Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction

Histological Evaluation of the Effect of Concentrated Growth Factor on Bone Healing

OBJECTIVES

The aim of this study was to evaluate the effects of concentrated growth factors (CGF) on the healing of peri-implant bone defects in an animal model.

STUDY DESIGN

Twenty 4-month-old New Zealand White rabbits, each with an average weight of 3.5 kg, were used in this blinded, prospective, experimental study. Two implants were placed and 2 peri-impant defects were prepared in each rabbit tibia. Bone defects were created monocortically in the tibia of each rabbit using a trephine burr with a diameter of 8 mm. The implants were installed in each hole. The rabbits were divided into 4 groups: in group E, the defect was left empty; in group CGF, the defects were filled only with CGF; in group AB, the defects were filled with autogenous bone; and in group AB+CGF, the defects were filled with autogenous bone and CGF. The animals were euthanized at week 8 postimplantation. All implants from the 20 animals were fixed in 10% formalin and evaluated histomorphometrically.

RESULTS

The mean defect area was highest in group E and lowest in group CGF+AB (P <0.05). The area of the defect differed significantly between groups AB and CGF+AB (P <0.05), but not between groups CGF and E. Implant-to-bone contact was lowest in group E. In the defect areas of groups CGF, AB and CGF+AB, a small amount of new bone formed around the implant.

CONCLUSIONS

In this animal model of a peri-implant bone defect, restoration was achieved using a combination of autogenous bone and CGF. Further studies are needed to determine the behavior of CGF when used in the repair of bone defects in humans.

Quality Assessment of Platelet-Rich Fibrin-Like Matrix Prepared from Whole Blood Samples after Extended Storage

The platelet-rich fibrin–like matrix (PRFM) is usually prepared onsite and immediately used for regenerative therapy. Nonetheless, to meet the clinical necessity of preserving the PRFM without quality deterioration, we developed a method for preparation of PRFMs from short-term-stored whole blood (WB) samples. In this study, to evaluate the practical expiration date of storage, we extended the storage time of WB samples from 2 to 7 days and assessed the quality of the resulting PRFMs. WB samples collected with acid-citrate-dextrose were stored with gentle agitation at ambient temperature. To prepare PRFMs, the stored WB samples were mixed with CaCl₂ in glass tubes and centrifuged. Fibrin fiber networks, CD41 and CD62P expression, and Platelet Derived Growth Factor-BB (PDGF-BB) levels were examined by scanning electron microscopy (SEM), flow cytometry, and an Enzyme-Linked ImmunoSorbent Assay (ELISA), respectively. Long-term storage had no significant effect on either blood cell counts or platelet functions tested. The resulting PRFMs were visually identical to freshly prepared ones. PDGF-BB levels did not markedly decrease in a time-dependent manner. However, fibrin fibers gradually became thinner after storage. Although the coagulation activity may diminish, we propose that PRFMs can be prepared—without evident loss of quality—from WB samples stored for up to 7 days by our previously developed method.

Morphological Observation on Critical-Sized Cranial Defect Repaired by Icariin and Autologous Concentrate Growth Factors in Rabbits

Background

Morphological changes repaired by icariin and autologous concentrate growth factors (ACGF) in critical-sized cranial defect were observed and their promoting effects were investigated.

Material/Methods

Seventy-two New Zealand white rabbits weighing 1.8~2.0kg were used to build a critical-sized cranial defect model and were randomly divided into 3 groups. X-ray, HE staining, general and histological observation, and immunohistochemistry were used to describe the changes caused by normal saline, icariin, and ACGF.

Results

Cranial defects were covered with newly formed bone tissue at the 12^th week in icariin and ACGF groups, with red color, hard surface, and no obvious boundary. Densities were the same in 2 groups at 4 timepoints. HE staining showed defects filled with a large amount of fibrous connective tissue, thick collagen fibers, and abundant osteoclasts. No new bone matrix appeared in any of the 3 groups. Trabecular area, trabeculae width, and osteoblast number in 2 groups were more than that of the control group, and osteoclast number was lower. However, osteoclast number among the 3 groups at the 12^th week had no significant difference, which was the same with 4 indicators between the icariin and ACGF groups. From the 4^th to 12^th week, regenerated cartilage was formed and showed positive reaction with BMP-2 and TGFβ1 from primary bone, which also was demonstrated by granulation tissue and uniform dyeing.

Conclusions

ACGF and icariin both can increase new bone quantity and improve bone quality, which can also promote healing. The effects and mechanisms of icariin and ACGF on the expression of gene are not exactly the same.

Evolution, current status and advances in application of platelet concentrate in periodontics and implantology

Platelet concentrates (PC) [platelet-rich plasma (PRP) and platelet-rich fibrin (PRF)] are frequently used for surgical procedures in medical and dental fields, particularly in oral and maxillofacial surgery, plastic surgery and sports medicine. The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration. Although leukocyte rich and leukocyte poor PRP’s have their own place in literature, the importance of non-platelet components in a platelet concentrate remains a mystery. PC have come a long way since its first appearance in 1954 to the T-PRF, A-PRF and i-PRF introduced recently. These PC find varied applications successfully in periodontics and implant dentistry as well. However, the technique of preparation, standing time, transfer process, temperature of centrifuge, vibration, etc., are the various factors for the mixed results reported in the literature. Until the introduction of a proper classification of terminologies, the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion. This review intends to clarify all these confusion by briefing the exact evolution of PC, their preparation techniques, recent advances and their various clinical and technical aspects and applications.

Histological evaluation of effectiveness of platelet-rich fibrin on healing of sinus membrane perforations: A preclinical animal study

The aim of this study was to evaluate the effectiveness of platelet-rich fibrin (PRF) in repairing of Schneiderian membrane perforations in rabbit maxillary sinus. A total of 42 female New Zealand rabbits were randomly divided into two groups. Symmetrical bony defects were created 1 cm in diameter and the sinus membranes were exposed. The Schneiderian membranes were elevated in both sinuses and each membrane was perforated with a 1 cm incision. No treatment was applied to the right perforations in both groups. Left-sided perforations were closed with collagen membrane in the first group and PRF membrane in the other group. Seven animals randomly selected from each group were sacrificed at weeks 1, 2 and 4 in order to be able to examine the amounts of lymphocytes, fibroblasts, veins, and collagen fibers in the area where the membranes were applied. Histological analyses showed that there were no statistically significant differences between the collagen membrane and the PRF membrane in the healing of sinus perforation area. PRF may be considered as an alternative application to collagen membrane in sinus membrane perforations.

Evaluation of effectiveness of concentrated growth factor on osseointegration

BACKGROUND

Growth factor-containing products have been reported to increase implant stability and accelerate osseointegration. Concentrated growth factor (CGF) can be used for this purpose with the growth factors it contains. The aim of this study is to assess the effect of CGF on implant stability and osseointegration.

METHODS

Twelve patients with maxillary anterior toothless were included in the study. Implant cavities prepared in the study group were covered with CGF membrane before implant placement, but conventional implant placement was performed in the control group. Resonance frequency measurements were performed with the Osstell device intra-operatively, post-operatively, at the 1st week, and at the 4th week.

RESULTS

The mean ISQ values were found to be 79.40 ± 2.604 for the study group and 73.50 ± 5.226 for the control group at 1st week, 78.60 ± 3.136 for the study group and 73.45 ± 5.680 for the control group at 4th week. The differences between the groups were statistically significant (p < 0.05).

CONCLUSIONS

It was observed that the concentrated growth factor had positive effects on implant stabilization. The ISQ measurements at week 1 and week 4 were notably higher in the study group. Application of this material seems to accelerate osseointegration.

Clinical efficacy of a centric relation occlusal splint and intra-articular liquid phase concentrated growth factor injection for the treatment of temporomandibular disorders

The agony that accompanies the incidence and symptoms of temporomandibular disorders (TMDs) is an important concern in the oral and maxillofacial region. The objective of this study was to explore the clinical findings after centric relation occlusal splint (CROS) treatment and intra-articular injection treatment with liquid phase concentrated growth factors (LPCGFs) in patients with disc displacement without reduction (DDWOR).The group under investigation of this retrospective cohort study included patients with DDWOR who received treatment from April 2014 until March 2016. The predictor variable was the therapeutic method. The outcome variables included joint crepitus sound, visual analog scale (VAS) of temporomandibular joint (TMJ) arthralgia, TMD-associated headache, myofascial pain with referral, deviation of the mandible during opening (DoM), and maximal interincisal opening (MIO). At the stage of CROS treatment, evaluation of all variables adopted the individual as the unit; at the stage after LPCGF injection, the evaluation of joint sound adopted the joint as the unit, whereas the other variables adopted the individual as the unit.Among the 29 patients, 6 (20.68%) were males and 23 (79.31%) were females. Distribution by age ranged from 15 to 84 years (mean age 39.55 ± 15.49 years). After CROS treatment, except for the joint crepitus sound, which failed to achieve significant improvement (P > 0.05), other symptoms, such as DOM, TMD-associated headache, myofascial pain with referral, TMJ arthralgia, and MIO, all achieved statistically significant improvements (P < 0.05). After 2 mL of LPCGF was injected once after CROS treatment, 26 joint crepitus sound symptoms were relieved (P < 0.001) after an average of 48.5 ± 64.1 days.CROS alone can alleviate TMD clinical symptoms, except for the joint crepitus sound. Approximately 72.2% of joint crepitus sounds could be improved within 48 days, on average, once 2 mL of LPCGF was injected. Comparisons were still required in the future, with the effects of other therapeutic methods.

Quantification of growth factors in different platelet concentrates

Concentrated growth factor (CGF), a new generation of platelet concentrate product, 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 contents of major growth factors in CGF and compare them with those found in PRP (platelet-rich plasma) and PRF (platelet-rich fibrin). PRP, PRF, and CGF were obtained from the same samples of peripheral blood. Concentrations of five representative growth factors in platelets were measured with enzyme-linked immunosorbent assay (ELISA): platelet-derived growth factor-BB (PDGF-BB), transforming growth factor β-1 (TGF-β1), insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF). The results showed that the bFGF levels in CGF and PRF were significantly higher than that in activated PRP. For other growth factors, such as PDGF-BB, TGF-β1, IGF-1, and VEGF, the levels did not differ significantly among activated PRP, PRF, and CGF. Our findings extended the currently available data on the release and measurement of growth factors in CGF and other platelet gels. In future studies, we need more data to find the proper therapeutic doses for platelet concentrates suitable for different clinical applications.

The effect of concentrated growth factors in the treatment of periodontal intrabony defects

AIM

To investigate the effect of concentrated growth factors (CGFs) in human intrabony defect treatment.

METHODS

Thirty-one intrabony defects were randomly treated with CGFs + bovine porous bone mineral (BPBM) or BPBM alone. Probing depth, clinical attachment level and hard tissue fill were evaluated at baseline and 1 year post surgery.

RESULTS

No differences in any of the investigated parameters were observed at baseline. At 1 year post therapy, both groups showed significant improvement in clinical parameters (p < 0.001). CGFs + BPBM was more effective than BPBM alone at decreasing probing depth (4.2 ± 1.3 mm vs 3.0 ± 1.6 mm) and clinical attachment level gain (3.7 ± 1.3 mm vs 2.4 ± 1.1 mm; p ≤ 0.05). A favorable increase of hard tissue fill was noted in CGFs + BPBM group compared with BPBM group (p > 0.05). The contents of growth factors in CGFs were statistically higher than those in platelet poor plasma (p < 0.001).

CONCLUSION

Addition of CGFs significantly improved clinical effectiveness of BPBM for intrabony defect treatment.

Effect of Concentrated Growth Factor on Survival of Diced Cartilage Graft

BACKGROUND

Diced cartilage grafts are important in rhinoplasty for raising the dorsum and eliminating dorsal irregularities. The most common problems with the use of diced cartilage are wrapping and cartilage resorption.

OBJECTIVES

To histopathologically investigate and compare the viability of diced cartilage grafts wrapped with concentrated growth factor, fascia and fenestrated fascia, or blood glue.

METHODS

Cartilage grafts were harvested from the ears of 10 New Zealand White rabbits and diced into 0.5 to 1 mm³ pieces. The grafts were divided into five groups for comparison: (1) bare diced cartilage; (2) diced cartilage wrapped with fascia; (3) diced cartilage wrapped with fenestrated fascia; (4) diced cartilage wrapped with concentrated growth factor (CGF); and (5) diced cartilage wrapped with blood glue. Each of the five grafts was autologously implanted into a subcutaneous pocket in the back of each rabbit. Three months later, the rabbits were sacrificed and the implants were harvested and examined histopathologically.

RESULTS

Nucleus loss, calcification, inflammation, and giant cell formation differed significantly between the CGF group and both fascia groups. Chondrocyte proliferation was the highest in the CGF group. Nucleus loss rates were similar between the fascia and fenestrated fascia groups.

CONCLUSIONS

Our findings suggest that CGF improves the viability of diced cartilage grafts, while fascia hampers it. Punching holes in the fascia does not improve diced cartilage graft viability and neither does blood glue wrapping.

Comparison of removal torques of SLActive® implant and blasted, laser-treated titanium implant in rabbit tibia bone healed with concentrated growth factor application

PURPOSE

The purpose of this study was to compare the removal torques of a chemically modified SLActive implant and a blasted, laser-treated (BLT) implant, which were soaked in saline for 2 weeks after their surface modifications. The removal torques of the two implants were measured 4 weeks after their implantation into the bone defect area in rabbit tibias with concentrated growth factor (CGF) application.

MATERIALS AND METHODS

To make artificial bone defects in the cortical layers of both tibias, an 8-mm diameter trephine bur was used. Then, prepared CGF was applied to the bony defect of the left tibia, and the bony defect of the right tibia was left unfilled. Four weeks later, the surgical sites of 16 rabbits were re-exposed. For 8 rabbits, the SLActive implants (Straumann, Switzerland) were inserted in the left tibia, and the BLT implants (CSM implant, Daegu, Korea) were inserted in the right tibia. For other rabbits, the BLT implants were inserted in the left tibia, and the SLActive implants were inserted in the right. Four weeks afger the insertion, torque removal was measured from 4 rabbits exterminated via CO2 inhalation.

RESULTS

No significant difference was observed between removal torques of the BLT implant and the SLActive implant (P>.05).

CONCLUSION

It was found that BLT surface modification exhibited excellent osseointegration. In addition, CGF application did not affect the insertion and removal torque of the implants.

Flapless transcrestal sinus augmentation using hydrodynamic piezoelectric internal sinus elevation with autologous concentrated growth factors alone

PURPOSE

The purpose of this retrospective study was to evaluate the success rate of implants and the amount of sinus augmentation using the flapless hydrodynamic piezoelectric internal sinus elevation (HPISE) technique with autologous concentrated growth factors (CGF) alone.

MATERIALS AND METHODS

A total of 11 maxillary sinuses were augmented using the HPISE technique through the flapless transcrestal approach. Sixteen implants (average 11.38 mm in length and 4.83 mm in diameter), with 2 different surfaces, were placed simultaneously with CGF alone. Plain panoramic radiograms and cone-beam computed tomograms (CBCT) were taken in all patients to evaluate the sinus augmentation preoperatively and postoperatively.

RESULTS

The sinus membranes were successfully elevated, averaging 13.95 ± 6.61 mm in immediate postoperative CBCT without any iatrogenic perforation. After an average 23.8 weeks, the average bone gain above the sinus floor was 8.23 ± 2.88 mm in the axial aspect of CBCT. No complications were recorded in any patients during the follow-up period.

CONCLUSION

The flapless transcrestal approach to the sinus augmentation using the HPISE technique with autologous CGF alone could be an alternative to the lateral approach, even at severely resorbed edentulous posterior maxilla with insufficient bone height.

Concentrated growth factor increases Schwann cell proliferation and neurotrophic factor secretion and promotes functional nerve recovery in vivo

Concentrated growth factor (CGF) is a newly generated complex that comprises a fibrin matrix incorporating growth factors and plasmatic and leukocyte cytokines. It has been widely used in bone regenerative medicine. However, the effect of CGF on peripheral nerve regeneration had not been previously investigated. The aim of the present study was to evaluate the possibility of using CGF for nerve regeneration by i) investigating the effect of CGF on the proliferation of Schwann cells (SCs) and secretion of neurotrophic factors nerve growth factor (NGF) and glial cell line‑derived neurotrophic factor (GDNF) in vitro; and ii) analyzing the effect of CGF on functional nerve recovery after nerve injury in vivo. CGF was prepared from venous blood taken from rats, and using scanning electron microscopy (SEM) we noted that it featured a fiber‑like appearance with pore size ranging from 0.1 to 1.0 µm. The soluble component of CGF was used to produce conditioned media with which to treat the Schwann cell line. A cell counting kit-8 assay and cell cycle analysis were both used to study the proliferative effect of CGF on SCs. Reverse transcription-quantitative PCR and western blot analysis demonstrated that there was an increase in the mRNA and protein expression of NGF and GDNF, both of which are markers of SC neurotrophic secretion. A model of sciatic nerve crush injury was established for the in vivo experiment, and CGF was found to increase the sciatic functional index (indicative of nerve function). We noted that CGF increased SC proliferation and secretion of neurotrophic factors in vitro, and promoted functional recovery after peripheral nerve injuries in vivo. These results suggest that CGF is a promising candidate biomaterial for peripheral nerve regeneration, and may potentially be utilized to repair nerve injuries.

Concentrated growth factor in the treatment of adjacent multiple gingival recessions: a split-mouth randomized clinical trial

AIM

The aim of this study was to determine the clinical effect of concentrated growth factor (CGF) in combination with coronally advanced flap (CAF) compared to CAF alone for the treatment of multiple adjacent gingival recessions (GRs).

MATERIALS AND METHODS

Twenty patients with a total of 119 Miller Class I and II GRs in the maxilla were included to this study. Recessions were randomly treated according to a split-mouth design by means of CAF + CGF (test; 60 defects) or CAF (control; 59 defects). Clinical outcomes were evaluated at baseline and 6 months after surgery.

RESULTS

The mean root coverage (MRC) was 82.06% and 86.67%, complete root coverage (CRC) was 45.8% (27/59) and 56.7% (34/60) for CAF and CAF + CGF, respectively at 6th month. Statistically no difference was demonstrated between the two groups in terms of recession depth (RD), MRC and CRC at 6th month. The increase in width of keratinized gingiva (KGW) and gingival thickness (GT) were statistically significant in the CAF + CGF group compared to the CAF group at 6th month.

CONCLUSIONS

The use of CGF in combination with CAF did not provide additional benefits in RD, CRC and MRC. This study suggests that use of CGF + CAF may increase the success of GRs because of a significant increase in KGW and GT.

The use of growth factors, CD34(+) cells and fibrin for the management of chronic venous ulcers

Chronic venous ulceration represents a very common event. Current standard treatment includes local wound care with the application of compression. We report the effects of platelet-rich plasma in patients with chronic venous ulcers, which is able to stimulate fibroblasts, macrophages and mesenchymal cells and growth factors in order to achieve re-epithelialisation and neovascularisation within the microenviroment of the wound. We also documented the efficacy of this method as the sole treatment without surgical procedures.

Platelet preparations in dentistry: How? Why? Where? When?

The aim of this article is to review the outcomes of platelet preparations in dentistry. A structured electronic search discovered 348 articles, which described the use of autologous platelet concentrates with a relevance to clinical dentistry. Among these articles, 220 articles investigated platelet rich plasma, 99 investigated platelet rich fibrin, 22 investigated plasma rich in growth factors and 7 investigated the use of concentrated growth factors. Several studies reported beneficial treament outcomes in terms of enhanced bone and soft tissue regeneration.

The Study of the Effect of Concentrated Growth Factors (CGF) on the New Bone Regeneration of Immediate Implant

Objective: To study the effect of concentrated growth factor (CGF) on reducing bone resorption in immediate implant. Methods: 20 immediate implant patients were divided into two groups, each group included 10 patients who were treated by adding CGF or Bio-oss to the gap of implant-bone, respectively; the labial new bone regeneration was evaluated in postoperative 1 years using cone beam CT. Results: The buccal bone width variation of the CGF group was 0.85±0.25mm, and the Bio-oss group was 0.35±0.25mm (p <0.05). Conclusion: The CGF has no significant role in promoting new bone regeneration when was used alone in the gap of implant - bone in immediate implant

Comparison of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF) in rabbit-skull defect healing

OBJECTIVES

The objective of this study was to evaluate the effect of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF) on bone healing.

STUDY DESIGN

Twelve rabbits were included in this randomized, blinded, prospective study. 15-mm×10-mm-sized defects were created in the parietal bone, filled with PRP, PRF, CGF, and void. The bone mineral density and bone volume were analyzed with microscopic computed tomography (micro-CT) and histomorphometrics at the 6th and 12th week.

RESULTS

In micro-CT analysis, bone mineral density and bone volume were greater in the experimental group than in controls at both 6th and 12th week, but not among the experimental groups. Similarly, histomorphometric examination revealed that more bone formation was seen in the experimental group.

CONCLUSION

The addition of PRP, PRF, and CGF had significantly increased bone formation at the 6th week. The effect of PRP, PRF, and CGF was similar and may be useful in the future to increase the success rate of bone grafting.

The bone integration effects of platelet-rich fibrin by removal torque of titanium screw in rabbit tibia

Platelet-rich fibrin (PRF) is nowadays often used in various fields, but no removal torque studies have yet been done to evaluate the effects of the platelet-rich fibrin on the bone integration at the initial healing period. An experimental study have been performed in rabbits to evaluate whether the complete PRF clots can accelerate the bone integration of implants at the initial healing period after creating bone defects in tibias. The effect of the complete PRF clots on bone integration was studied in two rabbit groups, 4-week group (group A) and 6-week group (group B) after preparing bony defects. Artificial bony defects were prepared in the tibias of rabbits. The complete PRF clots was applied to the defects in the experimental group, whereas the defects were unfilled in the control group. Four weeks later, machined implants were installed into the rabbit tibias (group A). Six weeks after installation, the removal torque from nine rabbits was measured to examine the bone healing effect of PRF. In another rabbits (group B), 6 weeks after preparing bony defects, installation was performed, and another 6 weeks after installation, the removal torque from nine rabbits was measured. The authors found a positive significant effect of the complete PRF clots on bone integration (higher bone density) in group A installed at 4 weeks after preparing bony defects (p = 0.008; t-test), but not in group B installed at 6 weeks after preparing bony defects (p = 0.677).

Minimally invasive sinus augmentation using ultrasonic piezoelectric vibration and hydraulic pressure: a multicenter retrospective study

PURPOSE

The purpose of this study was to evaluate the success rate of implants and vertical bone gain of edentulous posterior maxilla using ultrasonic piezoelectric vibration and hydraulic pressure, namely the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique through a crestal approach.

MATERIALS AND METHODS

A total of 250 maxillary sinuses were augmented using HPISE and 353 implants (averaging 11.8 mm in length and 4.5 mm in diameter), with 12 different systems, were placed simultaneously with or without additional bone grafting. Plain radiograms and cone beam computed tomograms were taken in all patients to evaluate sinus augmentation.

RESULTS

Membrane perforation was recorded at 10 of the 353 implant sites. The perforation rate was 2.83%. The total success rate of implantation was 97.2% after an average of 69.3 weeks of loading.

CONCLUSION

The crestally approached sinus augmentation using ultrasonic piezoelectric vibration and hydraulic pressure is an additional method of maxillary sinus augmentation.

Effect of concentrated growth factors on beagle periodontal ligament stem cells in vitro

Identifying a reliable and effective cytokine or growth factor group has been the focus of stem cell osteogenic induction studies. Concentrated growth factors (CGFs) as the novel generation of platelet concentrate products, appear to exhibit a superior clinical and biotechnological application potential, however, there are few studies that have demonstrated this effect. This study investigated the proliferation and differentiation of periodontal ligament stem cells (PDLSCs) co‑cultured with CGFs. The rate of proliferation was analyzed by cell counting and an MTT assay. Mineralization nodule counts, alkaline phosphatase activity detection, qPCR, western blot analysis and immunohistochemistry were used to analyze mineralization effects. The results showed that CGF significantly promoted the proliferation of PDLSCs, and exhibited a dose‑dependent effect on the activation and differentiation of the stem cells. The application of CGF on PDLSC proliferation and osteoinduction may offer numerous clinical and biotechnological application strategies.