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Introduction: The contemporary research interest inautologous platelet concentrates is backed by an emergingevidence of their promising regenerative potential in numberof clinical applications. Periapical inflammatory lesionsrepresent a chronic pathology of the periapical tissuesthat result in considerable bone resorption and worsen theoverall tooth prognosis. With this background, the presentstudy was designed to evaluate the effect of the most recentplatelet concentrate preparation, concentrated growth factors(CGF) on osseous regeneration after surgical management ofperiapical lesions.Material and methods: A prospective study was done intwenty patients where CGF was used to fill the periapicaldefects after periapical curettage. Area of radiolucency andmean gray values were assessed at baseline, 1 month, 3months and 6 months after surgery using Image J software.Paired t-test was used to evaluate changes occurring betweenbaseline and 1 month and baseline and 6 months.Results: And early and enhanced healing was evident formthe substantial decrease in area of radiolucency, and meangrayscale values indicated a progressive increase in bonedensity during the observational period. These changes werehighly significant (P< 0.05).Conclusion: CGF can be used as an efficacious and costeffective alternative to conventional bone substitutes forpromoting healing after the surgical debridement of periapicaldefects.
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OBJECTIVE@#To explore the effect of concentrated growth factors (CGF) on postoperative pain and swelling in patients with complex dental implants.@*METHODS@#A total of 28 patients with single maxillary anterior teeth loss and labial orbital bone defect were recruited randomly and divided into two groups. Each group included 14 patients. The experimental group was applied with CGF membrane to guide bone regeneration, whereas the control group was treated with collagen membrane to guide bone regeneration. The postoperative pain degree and swelling degree were compared, and data were analyzed with SPSS 23.0 software. Postoperative pain was measured by visual analogue scale (VAS), and the degree of swelling was divided into four grades according to swelling range.@*RESULTS@#VAS scores of patients in experimental and control groups reached 35.1±22.5 and 47.0±20.3, respectively. The duration of postoperative pain in experimental and control groups totaled (2.1±1.5) and (2.8±1.0) days, respectively. No statistically significant difference was observed between the two groups (P>0.05). Percentages of non-swelling, mild swelling, moderate swelling, and severe swelling in experimental group reached 21.4%, 57.1%, 21.4%, and 0, respectively, and those in control group were 7.1%, 35.7%, 35.7%, and 21.4%. Swelling duration reached (2.4±1.4) and (4.2±2.2) days in the experimental and control groups, respectively. A statistically significant difference was observed in the swelling degree of experimental and control groups (P<0.05).@*CONCLUSIONS@#The use of CGF can significantly reduce the degree of postoperative swelling and shorten swelling time but cause no significant effect on pain.
Subject(s)
Humans , Bone Regeneration , Dental Implants , Esthetics , Intercellular Signaling Peptides and Proteins , Maxilla , Pain, PostoperativeABSTRACT
@#As a new generation of autologous platelet concentrates, concentrated growth factors (CGF) have demonstrated potential for promoting soft and hard tissue regeneration in vitro and in vivo, and this potential has also been demonstrated in clinical trials. CGF may be used alone or with bone graft materials in guided tissue regeneration (GTR), bone regeneration, internal sinus elevation, and reconstruction of bone defects after the removal of jaw cysts. As a rich source of growth factors, CGF have performed well in periodontal regeneration.
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Objective:Concentrated growth factors (CGF),a new generation of platelet concentrate products,appears to have more abundant growth factors because of its special centrifugation process.However,there are few studies supporting this.This study was designed to evaluate the effect of CGFs in the treatment of Ⅱ ° furcations of mandibular molars.Methods:In the present study,thirty-one Ⅱ ° furcation involvements in twenty mandiblular molars were included and randomly divided into two groups.The furcation involvements in the experimental group were treated with bone graft therapy combined with CGFs,and the furcation involvements in the control group were treated with bone graft therapy alone.The clinical examination and cone beam computed tomography (CBCT) were performed at baseline and 1 year post-surgery for the two groups.The changes of clinical and CBCT data at baseline and 1 year postsurgery were compared between the experimental group and the control group.Results:At baseline,there were no significant differences between the two groups in the probing depth (PD),vertical clinical attachment loss (CAL-V) and horizontal clinical attachment loss (CAL-H):PD (7.36 ± 2.32) mm (the experimental group) vs.(7.53 ±2.06) mm (the control group);CAL-V (8.69 ± 1.65) mm (the experimental group) vs.(8.81 ±1.53) mm (the control group);CAL-H (5.24 ±2.01) mm (the experimental group) vs.(5.35 ±2.14) mm (the control group).At the end of 1 year post-surgery,the clinical parameters of both groups were significantly improved (P ＜ 0.001).For the experimental group,the average vertical attachment gain was (2.78 ± 1.66) mm,and the vertical attachment loss was improved significantly compared with the baseline (P ＜ 0.001);the average horizontal attachment gain was (2.10 ± 1.89) mm,and the horizontal attachment loss were improved significantly compared with the baseline (P ＜ 0.001).Furthermore,the improvement degree of the experimental group was significantly higher than that of the control group (P ＜ 0.001).At baseline,there were no statistical differences in the vertical bone loss (BL-V) or horizontal bone loss (BL-H) between the two groups (P ＞ 0.05):BL-V (5.08 ± 2.17) mm (the experimental group) vs.(5.84 ± 2.65) mm (the control group);BL-H (5.85 ±2.13) mm (the experimental group) vs.(6.01 ±2.27) mm (the control group).At 1 year post-surgery,both groups showed significant radiographic bone gain at vertical and horizontal directions compared with baseline (P ＜ 0.001).For the experimental group,the average vertical radiographic bone gain was (2.20 ± 1.98) mm,the horizontal radiographic bone gain was (2.51 ±2.18) mm,the vertical and horizontal radiographic bone loss were both significantly reduced compared with the baseline (P ＜ 0.001).For the control group,the average vertical radiographic bone gain was (1.89 ± 2.15) mm,the horizontal radiographic bone gain was (1.30 ± 2.47) mm,the vertical and horizontal radiographic bone losses were both significantly reduced compared with the baseline (P ＜ 0.001).And the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with the control group (P ＜ 0.001).Conclusion:Within the limitation of the present study,CGFs showed positive role in the treatment of Ⅱ° furcation involvements of mandibular molars.
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Objective:To investigate the distribution and content of transforming growth factor-β1 (TGF-β1)and vascular endothelial growth factor (VEGF)in concentrated growth factors (CGF)gel, and to clarify the difference among different layers of CGF.Methods:Venous blood samples were col-lected from 6 healthy volunteers to prepare CGF.The distribution,integrated optical density (IOD)and average optical density (AOD)of TGF-β1 and VEGF in CGF gel and red blood cell (RBC)layer were measured using immunohistochemistry.The concentrations of TGF-β1 and VEGF in the supernatant se-rum at baseline and the CGF releasate after 1 day were evaluated with enzyme-linked immunosorbent as-says.Results:Abundant TGF-β1 and VEGF were concentrated in CGF gel.However,only a little could be found in polykaryocytes and sporadic platelets in RBC layer.Platelets and leukocytes were concentra-ted in between the two layers with high expression of TGF-β1.The concentrations of TGF-β1 and VEGF in the CGF releasate(55 236.78 ±3 686.34),(610.99 ±148.81)ng/L were significantly higher than those in the supernatant serum (20 710.20 ±4 523.14),(335.20 ±51.69 )ng/L (P <0.001 ). Conclusion:CGF contains high quantities of TGF-β1 that can promote new bone formation and tissue healing.We suggest that CGF gel should be used right after being prepared.Supernatant serum and the area between CGF gel and RBC layer could also be mixed with bone substitute materials.
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INTRODUCTION: This study examined the predictability of new bone formation in the pneumatized maxillary sinus using only fibrin-rich blocks with concentrated growth factors as an alternative to bone grafts. MATERIALS AND METHODS: Maxillary sinus augmentation was performed in thirty-three patients with a deficient alveolar bone height (mean 3.9 mm). All patients were treated consecutively with sinus membrane elevation via the lateral window approach and panoramic radiograms and cone-beam computed tomograms were taken to evaluate the remaining bone height and the new bone formation in the maxillary sinus, before and after surgery. Four biopsy specimens were taken at the time of implant consolidation (after an average of five months healing) and were stained by H & E and Trichrome staining. RESULTS: None of the patients had postoperative complications during implant consolidation. After an average of 5 months since sinus augmentation, newly formed bone was observed in all cases by a radiographic evaluation. In 4 biopsy samples, newly formed bone was observed along the floor of the replaced bony window. The osteoblast lining and well distinguished Osteocytes in the lacunas were observed in the newly formed bone. Of the 74 implants (4 different surfaced implants - resorbable blast media-surfaced (RBM), Hydroxyapatite (HA) coated, acid-etched, sintered porous-surfaced implant) placed, one RBM implant failed. The success rate was 98.6% after a mean of 15 months. DISCUSSION: These results suggest that maxillary sinus augmentation using fibrin rich block with concentrated growth factors is a successful and predictable technique.