Evaluation of Platelet-Rich Plasma as an Adjunct to Closed Reduction of Unilateral Condylar Fractures of Mandible.

BACKGROUND

Condylar fractures lack clear treatment guidelines and may have a lasting effect on temporomandibular joint function. Platelet-rich plasma (PRP), containing growth factors enhances healing in orthopedic fractures, but its role in condylar fractures remains unexplored.

PURPOSE: The purpose of this study was to evaluate PRP's effect on pain, function, and signs and symptoms of anterior disc displacement (ADD) in treating unilateral condylar fractures. Study design, setting, and sample: The investigators implemented a double-blinded nonrandomized placebo-controlled trial enrolling subjects with unilateral condylar fractures, being treated with closed reduction, between January 2022 and July 2023 at the JSS hospital, Mysuru, Karnataka, India. Subjects eligible for open reduction, having prior history of joint pain or ADD, edentulous subjects, and individuals with contraindications for maxillomandibular fixation were excluded.

PREDICTOR: The predictor variable was PRP exposure and subjects were assigned to receive intra-articular injections of PRP or saline.

MAIN OUTCOME VARIABLES: Main outcome variable was therapeutic effect assessed using pain [by visual analog scale] and maximal mouth opening measured as interincisal distance. The measurements were made on day of reporting and during 2 consecutive follow-ups. Secondary outcome assessed was signs and symptoms suggestive of ADD measured at 3 months.

COVARIATES: Baseline demographics and relevant medical history were recorded.

ANALYSES: Independent t-tests compared baseline variables. Repeated measures analysis of variance evaluated pain and maximal mouth opening over time; χ2 test assessed ADD symptoms between groups. A P value of ≤0.01 was considered statistically significant.

RESULTS

The study population composed of 56 subjects. The final sample composed of 30 (53.5%) subjects meeting the study criteria. The mean age was 36.13 ± 8.5 years; 66.6% were males and 33.3% were females. All subjects were followed up for total 3 months. The PRP group reported lower pain score (1.4 ± 1.1) than the control group (3.6 ± 1.9) (P value<.01) and greater mouth opening (37.13 ± 5.31 mm) than the control group (27.20 ± 4.70 mm) (P value <.01). The PRP group showed reduced signs and symptoms indicative of ADD (P = .01).

CONCLUSIONS AND RELEVANCE: The use of PRP was associated with reduced pain, improved function, and reduced signs and symptoms of ADD in condylar fractures.