazeman P, Dehghan MM. The effect of a platelet-rich fibrin conduit on neurosensory recovery following inferior alveolar nerve lateralization: a preliminary clinical study. Int J Oral Maxillofac Surg. 2016 Oct;45(10):1303-8. doi: 10.1016/j.ijom.2016.06.003. Epub 2016 Jun 30.

Reference Type BACKGROUND
PMID: 27371997 (View on PubMed)

Boffano P, Roccia F, Gallesio C, Karagozoglu K, Forouzanfar T. Inferior alveolar nerve injuries associated with mandibular fractures at risk: a two-center retrospective study. Craniomaxillofac Trauma Reconstr. 2014 Dec;7(4):280-3. doi: 10.1055/s-0034-1375169. Epub 2014 Jun 5.

Reference Type BACKGROUND
PMID: 25383147 (View on PubMed)

Abhinav RP, Selvarasu K, Maheswari GU, Taltia AA. The Patterns and Etiology of Maxillofacial Trauma in South India. Ann Maxillofac Surg. 2019 Jan-Jun;9(1):114-117. doi: 10.4103/ams.ams_233_18.

Reference Type BACKGROUND
PMID: 31293938 (View on PubMed)

Other Identifiers

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ERB172/ 2 /10-10-2024/S1 ERB

Identifier Type: -

Identifier Source: org_study_id

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