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Platelet-Rich Fibrin for Preventing Osteoradionecrosis After Dental Extractions

28 de septiembre de 2026 actualizado por: Reda Elgazzar, University of Manitoba

Multicentre Randomized Controlled Trial Evaluating Platelet-Rich Fibrin (PRF) for the Prevention of Osteoradionecrosis in Patients Requiring Dental Extractions After Radiation Therapy

The goal of this clinical trial is to learn whether platelet-rich fibrin (PRF) can help prevent osteoradionecrosis (ORN) after dental extractions in adults who previously received radiation therapy to the head and neck. ORN is a condition in which jawbone damaged by radiation does not heal properly and may become exposed.

The main question this study aims to answer is:

Does placing PRF into dental extraction sites lower the chance of developing ORN within 6 months after extraction?

PRF is made from a small sample of a participant's own blood. The blood is processed in a centrifuge to form PRF, which can then be placed into the tooth extraction site.

Researchers will compare participants who receive PRF in addition to standard extraction care with participants who receive standard extraction care alone.

Participants will:

Have one or more teeth removed from an area of the jaw that previously received radiation therapy.

Be randomly assigned to receive either PRF plus standard care or standard care alone.

Return for follow-up visits at approximately 2 weeks, 6 weeks, 3 months, and 6 months after extraction.

Have their healing, pain, any potential postoperative complications, and development of ORN assessed during follow-up.

Descripción general del estudio

Estado

Aún no reclutando

Condiciones

Intervención / Tratamiento

Descripción detallada

This is a multicentre, randomized controlled trial evaluating platelet-rich fibrin (PRF) for the prevention of osteoradionecrosis (ORN) following dental extraction in adults who have previously received radiation therapy involving the jaws.

Eligible participants requiring extraction of one or more teeth within a previously irradiated field will be randomized in a 1:1 ratio to receive either PRF plus standard extraction care or standard extraction care alone.

For participants allocated to the intervention group, autologous PRF will be prepared chairside from venous blood using horizontal centrifugation and placed into the extraction socket(s) during the same procedure. The PRF will not be stored or transported.

The study will evaluate whether adjunctive PRF reduces the occurrence of ORN following dental extraction and will also evaluate clinical soft-tissue healing, radiographic bone healing, postoperative pain, analgesic use, postoperative complications, and adverse events.

The study will be conducted at participating centres in Winnipeg, Manitoba, and Calgary, Alberta, Canada.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

112

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Julia M Burgess, DMD (current OMFS Resident)
  • Número de teléfono: 6042206648
  • Correo electrónico: burges16@myumanitoba.ca

Copia de seguridad de contactos de estudio

  • Nombre: Reda Elgazzar, Oral and Maxillofacial Surgeon
  • Número de teléfono: 2047893634
  • Correo electrónico: Reda.Elgazzar@umanitoba.ca

Ubicaciones de estudio

    • Alberta
      • Calgary, Alberta, Canadá, T2N 5G2
    • British Columbia
      • Vancouver, British Columbia, Canadá, V6T 1X4
        • Health Sciences Centre Oral Surgery Clinic
        • Contacto:
          • Julia Burgess, DMD (Current OMFS Resident)
          • Número de teléfono: 204-787-3645
          • Correo electrónico: burges16@myumanitoba.ca
        • Contacto:
          • Reda Elgazzar, Oral and Maxillofacial Surgeon
          • Número de teléfono: +12047893634
          • Correo electrónico: Reda.Elgazzar@umanitoba.ca

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

Age 18 years or older. History of head and neck cancer treated with radiation therapy. Requires at least one dental extraction within an area of the jaw that was previously treated with radiation.

Willing and able to attend all study follow-up visits. No minimum or maximum time since completion of radiation therapy is required.

Exclusion Criteria:

Abscess or draining sinus tract associated with a planned study extraction site.

Blood disorder affecting platelet production or function, such as thrombocytopenia, hemophilia, von Willebrand disease, or a qualitative platelet disorder.

Current immunosuppressive therapy, including calcineurin inhibitors, antimetabolites, biologic therapy, or active cytotoxic chemotherapy.

Current tobacco use in any form, including nicotine vaping, within the previous 30 days.

Known recurrence of head and neck cancer. Previous re-irradiation or re-irradiation currently planned. Chronic systemic corticosteroid use equivalent to at least 5 mg of prednisone daily for at least 30 consecutive days within the previous 3 months.

Current or previous bisphosphonate therapy by any route. Denosumab within the previous 12 months or use of another antiresorptive or antiangiogenic medication.

Current pregnancy. Therapeutic low-molecular-weight heparin or unfractionated heparin that cannot be scheduled at trough level.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Prevención
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Doble

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Platelet-Rich Fibrin (PRF) + Standard Care

Participants randomized to this arm will undergo dental extraction with standard extraction care and adjunctive placement of autologous platelet-rich fibrin (PRF) into the extraction socket(s). PRF will be prepared chairside from the participant's venous blood using horizontal centrifugation and placed into the extraction socket(s) during the same procedure.

Autologous platelet-rich fibrin (PRF) will be prepared chairside from venous blood collected from the participant. Blood will be processed using horizontal centrifugation to produce PRF. The prepared PRF will be placed into the eligible dental extraction socket(s) during the same procedure. PRF will not be stored or transported.

Participants will undergo extraction of one or more eligible teeth within a previously irradiated area of the jaw using standard dental extraction care. No platelet-rich fibrin (PRF) will be placed in the extraction socket(s) as part of this intervention.

Comparador activo: Standard Care Alone

Participants randomized to this arm will undergo dental extraction with standard extraction care without placement of platelet-rich fibrin (PRF) into the extraction socket(s).

Participants will undergo extraction of one or more eligible teeth within a previously irradiated area of the jaw using standard dental extraction care. No platelet-rich fibrin (PRF) will be placed in the extraction socket(s) as part of this intervention.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Incidence of Osteoradionecrosis Within 6 Months
Periodo de tiempo: From dental extraction through 6 months after extraction

Osteoradionecrosis (ORN) will be assessed at the participant level using the ClinRad definition adopted by the ISOO-MASCC-ASCO guideline. ORN is defined as a radiographic lytic or mixed sclerotic lesion of bone, visibly exposed bone, and/or bone probeable through a periodontal pocket or fistula within an anatomical site previously exposed to therapeutic head and neck radiation. A participant will meet the primary endpoint if at least one study extraction socket meets the definition at any scheduled or unscheduled visit through 6 months.

From dental extraction through 6 months after extraction

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Complete Mucosal Closure of the Extraction Site
Periodo de tiempo: 2 weeks, 6 weeks, 3 months, and 6 months after dental extraction

Complete mucosal closure will be assessed clinically at each study extraction socket and recorded as a binary outcome (yes/no). Complete mucosal closure is defined as intact epithelium across the entire socket orifice, with no dehiscence and no exposed bone. Socket-level outcomes will account for clustering of multiple extraction sockets within individual participants.

2 weeks, 6 weeks, 3 months, and 6 months after dental extraction
Radiographic Bone Healing at the Extraction Site
Periodo de tiempo: Baseline to 6 months after dental extraction

Radiographic bone healing at each study extraction site will be assessed by qualitative comparison of the 6-month cone-beam computed tomography (CBCT) scan with the pre-extraction baseline CBCT. Assessment will include the presence, absence, and extent of lytic or mixed sclerotic changes and cortical continuity at the socket crest.

Baseline to 6 months after dental extraction
Postoperative Pain Intensity
Periodo de tiempo: 2 weeks, 6 weeks, 3 months, and 6 months after dental extraction

Pain intensity at each study extraction socket will be assessed using the 11-point Numeric Rating Scale (NRS-11), ranging from 0 to 10, where 0 represents no pain and 10 represents the worst pain imaginable. Participants will rate pain at each extraction site over the preceding 24 hours. Higher scores indicate greater pain intensity.

2 weeks, 6 weeks, 3 months, and 6 months after dental extraction

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Investigadores

  • Investigador principal: Julia M Burgess, DMD (current OMFS Resident), University of Manitoba
  • Director de estudio: Reda Elgazzar, Oral and Maxillofacial Surgeon, University of Manitoba
  • Director de estudio: Edmund Chan, DMD, University of Calgary

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

1 de enero de 2027

Finalización primaria (Estimado)

31 de diciembre de 2028

Finalización del estudio (Estimado)

31 de diciembre de 2028

Fechas de registro del estudio

Enviado por primera vez

28 de septiembre de 2026

Primero enviado que cumplió con los criterios de control de calidad

28 de septiembre de 2026

Publicado por primera vez (Actual)

5 de octubre de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

5 de octubre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

28 de septiembre de 2026

Última verificación

1 de septiembre de 2026

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • PRF-ORN-RCT-2026

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .