Efficacy of concentrated growth factor (CGF) in the surgical treatment of oral diseases: a systematic review and meta-analysis

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.

Application of sticky bone combined with concentrated growth factor (CGF) for horizontal alveolar ridge augmentation of anterior teeth: a randomized controlled clinical study

“…The degree of postoperative swelling was not specifically assessed in this study, but a reduction in swelling would also significantly reduce the patient’s postoperative pain and discomfort. A meta-analysis on CGF [ 33 ] also suggested that CGF has the potential to significantly improve healing and reduce pain within one week of oral surgery. The mechanism behind pain relief lies in the fact that the fibrin structure of CGF acts as a scaffolding material and reservoir to transfer growth factors, including PDGF, TGFb1, VEGF, and proinflammatory cytokines, which can greatly reduce pain caused by inflammatory responses [ 34 ].…”

Effect of intranasal administration of concentrated growth factors on regeneration of the olfactory epithelium in an olfactory dysfunction-induced rat model

“…Therefore, CGFs may be more suitable than PRP or bFGF for the treatment of olfactory dysfunction. CGF has been clinically applied and shown to be effective [ 45 ]. Zhao et al used CGF for mucosal defects of the nasal septum and reported efficacy and no side effects [ 46 ].…”

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

“…Using the special CGF speed‐changing centrifuge made by Hersey Company and the special vacuum negative pressure blood vessel according to the preparation procedure of manual, the venous blood suitable for the size of tooth extraction socket was collected and put into the rotating cylinder of the centrifuge; after centrifugation for 15 min, the blood in the tubes was taken out. It was obvious that the blood in the vessel had been divided into three layers, and the lighter‐coloured serum on the top layer and the precipitate of red blood cells on the bottom layer was discarded, the middle layer gel, which is called CGF gel, was cut into pieces of 2 mm in size and put into a normal saline solution for use 17 , 18 ; then carefully clean the blood clots in the sockets, rinse with normal saline and then fill the sockets with the crushed CGF gel, a Hemostatic Wound Healing Gauze patch was then applied to the wound surface to prevent CGF gel from falling off or food residue from contaminating the tooth extraction pit. All operations are performed by the same surgeon.…”