Pharmacological Treatment on the Recovery of Neurosensory Disturbance After Bilateral Sagittal Split Osteotomy
Pharmacological Treatment on the Recovery of Neurosensory Disturbance After Bilateral Sagittal Split Osteotomy: a Randomized, Double-blind Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The study will be done according to the international standards of the Helsinki convention for medical research and approved by the scientific ethics committee of Universidad de los Andes Clinic.
All subjects will give their signed consent to participate of this clinical research.
This clinical randomized trial will be double-blinded as both the patient and the surgeon will not know the treatment used until the experiment is over. The randomization will be done using "random.org" software to assign participants into 4 groups. Groups A, B and C will receive the medication, whereas the Group P will receive a placebo.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Pedro Sole, DMD, OMFS
- Phone Number: +56 9 9235 2728
- Email: psole@uic.es
Study Contact Backup
- Name: Maximiliano Bravo, DMD
- Phone Number: +56 9 7690 0878
- Email: mabravo9@uc.cl
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria: Patients with dentomaxillofacial anomalies who present a complete mandibular dental arch and who have not undergone previous mandibular surgery.
Exclusion Criteria:
patients who:
- do not have sufficient information in their clinical records
- cannot be contacted
- do not attend their check-ups (for at least 24 postoperative months in cases with DNS)
- have refused consent to the use of their information for purposes of research.
- already undergoing Orthognathic Surgery
- with systemic conditions prone to alter recovery patterns or serious systemic diseases (decompensated metabolic disorders; neoplasms; osteodysplasias; neuropathies).
- pregnancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Citoneurone
Groups A will receive the pharmacology treatment with 1.5 mg uridine triphosphate, 2.5 mg cytidine monophosphate and 1 mg hydroxycobalamin (Citoneurone).
One capsule orally three times a day for 60 days as suggested by the manufacturer for patients with trauma - compressive peripheral neural disorders.
|
Prognathism/Retrognathism correction through surgical procedures
Other Names:
Groups A will receive the pharmacology treatment with 1.5 mg uridine triphosphate, 2.5 mg cytidine monophosphate and 1 mg hydroxycobalamin (Citoneuron).
One capsule orally three times a day for 60 days as suggested by the manufacturer for patients with trauma - compressive peripheral neural disorders.
Other Names:
|
|
Experimental: Melatonin
Group B will receive the pharmacology treatment with 10 mg Melatonin.
One capsule orally at night for 60 days.
|
Prognathism/Retrognathism correction through surgical procedures
Other Names:
Group B will receive the pharmacology treatment with 10 mg Melatonin.
One capsule orally at night for 60 days.
|
|
Experimental: Hydroxycobalamin
Group C will receive the pharmacology treatment with 1 mg hydroxycobalamin (vitamin B12).
One capsule daily for 60 days.
|
Prognathism/Retrognathism correction through surgical procedures
Other Names:
Group C will receive the pharmacology treatment with 1 mg hydroxycobalamin (vitamin B12).
One capsule daily for 60 days.
|
|
Placebo Comparator: Placebo
The controls will receive 1 capsule placebo containing 5 mg starch to be taken once daily.
|
Prognathism/Retrognathism correction through surgical procedures
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Neurosensory Activity
Time Frame: pre-operative
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
pre-operative
|
|
Neurosensory Activity
Time Frame: 1 day postoperative
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
1 day postoperative
|
|
Neurosensory Activity
Time Frame: 3 day postoperative
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
3 day postoperative
|
|
Neurosensory Activity
Time Frame: 2 weeks postoperative.
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
2 weeks postoperative.
|
|
Neurosensory Activity
Time Frame: 1 month postoperative
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
1 month postoperative
|
|
Neurosensory Activity
Time Frame: 2 month postoperative
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
2 month postoperative
|
|
Neurosensory Activity
Time Frame: 6 month postoperative
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
6 month postoperative
|
|
Neurosensory Activity
Time Frame: 12 month postoperative
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
12 month postoperative
|
|
Neurosensory Activity
Time Frame: 18 month postoperative
|
Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others
|
18 month postoperative
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Subjective Test
Time Frame: pre-operative, at day 1 and 3, at week 2, and at month 1, 2, 6, 12 and 18 after surgery.
|
Subjective testing using a questionnaire and visual analogue scale.
0 = normal sensation, 10= more severe sensory deficit.
|
pre-operative, at day 1 and 3, at week 2, and at month 1, 2, 6, 12 and 18 after surgery.
|
|
Objetive Test
Time Frame: pre-operative, at day 1 and 3, at week 2, and at month 1, 2, 6, 12 and 18 after surgery.
|
The Semmes-Weinstein (SW) test of sensitivity to touch/pressure will be used.
|
pre-operative, at day 1 and 3, at week 2, and at month 1, 2, 6, 12 and 18 after surgery.
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Pedro Sole, DMD, OMFS, Universidad De Los Andes
Publications and helpful links
General Publications
- Ylikontiola L, Kinnunen J, Oikarinen K. Factors affecting neurosensory disturbance after mandibular bilateral sagittal split osteotomy. J Oral Maxillofac Surg. 2000 Nov;58(11):1234-9; discussion 1239-40. doi: 10.1053/joms.2000.16621.
- Colella G, Cannavale R, Vicidomini A, Lanza A. Neurosensory disturbance of the inferior alveolar nerve after bilateral sagittal split osteotomy: a systematic review. J Oral Maxillofac Surg. 2007 Sep;65(9):1707-15. doi: 10.1016/j.joms.2007.05.009.
- Alolayan AB, Leung YY. Resolution of neurosensory deficit after mandibular orthognathic surgery: A prospective longitudinal study. J Craniomaxillofac Surg. 2017 May;45(5):755-761. doi: 10.1016/j.jcms.2017.01.032. Epub 2017 Feb 12.
- Teerijoki-Oksa T, Jaaskelainen SK, Forssell K, Forssell H, Vahatalo K, Tammisalo T, Virtanen A. Risk factors of nerve injury during mandibular sagittal split osteotomy. Int J Oral Maxillofac Surg. 2002 Feb;31(1):33-9. doi: 10.1054/ijom.2001.0157.
- da Costa Senior O, Gemels B, Van der Cruyssen F, Agbaje JO, De Temmerman G, Shaheen E, Lambrichts I, Politis C. Long-term neurosensory disturbances after modified sagittal split osteotomy. Br J Oral Maxillofac Surg. 2020 Oct;58(8):986-991. doi: 10.1016/j.bjoms.2020.05.010. Epub 2020 Jul 4.
- Seddon HJ. A Classification of Nerve Injuries. Br Med J. 1942 Aug 29;2(4260):237-9. doi: 10.1136/bmj.2.4260.237. No abstract available.
- Schlund M, Grall P, Ferri J, Nicot R. Effect of modified bilateral sagittal split osteotomy on inferior alveolar nerve neurosensory disturbance. Br J Oral Maxillofac Surg. 2022 Oct;60(8):1086-1091. doi: 10.1016/j.bjoms.2022.04.001. Epub 2022 Apr 13.
- Yoshioka I, Tanaka T, Khanal A, Habu M, Kito S, Kodama M, Oda M, Wakasugi-Sato N, Matsumoto-Takeda S, Seta Y, Tominaga K, Sakoda S, Morimoto Y. Correlation of mandibular bone quality with neurosensory disturbance after sagittal split ramus osteotomy. Br J Oral Maxillofac Surg. 2011 Oct;49(7):552-6. doi: 10.1016/j.bjoms.2010.09.014. Epub 2010 Nov 10.
- van Merkesteyn JP, Zweers A, Corputty JE. Neurosensory disturbances one year after bilateral sagittal split mandibular ramus osteotomy performed with separators. J Craniomaxillofac Surg. 2007 Jun-Jul;35(4-5):222-6. doi: 10.1016/j.jcms.2007.04.006. Epub 2007 Jul 30.
- Panula K, Finne K, Oikarinen K. Neurosensory deficits after bilateral sagittal split ramus osteotomy of the mandible--influence of soft tissue handling medial to the ascending ramus. Int J Oral Maxillofac Surg. 2004 Sep;33(6):543-8. doi: 10.1016/j.ijom.2003.11.005.
Study record dates
Study Major Dates
Study Start (Anticipated)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Congenital Abnormalities
- Musculoskeletal Diseases
- Stomatognathic Diseases
- Stomatognathic System Abnormalities
- Jaw Abnormalities
- Jaw Diseases
- Maxillofacial Abnormalities
- Craniofacial Abnormalities
- Musculoskeletal Abnormalities
- Mandibular Diseases
- Retrognathia
- Prognathism
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Protective Agents
- Micronutrients
- Vitamins
- Antioxidants
- Vitamin B Complex
- Hematinics
- Melatonin
- Vitamin B 12
- Hydroxocobalamin
Other Study ID Numbers
Other Study ID Numbers
- PISV01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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