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Jia K, You J, Zhu Y, Li M, Chen S, Ren S, Chen S, Zhang J, Wang H, Zhou Y. Platelet-rich fibrin as an autologous biomaterial for bone regeneration: mechanisms, applications, optimization. Front Bioeng Biotechnol 2024; 12:1286035. [PMID: 38689760 PMCID: PMC11058865 DOI: 10.3389/fbioe.2024.1286035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
Platelet-rich fibrin, a classical autologous-derived bioactive material, consists of a fibrin scaffold and its internal loading of growth factors, platelets, and leukocytes, with the gradual degradation of the fibrin scaffold and the slow release of physiological doses of growth factors. PRF promotes vascular regeneration, promotes the proliferation and migration of osteoblast-related cells such as mesenchymal cells, osteoblasts, and osteoclasts while having certain immunomodulatory and anti-bacterial effects. PRF has excellent osteogenic potential and has been widely used in the field of bone tissue engineering and dentistry. However, there are still some limitations of PRF, and the improvement of its biological properties is one of the most important issues to be solved. Therefore, it is often combined with bone tissue engineering scaffolds to enhance its mechanical properties and delay its degradation. In this paper, we present a systematic review of the development of platelet-rich derivatives, the structure and biological properties of PRF, osteogenic mechanisms, applications, and optimization to broaden their clinical applications and provide guidance for their clinical translation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Yanmin Zhou
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
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Xie Y, Qin Y, Wei M, Niu W. Application of sticky bone combined with concentrated growth factor (CGF) for horizontal alveolar ridge augmentation of anterior teeth: a randomized controlled clinical study. BMC Oral Health 2024; 24:431. [PMID: 38589825 PMCID: PMC11003068 DOI: 10.1186/s12903-024-04229-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/04/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE This study was designed to estimate the effect of sticky bone combined with concentrated growth factor (CGF) on anterior alveolar horizontal augmentation during implantation. METHODS Twenty-eight patients were randomly assigned to either the test group (Group 1, n = 14) or the control group (Group 2, n = 14). Patients in Group 1 and Group 2 underwent GBR using sticky bone combined with CGF and bone powders mixed with saline, respectively. On postoperative Day 7, the patients completed the visual analogue scale (VAS). Three-dimensional models of maxillary alveolar bone were reconstructed from CBCT data at different periods, and the bone volume conversion rate was calculated with the assistance of a measurement marker guide. Labial bone thickness before and after trauma closure and bone density at six months postoperatively were also measured. RESULTS The mean bone volume conversion rate for Group 1 (72.09 ± 12.18%) was greater than that for Group 2 (57.47 ± 9.62%, P = 0.002). The VAS score was lower for Group 1 than for Group 2 (P = 0.032). At six months postoperatively, greater bone density was found in patients in Group 1 than in those in Group 2, although the difference was not statistically significant (P > 0.05). The change in the thickness of the labial bone graft material in Group 1 was smaller than that in Group 2 (P = 0.025). CONCLUSION Sticky bone combined with CGF was able to achieve better bone augmentation than conventional GBR. With excellent mechanical properties and the capacity to release growth factors, sticky bone is an ideal material for bone grafting. TRIAL REGISTRATION The study was registered at the Chinese Clinical Trial Registry on 10/04/2022 (Identification number: ChiCTR2200058500).
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Affiliation(s)
- Yu Xie
- School of Stomatology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Implant Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yanyan Qin
- Department of Implant Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Miao Wei
- School of Stomatology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Implant Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wenzhi Niu
- School of Stomatology, Xuzhou Medical University, Xuzhou, Jiangsu, China.
- Department of Implant Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
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El-Wakeel N, Mohamed Abd-Elaziz L. Single-flap approach versus without concentrate growth factor in the treatment of periodontal supra-osseous defects: A randomized controlled clinical trial. Saudi Dent J 2024; 36:328-333. [PMID: 38419996 PMCID: PMC10897590 DOI: 10.1016/j.sdentj.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 03/02/2024] Open
Abstract
Objectives We aimed to compare treatment outcomes of periodontal supra-bony defects using single flap (SFA) plus concentrate growth factor versus SFA alone. Methods 32 supra-bony periodontal defects were randomly assigned to test and control groups. Outcome variables were clinical attachment level (primary outcome). Probing pocket depths, gingival recessions, bone gain, post-surgical pain using visual analogue scale and wound healing index were recorded as secondary outcomes. Clinical and radiographic assessments were recorded at baseline and 6 months after treatment, whereas pain score and wound healing index were recorded within 10 days after surgery. Results Test group showed a significant improvement in all tested parameters compared to control group (P-value ≤ 0.05). Better patient centered outcomes (wound healing and pain scores) were highly achieved in the test group compared to controls. Conclusion The tested combined approach offers better periodontal and patient centered treatment outcomes in management of periodontal supra-bony defects.
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Affiliation(s)
- Naglaa El-Wakeel
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Al-Azhar University (Girls Branch), Cairo, Egypt
| | - Lobna Mohamed Abd-Elaziz
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Al-Azhar University (Girls Branch), Cairo, Egypt
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Lu Z, Bingquan H, Jun T, Fei G. Effectiveness of concentrated growth factor and laser therapy on wound healing, inferior alveolar nerve injury and periodontal bone defects post-mandibular impacted wisdom tooth extraction: A randomized clinical trial. Int Wound J 2024; 21:e14651. [PMID: 38272792 PMCID: PMC10789919 DOI: 10.1111/iwj.14651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
The extraction of wisdom teeth with mandibular impact frequently results in complications including damage to the inferior alveolar nerve (IAN) and malformations of the bone. The objective of this research endeavour was to assess the efficacy of low-level laser therapy and concentrated growth factor (CGF) in facilitating nerve recovery and wound healing in such instances. A total of thirty-one patients (mean age 27.52 ± 5.79 years) who presented with IAN injury after extraction were randomly assigned to one of three groups: control group (which received oral mecobalamin), CGF group (which received CGF gel applied to the extraction sockets) and laser group (which received low-level lasers (808 nm, 30 mW, 10 J/cm2 )) at the extraction site. Patients' recovery from IAN paresthesia was evaluated seven times over the course of 14 days utilizing visual analogue scale (VAS) and the pinprick test (PP). At multiple intervals following surgery, periodontal probing and bone level measurements were utilized to assess the recovery of both soft and hard tissues. The findings revealed that, compared with the control group, both the CGF and laser treatment groups exhibited a markedly greater improvement in VAS scores and wound healing of soft tissues, as well as in PP results (p < 0.001), indicating enhanced wound healing processes. Despite these improvements, there was no significant difference in wound healing outcomes between the CGF and laser groups. Notably, the CGF group showed a statistically significant improvement in healing bone defects at 30 and 90 days post-treatment compared with the control group (p = 0.003 and p = 0.004, respectively), underscoring its effectiveness in bone healing as a critical aspect of the overall wound healing process. However, in terms of other wound healing comparisons, no significant differences were observed. CGF and laser therapy significantly enhanced the healing of wounds, including soft tissue and bone recovery, in addition to accelerating the recovery of IAN injuries following mandibular wisdom tooth extraction. Although both treatments were equally effective in nerve recovery, CGF notably excelled in promoting bone healing, suggesting its pivotal role in comprehensive wound healing. This highlights that both CGF and laser therapy are viable options for not only nerve recovery but also for overall wound healing in such dental procedures.
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Affiliation(s)
- Zhu Lu
- Department of StomatologySouth China Hospital Affiliated to Shenzhen UniversityShenzhenGuangdongChina
| | - Huang Bingquan
- Department of StomatologyLonggang Central Hospital of ShenzhenShenzhenGuangdongChina
| | - Tan Jun
- Foshan Stomatological HospitalFoshanGuangdongChina
| | - Ge Fei
- Department of StomatologySouth China Hospital Affiliated to Shenzhen UniversityShenzhenGuangdongChina
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Chen L, Cheng J, Cai Y, Zhang J, Yin X, Luan Q. Efficacy of concentrated growth factor (CGF) in the surgical treatment of oral diseases: a systematic review and meta-analysis. BMC Oral Health 2023; 23:712. [PMID: 37794381 PMCID: PMC10548564 DOI: 10.1186/s12903-023-03357-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/26/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Concentrated growth factor (CGF), a new autologous platelet concentrate, has been widely investigated to the adjunctive treatment of oral diseases. This study aims to evaluate the efficacy of CGF in the surgical treatment of oral diseases. METHODS MEDLINE, Web of Science, Scopus, Cochrane, and EMBASE databases were searched up to July 2023. Only randomized clinical trials were included. The methodologic quality was evaluated by the Cochrane Risk of Bias Tool. RevMan 5.4 software was used for data analysis. RESULTS In the treatment of periodontal intrabony defects, bone graft combined with CGF was significantly superior to bone graft (P < 0.01), with mean intrabony defect depth reduction of 1.41 mm and mean clinical attachment level gain of 0.55 mm. In the regenerative surgery of furcation defects, the effect of CGF group was significantly better than control group (P < 0.0001), with mean probing depth reduction of 0.99 mm, vertical bone gain of 0.25 mm, and horizontal bone gain of 0.34 mm. CGF combined with coronally advanced flap (CAF) was more effective than CAF alone (mean keratinized tissue width increase of 0.41 mm, mean gingival thickness increase of 0.26 mm, P < 0.00001), but less effective than connective tissue graft (CTG) combined with CAF (mean root coverage difference of -15.1%, mean gingival thickness difference of -0.5 mm, P < 0.0001). In the alveolar ridge preservation, additional use of CGF reduced horizontal bone resorption by 1.41 mm and buccal vertical bone resorption by 1.01 mm compared to control group (P < 0.0001). The VAS score of CGF group was significantly lower than that of the control group at the 1st and 7th day after oral surgery (P < 0.0001). CONCLUSIONS CGF can exert a positive adjunctive effect for the regenerative surgery of periodontal intrabony defects, furcation defects, and alveolar ridge preservation procedure. CGF combined with CAF has a better therapeutic effect on gingival recession compared to CAF alone, although it is not as effective as CTG combined with CAF. CGF could promote postoperative healing and pain relief in oral surgery within a week. There is currently not enough evidence to support the clinical benefits of CGF in other oral surgeries.
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Affiliation(s)
- Liang Chen
- Department of Periodontology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Jing Cheng
- Stomatological Hospital of Xiamen Medical College, Xiamen Medical College, Xiamen, PR China
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, PR China
| | - Yu Cai
- Department of Periodontology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Jingran Zhang
- Department of Periodontology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Xiaohui Yin
- First Clinical Division, Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology & National, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Qingxian Luan
- Department of Periodontology, National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China.
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Deng TG, Liu P, Zhou HZ, Xue Y, Zheng XN, Ji ZH, Wang L, Hu KJ, Ding YX. Effect on implant drills and postoperative reactions for pre-extraction interradicular implant bed preparation during the COVID-19 pandemic and beyond. Medicine (Baltimore) 2022; 101:e29249. [PMID: 35984133 PMCID: PMC9387664 DOI: 10.1097/md.0000000000029249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The aim of the present study was to observe the abrasion of implant drills and postoperative reactions for the preparation of the interradicular immediate implant bed during the COVID-19 pandemic and beyond. Thirty-two implant drills were included in four groups: blank, improved surgery, traditional surgery, and control. In the improved surgery group, a dental handpiece with a surgical bur was used to decoronate the first molar and create a hole in the middle of the retained root complex, followed by the pilot drilling protocol through the hole. The remaining root complex was separated using a surgical bur and then extracted. Subsequently, the implant bed was prepared. Implant drills were used in the traditional surgery group to complete the decoronation, hole creation, and implant-drilling processes. The tooth remained intact until the implant bed was prepared. The surface roughness of the pilot drill was observed and measured. Surgery time, postoperative reactions (swelling, pain, and trismus), and fear of coronavirus disease 2019 scale (FCV-19S) were measured and recorded, respectively. Statistical analysis revealed significant difference with surface roughness among blank group (0.41 ± 0.05 μm), improved surgery group (0.37 ± 0.06 μm), traditional surgery group (0.16 ± 0.06 μm), and control group (0.26 ± 0.04 μm) (P < .001). Significant differences were revealed with surgery time between improved surgery group (5.63 ± 1.77 min) and traditional surgery group (33.63 ± 2.13 min) (P < .001). Swelling, pain, and trismus (improved group: r ≥ 0.864, P ≤ .006; traditional group: r ≥ 0.741, P ≤ .035) were positively correlated with the FCV-19S. This study proved that a new pilot drill could only be used once in traditional surgery but could be used regularly in improved surgery. Improved surgery was more effective, efficient, and economical than the traditional surgery. The higher FCV-19S, the more severe swelling, pain, and trismus.
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Affiliation(s)
- Tian-Ge Deng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Ping Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Hong-Zhi Zhou
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Yang Xue
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Xue-Ni Zheng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Zhao-Hua Ji
- Department of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, China
| | - Lei Wang
- Department of Female Mental Health, Xi’an Mental Health Center, Xi’an, China
- *Correspondence: Lei Wang, Department of Female Mental Health, Xi’an Mental Health Center, Dong Hangtian Road, Xi’an 710061, China (e-mail: )
| | - Kai-Jin Hu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - Yu-Xiang Ding
- Department of Dental Implant, Xi’an Savaid Stomatolgy Hospital, University of Chinese Academy of Sciences, Xi’an, China
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Concentrated Growth Factors (CGF) Combined with Melatonin in Guided Bone Regeneration (GBR): A Case Report. Diagnostics (Basel) 2022; 12:diagnostics12051257. [PMID: 35626412 PMCID: PMC9141849 DOI: 10.3390/diagnostics12051257] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/06/2022] [Accepted: 05/16/2022] [Indexed: 12/23/2022] Open
Abstract
During implant restorative dentistry, common and crippling postoperative complications are pain and swelling of perioral soft tissues which engraving on patient quality of life. Concentrated growth factors (CGF), a novel generation of autologous platelet concentrate, and melatonin, endogenous indoleamine with also bone regenerative properties, may be useful for reconstruction of bony defects as well as in prosthetic and esthetic rehabilitation. We report a clinical case in which guided bone regeneration was performed combining CGF, melatonin and heterologous biomaterial. Great postoperative recovery without any complications was reported. In conclusion, in restorative dentistry the combined use of CGF and melatonin may have important roles in restoring bone defect, in improving implant osteointegration and, not less important, in preventing postoperative complications.
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