Leukocyte- and Platelet-Rich Fibrin in the Surgical Treatment of Medication-related Osteonecrosis of the Jaw
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Surgery with the use of L-PRF, Standard surgery.
- Кому может быть актуально
- Состояния в реестре: Osteonecrosis of the Jaw. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Франция
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Use of Leukocyte- and Platelet-Rich Fibrin in the Surgical Treatment of Medication-related Osteonecrosis of the Jaw: a Randomized Controlled Trial
Обзор
Medication-related osteonecrosis of the jaw (MRONJ) is a rare but serious side-effect of antiresorptive therapies used in the management of bone diseases, such as osteoporosis or bone metastases. A surgical management can lead to a resolution of the disease, but with perfectible results. For this purpose, the use of autologous platelet concentrates (APC) can be useful. With this study, researchers aim to demonstrate the efficacy of L-PRF (Leukocyte- and Platelet-Rich Fibrin) as an adjunct to the surgical treatment of MRONJ in terms of wound healing.
Подробное описание
Resulting in bone loss, infection, pain or discomfort, the presence of MRONJ decreases the quality of life of patients. There isn't any consensus about the treatment modalities for MRONJ, nor about its main goals. Traditionally, therapeutics only aimed to control and prevent the progression of the disease, but recent studies suggest that a whole resolution can currently be expected, especially from surgical therapies. These, when indicated, are not only intended for the removal of the pathological tissue, but above all for an hermetic mucosal healing, preventing secondary infection of the underlying bone.
The L-PRF (Leukocyte- and Platelet-Rich Fibrin) is a second-generation APC, produced in a strictly autologous way, by extemporaneous centrifugation of the patient's own blood. A fibrin clot, containing leukocytes and thrombocytes, is thereby isolated and transformed into membranes by compression. Their appliance to the surgical site allows a slow release of growth factors and cytokines with a positive effect on the revascularization of the wound.
Unfortunately, scientific evidence of their efficiencies is lacking. Therefore, a protocol of randomized clinical trial is proposed, aimed at evaluating the effect of the adjunction of APC to surgical procedures on the complete mucosal healing and thus the resolution of the MRONJ.
The control treatment strategy consists of the complete removal of the necrotic bone, in bleeding margins, followed by a tension-free and hermetic closure. In the test group, suturing will be preceded by the application of L-PRF membranes under the wound.
Patients will be followed for 6 months, during which the maintain of wound closure will be monitored. An evaluation of pain, health-related quality of life and oral health-related quality of life, will also be reported, such as the occurrence of adverse events.
Вмешательства
- Процедура Surgery with the use of L-PRF
The study protocol is the same as the standard surgery one but with additional use of L-PRF membranes - Процедура Standard surgery
The standard surgical treatment, taking place in the operating room under general anesthesia
Первичные конечные точки
- Evaluation of the efficacy of the use of L-PRF during the surgical treatment of MRONJ, compared to surgical treatment alone, on complete mucosal healing. [Срок оценки: 6 months postoperatively]
Вторичные конечные точки (12)
- MRONJ stage - Month 1 [Срок оценки: 1 month postoperatively]
- MRONJ stage - Month 3 [Срок оценки: 3 months postoperatively]
- MRONJ stage - Month 6 [Срок оценки: 6 months postoperatively]
- the postoperative pain - Month 1 [Срок оценки: 1 month postoperatively]
- the postoperative pain - Month 3 [Срок оценки: 3 months postoperatively]
- the postoperative pain - Month 6 [Срок оценки: 6 months postoperatively]
- health-related quality of life - Month 1 - World Health Organization Quality of Life WHOQOL-BREF [Срок оценки: 1 month postoperatively]
- health-related quality of life - Month 1 - OHIP-14 [Срок оценки: 1 month postoperatively]
- health-related quality of life - Month 3 WHOQOL-BREF [Срок оценки: 3 months postoperatively]
- health-related quality of life - Month 3 Oral health-related quality OHIP-14 [Срок оценки: 3 months postoperatively]
- health-related quality of life - Month 6 WHOQOL-BREF [Срок оценки: 6 months postoperatively]
- health-related quality of life - Month 6 - OHIP-14 [Срок оценки: 6 months postoperatively]
Критерии участия
Критерии включения
- MRONJ requiring surgical treatment according to AAOMS criteria (stage 2 or 3; failure of first-line treatments; sequestration of a necrotic bone block), the resection of which needs general anesthesia;
- Affiliates or beneficiaries of a social security scheme.
- Having given free and informed written consent.
Критерии исключения
- Presence of a maxillo-mandibular neoplastic lesion;
- Presence of several MRONJ lesions;
- History of cervico-facial radiotherapy;
- Contraindication to general anesthesia;
- Reduced life expectancy (estimated at less than 6 months).
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Двойное слепое
- Основная цель
- Лечение
Центры проведения
Франция · 7 центров
- University Hospital - Centre François-Xavier Michelet — Bordeaux
- University Hospital - Groupe hospitalier Pellegrin — Bordeaux
- University Hospital — Limoges
- University Hospital Gui de CHAULIAC — Montpellier
- University Hospital Pitié-Salpêtrière — Paris
- University Hospital — Toulouse
- University Hospital — Toulouse
Идентификаторы
NCT: NCT06419010 · RC31/21/0165