Clinical applications of concentrated growth factors combined with bone substitutes for alveolar ridge preservation in maxillary molar area: a randomized controlled trial

Abstract

Purpose To evaluate the clinical effects of concentrated growth factors (CGFs) combined with bone substitutes for alveolar ridge preservation (ARP) in the maxillary molar area. Methods Thirty-six patients who underwent extraction of the upper molars were recruited and randomly divided into three groups: 1. Grafted with CGFs combined with deproteinized bovine bone mineral (DBBM) and covered with CGFs membrane (CGFs/DBBM group), 2. Grafted with DBBM alone and covered with collagen membrane (DBBM group), 3. Control group spontaneous healing. The area of the alveolar bone in center (C-), mesial (M-) and distal (D-) section was compared with preoperative in radiography. Bone cores were obtained for histopathology observation and comparison. Results In C-, M- and D-section, the alveolar ridge area in all three groups was significantly reduced at 8 months postoperatively compared to the baseline (P < 0.05). The alveolar ridge area declines in the CGFs/DBBM group (C-12.75 ± 2.22 mm2, M-14.69 ± 2.82 mm2, D-16.95 ± 4.17 mm2) and DBBM group (C-14.08 ± 2.51 mm2, M-15.42 ± 3.47 mm2, D-16.09 ± 3.97 mm2) were non-significant differences. They were significantly less than the decline in the control group (C-45.04 ± 8.38 mm2 M-31.98 ± 8.34 mm2, D-31.85 ± 8.52 mm2) (P < 0.05). The percentage of newly formed bone in the CGFs/DBBM group (41.99 ± 12.99%) was significantly greater than that in DBBM group (30.68 ± 10.95%) (P < 0.05). The percentage of residual materials in the CGFs/DBBM group (16.19 ± 6.63%) was significantly less than that in the DBBM group (28.35 ± 11.70%) (P < 0.05). Conclusion Combined application of CGFs and DBBM effectively reduced the resorption of alveolar ridge and resulted in more newly formed bone than the use of DBBM with collagen membranes.

Efficacy of biologics for alveolar ridge preservation/reconstruction and implant site development: An American Academy of Periodontology best evidence systematic review

“… 27 On the other hand, Lin et al. compared (1) concentrated growth factors (CGFs) combined with DBBM versus (2) DBBM alone versus (3) unassisted healing 30 . Last, four investigations had four different groups 26,28,29 .…”

“…Overall, ABPs were the most investigated biologic (12 studies) 24–31,36–39 . The ABPs studied in these investigations included: PRF, L‐PRF, A‐PRF, A‐PRF+, PRGF, and CGF.…”

“…Other investigations reported on alternative methods for assessment such as radiographic bone fill 27,31,37,39 and evaluation of the so‐called “alveolar bone area” 30 . These alternative analyses typically resulted in more favorable outcomes for the test group 30,31,37,39 .…”

“…Histomorphometric assessment of bone biopsies was performed in six investigations 9,24–26,29,30 . Overall, the use of biologics (i.e., ABPs and EMD) seems to have a beneficial effect on mineralized tissue formation with all six studies reporting superior percentages for the groups involving the use of biologic mediators as a monotherapy or in combination with graft materials.…”

Clinical applications of concentrated growth factors membrane for sealing the socket in alveolar ridge preservation: a randomized controlled trial

“…It was found in several studies that researchers filled CGF in combination with bone grafting material in extraction sockets or put CGF alone for ARP. For example, Lin et al [28] used CGF gels mixed with DBBM then filled this mixture in the socket and covered with CGFs membranes in the test group, while filled DBMM alone and covered with Bio-Gide ® collagen membranes in control group. Mixing CGF with DBBM makes it impossible to objectively evaluate the effect of CGF on wound closure.…”