CClinicalTrials.gg
Status unknownNCT05536596Updated Sep 13, 2022

Pharmacological Treatment on the Recovery of Neurosensory Disturbance After Bilateral Sagittal Split Osteotomy

A Phase 2/3 interventional study of Orthognathic Surgery and Melatonin 10 MG Oral Tablet in Retrognathism, Prognathism and Orthognathic Surgery, sponsored by Universitat Internacional de Catalunya. Status unknown. Open to participants aged 13 Years to 70 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-09-13.

Sponsored by Universitat Internacional de Catalunya · Phase 2/3, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Sep 2022), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Phase 2/3
Study type
Interventional
Enrollment
220
Allocation
Randomized
Ages
13 Years to 70 Years
Sex
All
01

Study summary

The bilateral sagittal split osteotomy (BSSO) of the mandible is one of the most used surgical techniques to achieve a harmonious jaw relation in the context of orthognathic surgery. Nevertheless, one of its main complications is neurosensory damage to the inferior alveolar nerve, which can cause severe impact in the quality of life on patients who suffer from it permanently. The purpose of this randomized clinical trial is to provide rigorous scientific evidence of the pharmacological effect of 1) Melatonin, 2) combination uridine triphosphate (UTP), cytidine monophosphate (CMP), and hydroxycobalamin (UTP/CMP/hydroxycobalamin) and 3) hydroxycobalamin regarding neurosensory disturbances incidence and persistence after BSSO.

Read the 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.

02

Conditions studied

  • Retrognathism
  • Prognathism
  • Orthognathic Surgery
  • Neurosensory Disorder

Keywords

  • Bilateral Sagittal Split Osteotomy
  • Neurosensory Disturbances
03

Who can participate

Ages eligible
13 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

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
04

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Care provider)
Enrollment
220 participants (estimated)

Study arms

  • 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.

    Procedure: Orthognathic Surgery · Drug: Centrum

  • Experimental
    Melatonin

    Group B will receive the pharmacology treatment with 10 mg Melatonin. One capsule orally at night for 60 days.

    Procedure: Orthognathic Surgery · Drug: Melatonin 10 MG Oral Tablet

  • Experimental
    Hydroxycobalamin

    Group C will receive the pharmacology treatment with 1 mg hydroxycobalamin (vitamin B12). One capsule daily for 60 days.

    Procedure: Orthognathic Surgery · Drug: Hydroxycobalamin

  • Placebo comparator
    Placebo

    The controls will receive 1 capsule placebo containing 5 mg starch to be taken once daily.

    Procedure: Orthognathic Surgery

Interventions

  • ProcedureOrthognathic Surgery

    Prognathism/Retrognathism correction through surgical procedures

    Also known as: Bilateral Sagittal Split Osteotomy

  • DrugMelatonin 10 MG Oral Tablet

    Group B will receive the pharmacology treatment with 10 mg Melatonin. One capsule orally at night for 60 days.

  • DrugHydroxycobalamin

    Group C will receive the pharmacology treatment with 1 mg hydroxycobalamin (vitamin B12). One capsule daily for 60 days.

  • DrugCentrum

    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.

    Also known as: Citoneurone [Cytidine + Hydroxocobalamin, + Uridine]

05

What researchers measure

Primary outcomes

  1. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: pre-operative

  2. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: 1 day postoperative

  3. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: 3 day postoperative

  4. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: 2 weeks postoperative.

  5. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: 1 month postoperative

  6. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: 2 month postoperative

  7. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: 6 month postoperative

  8. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: 12 month postoperative

  9. Neurosensory Activity

    Presence or absense of symptoms and signs such as hypoesthesia, pain, anesthesia, numbness, among others

    Time frame: 18 month postoperative

Secondary outcomes

  1. Subjective Test

    Subjective testing using a questionnaire and visual analogue scale. 0 = normal sensation, 10= more severe sensory deficit.

    Time frame: pre-operative, at day 1 and 3, at week 2, and at month 1, 2, 6, 12 and 18 after surgery.

  2. Objetive Test

    The Semmes-Weinstein (SW) test of sensitivity to touch/pressure will be used.

    Time frame: pre-operative, at day 1 and 3, at week 2, and at month 1, 2, 6, 12 and 18 after surgery.

06

Study locations

No study locations are listed for this record.

07

References and documents

Publications

  • 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. PubMed 28318920 ↗
  • 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. PubMed 11936397 ↗
  • 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. PubMed 32631751 ↗
  • 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. PubMed 20784403 ↗
  • 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. PubMed 35606209 ↗
  • 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. PubMed 11078134 ↗
  • 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. PubMed 21071118 ↗
  • 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. PubMed 17681774 ↗
  • 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. PubMed 17719387 ↗
  • 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. PubMed 15308252 ↗

Individual participant data

Plan to share: No — Individual participant data will not be available due to anonymity and ethical considerations.

08

Registry details

Key details

Study ID
NCT05536596
Lead sponsor
Universitat Internacional de Catalunya
Collaborators
Universidad de los Andes, Chile
Responsible party
Pedro Sole Ventura (Principal Investigator, Surgeon, Universitat Internacional de Catalunya) — Principal investigator
First posted
Sep 13, 2022
Start date
Sep 30, 2022 (estimated)
Primary completion
Jun 30, 2024 (estimated)
Completion
Dec 31, 2024 (estimated)
Last update
Sep 13, 2022

Study contacts

Pedro Sole, DMD, OMFS
Contact
psole@uic.es
+56 9 9235 2728
Maximiliano Bravo, DMD
Contact
mabravo9@uc.cl
+56 9 7690 0878
Pedro Sole, DMD, OMFS
principal investigator · Universidad de Los Andes

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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