EFFECT OF INTRANASAL SALMON CALCITONIN ON BONE HEALING FOLLOWING OPEN REDUCTION AND INTERNAL FIXATION OF MANDIBULAR FRACTURES – A PROSPECTIVE INTERVENTIONAL CLINICAL STUDY

Abstract Background: Successful mandibular fracture treatment depends on both stable fixation and satisfactory biological repair. Intranasal salmon calcitonin has antiresorptive and analgesic effects and may support the early healing response. Aim: To evaluate the effect of intranasal salmon calcitonin on radiographic bone healing, soft-tissue healing, and postoperative pain following open reduction and internal fixation (ORIF) of mandibular fractures. Materials and Methods: A prospective interventional single-arm clinical study was conducted in 13 patients with mandibular fractures requiring ORIF. After fixation with titanium miniplates and monocortical screws, patients received intranasal salmon calcitonin 200 IU/day together with calcium and vitamin D supplementation. CBCT bone density was recorded at the apical, middle, and crestal thirds of the fracture site at baseline and 3 months. Wound healing was assessed on postoperative days 7 and 15 using the Landry Wound Healing Index, while pain was recorded on days 1, 3, 7, and 15 using the Visual Analogue Scale (VAS). Results: Bone density increased significantly at all three regions at 3 months (p < 0.001). Mean Landry scores increased from 3.00 ± 0.577 on day 7 to 4.23 ± 0.439 on day 15 (p < 0.001). Mean VAS scores declined from 9.00 ± 0.213 on day 1 to 3.25 ± 0.279 on day 15, with a significant time effect on repeated-measures ANOVA (F = 180.600, p < 0.001). Conclusion: Within the limitations of this single-arm study, intranasal salmon calcitonin was associated with progressive radiographic and clinical improvement after mandibular fracture fixation. Larger controlled studies are needed to determine its independent contribution to fracture healing. Keywords: Mandibular fracture; salmon calcitonin; intranasal therapy; bone healing; cone-beam computed tomography; postoperative pain