Traumatic Bone Cyst Clinical Trial
Official title:
Efficacy of Platelet-rich Plasma in Treatment of Mandibular Traumatic Bone Cyst
The traumatic bone cyst (TBC) is an infrequent nonepithelial lined cavity of the jaws, which
was first expressed by lucassin 1929, the lesion has attracted a great deal of interest in
the dental literature, but its pathogenesis is still not evidently recognized. It determines
a bone cavity of irregular shape which appears like a cyst on a radiograph, and
histopathologically there are no elements to confirm a diagnosis of a cysts. TBC the
international histological classification assumed by the World Health Organisation for
odontogenic tumours utilizes the term "solitary bone cyst", nevertheless the term "traumatic
bone cyst" (TBC) is more extensively used in the literature. The WHO classification explains
TBC as a non-neoplastic osseous lesion because it demonstrates no epithelial lining, which
differentiates this lesion from the true cysts. There is general conformity that most
traumatic bone cysts present without symptoms or signs. Seldom, expansion of the cortical
plate may occur with extraoral swelling, less commonly there may erosion through the
cortical bone may take place.' Teeth in the area of involved bone usually remain vital,
without root resorption or tooth mobility. Treatment of traumatic bone cysts has included
surgical exploration and curettage to motivate bleeding within the bony cavity,' packing of
the cyst cavity with Gelfoam which has been saturated with thrombin and penicillin, and bone
grafting based on previous study Injection of autogeneic blood into the bony cavity of a
traumatic bone cyst was followed by rapid resolution of the lesion.
Platelet-rich plasma (PRP) is a rich source of growth factors. The growth factors present in
PRP are familiar, including transforming growth factor-_ (TGF-_1 and TGF-_2), vascular
endothelial growth factor, 3 isomers of platelet-derived growth factor (PDGF-__,PDGF-__, and
PDGF-__), and endothelial growth factor. These growth factors are considered to have the
capacity to accelerate chemotaxis, mitogenesis, angiogenesis, and synthesis of collagen
matrix and support tissue repair when applied on bone wounds. Due to this high platelet
content, PRP has been used in orthopaedic surgery, oral implantology, and periodontics with
the aim of making the repair process as fast and natural as possible, as it can potentially
afford considerable tissue improvement in bone and soft tissue in a similar way. PRP is
easily acquired, rich in cell signalling molecules, completely autogenous and can be
obtained from minimal blood volumes.the purpose of the present study is to determine the
efficacy of PRP in the treatment of mandibular TBC.
The study sample consisted of 12 young adult volunteers presenting with TBC of mandible. Local ethical committee approval will be obtained before the trial starts. Laboratory tests (complete blood count, glucose, creatinine, platelets, lipid profile) were performed for all patients. These tests provided an important overview of patient health and a baseline for analysis of the prognosis of PRP use. The process for obtaining PRP basically consists of collection of a 20-mL sample of blood, centrifugation of this sample for 8 min, isolation of a 1-mL aliquot of plasma collected near the erythrocyte fraction. Surgical procedure includes: surgical exploration and injection of PRP to stimulate bone regeneration within the bony cavity . Bone repair was assessed by panoramic X-rays obtained at 2, 4, and 6 months postoperatively. Bone density was measured by area histogram analysis. ;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment