PURPOSE:The objective of this study was to evaluate the role of teriparatide in promoting mandibular fracture healing. METHODS:In this prospective cohort study, 12 patients belonging to American Society of Anesthesiologists status II, who required open reduction and internal fixation of mandibular fractures were categorized into exposure group 9 (52.94%) fractures and non-exposure group 8 (47.06%) fractures. Following open reduction and internal fixation, patients in the exposure group were administered 28.2 μg of teriparatide subcutaneously, twice a week for 4 weeks, while the non-exposure group did not receive any treatment. The groups were followed up and reviewed for a period of 6 weeks to assess fracture healing. The primary outcome parameters were postoperative pain, levels of serum osteocalcin and pro collagen type 1 N-terminal propeptide (P1NP) and bone density on CT. The secondary outcome parameters were requirement of analgesics and mouth opening. Pain was assessed using numerical pain rating scale. Serum osteocalcin and P1NP were assessed pre-operatively and on the 30th post-operative day. Bone density was assessed pre-operatively and on the 6th post-operative week. The data was analyzed for descriptive and analytical statistics (comparison of means and proportions). To analyze the data SPSS (IBM SPSS Statistics for Windows, Version 26.0, Armonk, NY: IBM Corp. Released 2019) is used. Significance level is fixed as 5% (α = 0.05). RESULTS:All patients were pain-free by the 3rd and 7th post-operative day, in the exposure and non-exposure groups, respectively (p < 0.001). Mean post-operative serum osteocalcin and P1NP levels were higher for the exposure group (p = 0.011; p = 0.105, respectively). The mean bone mineral density was significantly increased in the exposure group (p < 0.001). CONCLUSION:Within the limitations of this study, it can be inferred that teriparatide effectively reduces post-operative pain and facilitates bone formation and mineralisation.
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