CLINICAL AND RADIOGRAPHIC STUDY OF HEALING OF MANDIBULAR FRACTURES USING PLASMA RICH FIBRIN MEMBRANE WITH MINIPLATE FIXATION

Abstract

INTRODUCTION: The development of bioactive surgical additives to regulate the inflammation and increase the speed of the healing processis one of the greatest challenges in clinical research. Various materials and techniques have been developed to enhance the process of fracturebone healing and to fasten it.Numerous techniques using autologous platelet concentrates have been developed and applied; platelet rich fibrin [PRF] being one of them,one that is completely autogenous in nature, simple and relatively inexpensive with a specific three-dimensional architecture of the fibrin. PRFhas also shown increased levels of numerous cytokines and growth factors that influence bony regeneration.OBJECTIVES: The aim in this study was to compare between fracture healing using miniplates with and without PRF membrane in bilateralmandibular fractures clinically and radiographically.MATERIALS AND METHODS: all twelve patients had bilateral mandibular fractures. Each patient was treated as follows: (Study Group):The mandibular fracture on the right side was treated by using the conventional 2.0 mm miniplates and screws with placement of PRFmembrane. (Control Group): The mandibular fracture on the left side was treated by using the conventional 2.0 mm miniplates and screws.Follow-up was carried out every week during the first month, then at three months, and six months postoperatively.RESULTS: none of the patients in either of the groups had an infection or signs of nonunion within the follow- up period. There was nostatistically significant difference in the mean value of pain score between the fractures in the two groups. In both groups, edema was limitedto the area of operation and resolved completely by the end of 4th week postoperatively. On immediate, 3 and 6 months postoperatively, themean bone density in the study group was statistically significantly higher than the control group, but the percentage change in the bone densityfrom immediate postoperative to 3 months, immediate postoperative to 6 months and from 3 to 6 months was not statistically significantcomparing the two groupsCONCLUSIONS: PRF application on the fracture line in the mandible may be helpful in improvement of the fracture healing but comparingthe two groups, the pattern of improvement was nearly the same along time.KEYWORDS: Alveolar bone, Fish oil, Induced rheumatoid arthritis, Freund's complete adjuvant