Innovative photobiomodulation-enhanced T-PRF in posterior mandibular fractures: a randomized pilot study

BACKGROUND: Mandibular body fractures are common maxillofacial injuries, often resulting from road traffic accidents. Optimal management seeks anatomical reduction and stable fixation. Recent advances highlight the adjunctive use of low-level laser therapy (LLLT) and Titanium-Prepared Platelet-Rich Fibrin (T-PRF) to enhance bone healing. LLLT stimulates osteogenesis and angiogenesis, while T-PRF provides sustained growth factor release. This pilot study examines the synergistic potential of LLLT and T-PRF in improving bone regeneration and clinical outcomes in mandibular body fracture repair. PATIENTS AND METHODS: Open reduction and internal fixation (ORIF) of posterior mandibular fractures was performed using titanium plates and screws. Patients were divided into two groups: the control group received T-PRF placement at the fracture site, while the study group received T-PRF followed by postoperative LLLT sessions. Using Computerized Tomography, bone mineral density was evaluated at three months postoperatively. Clinical parameters, including pain, wound healing, maximum mouth opening, and edema, were monitored postoperatively to evaluate recovery dynamics. RESULTS: Twelve patients (14 fracture lines) were treated with ORIF and divided equally into two groups. All patients achieved satisfactory anatomical reduction and stable occlusion. The study group demonstrated significantly higher bone density at 12 weeks and experienced significantly greater pain reduction during the first and second weeks postoperatively (p < 0.05) compared to controls. Both groups showed similar results in mouth opening, wound healing, and edema resolution, with no significant intergroup differences in these parameters. CONCLUSION: The adjunctive application of LLLT with T-PRF significantly enhanced osseous regeneration in the study group, yielding higher bone density at 12 weeks and greater pain reduction compared to T-PRF alone. However, both groups demonstrated equivalent improvements in clinical outcomes - including edema resolution, maximum mouth opening, and wound healing - with no significant intergroup differences.