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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (2): 346-352. doi: 10.19723/j.issn.1671-167X.2020.02.024

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Effect of concentrated growth factors combined with guided tissue regeneration in treatment of classⅡ furcation involvements of mandibular molars

Fei LI,Jing QIAO,Jin-yu DUAN,Yong ZHANG,Xiu-jing WANG()   

  1. First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
  • Received:2018-08-08 Online:2020-04-18 Published:2020-04-18
  • Contact: Xiu-jing WANG E-mail:wang_xiu_jing@163.com
  • Supported by:
    Supported by the New Technology and New Treatment Foundation of Peking University School;Hospital of Stomatology, the National Natural Science Foundation of China(81600868);the Cao Caifang Periodontal Gengyun Foundation of Peking University School and Hospital of Stomatology(2016)

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Abstract:

Objective: Tissues loss due to periodontal disease is typically treated by a variety of rege-nerative treatment modalities, including bone grafts, guided tissue regeneration (GTR) and growth factors, to reform the supporting tissues of teeth. Concentrated growth factors (CGF) are produced by centrifuging blood samples at alternating and controlled speeds using a special centrifuge. The purpose of this study was to evaluate whether GTR could improve the effect of CGF combined with bone graft in the treatment of classⅡ furcations of mandibular molars.Methods: In the present study, thirty-five classⅡ furcation involvements were included and randomly divided into two groups. The experimental group (n=17) accepted GTR combined with CGF and bone graft therapy, and the controlled group (n=18) accepted CGF combined with bone graft therapy. The clinical examinations and cone beam computed tomography (CBCT) were performed at baseline and 1 year post-surgery. Comparisons of clinical and CBCT data before and after operation between the experimental group and the control group were made.Results: The clinical and CBCT data of both groups were not statistically different at baseline (P>0.05). At the end of 1 year post-surgery, the clinical parameters of both groups were significantly improved (P<0.001). The probing depths of the experimental group were (4.81±1.95) mm and (3.56±1.94) mm, respectively, significantly higher than the changes of the control group (P<0.001). The vertical and horizontal attachment gains of the experimental group were (4.11±1.98) mm and (3.84±1.68) mm, respectively, significantly higher than the changes of the control group (P<0.001). At the end of 1 year post-surgery, the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with those of the control group: (3.84±1.68) and (3.88±2.12) mm, respectively (P<0.001).Conclusion: Within the limitation of the present study, GTR showed positive role in the effect of CGF combined with bone graft in the treatment of classⅡ furcation involvements of mandibular molars.

Key words: Concentrated growth factors, Furcation involvement, Bone grafting, Guided tissue regeneration

CLC Number: 

  • R781.3

Table 1

The distribution of furcation involvement in experimental and controlled group"

Group Number of teeth Furcation location Total
Buccal Lingual
Experimental group 11 9 8 17
Controlled group 11 9 9 18

Figure 1

Schematic diagram of marking points of CBCT for furcation involvements CEJ, cementoenamel junction; FE, furcation entrance; BP, bottom of bone pocket; DH, deepest site of horizontal bone loss; BL-H, bone loss in the horizontal direction, the distance from furcation entrance to the deepest site of horizontal bone loss; BL-V, bone loss in the vertical direction, the distance from furcation entrance to the bottom of bone pocket."

Figure 2

Preparation of concentrated growth factors A, three blood fractions were obtained through centrifuge process, a superior phase represented by the serum, an interim phase represented by a very large and dense polymerized fibrin block containing the CGF, white blood cells and stem cells, and the lower red blood cell layer; B, CGF."

Figure 3

Preparation of CGF-Bio-Gide-CGF sandwich membraneA, CGF membrane; B, Bio-Gide membrane; C, CGF-Bio-Gide-CGF sandwich membrane."

Figure 4

The baseline, in surgery and post-surgery of patient no.5 in the experimental group A, baseline; B, intrasurgical findings; C, bone graft mixed with CGF; D, mixture in site; E, CGF-Bio-Gide-CGF sandwich membrane in site; F, wound closed;G,1 year post-surgery."

Figure 5

CBCT images of patient no.5 of the experimental group at baseline"

Figure 6

CBCT images of patient no.5 of the experimental group at 1 year post-surgery"

Figure 7

The baseline, in surgery and post-surgery of patient no.4 in the control group A, baseline; B, intrasurgical findings; C, mixture in site; D, CGF membrane in site; E, wound closed; F, 1 year post-surgery."

Figure 8

CBCT images of patient no.4 of the control group at baseline"

Figure 9

CBCT images of patient no.4 of the control group at 1 year post-surgery"

Table 2

Clinical measurements of experimental and controlled group at baseline and 1 year post-surgery"

Items Experimental group Controlled group
PPD/mm, $\bar{x}±s$
Baseline 7.86±2.47 7.73±2.15
1 year post-surgery 3.05±1.33* 4.17±2.09*
PPD reduction 4.81±1.95# 3.56±1.94
REC/mm, $\bar{x}±s$
Baseline 1.42±0.87 1.48±0.69
1 year post-surgery 2.12±1.05* 2.14±1.03*
REC increase 0.70±0.63 0.66±0.62
CAL-V/mm, $\bar{x}±s$
Baseline 9.28±2.65 9.21±2.51
1 year post-surgery 5.17±1.48* 6.31±2.45*
Vertical attachment gain 4.11±1.98# 2.90±2.01
CAL-H/mm, $\bar{x}±s$
Baseline 6.08±2.31 6.05±2.44
1 year post-surgery 2.24±1.29* 3.35±1.67*
Horizontal attachment gain 3.84±1.68# 2.70±1.47

Table 3

The CBCT data of experimental and controlled group at baseline and 1 year post-surgery"

Items Experimental group Controlled group
BL-V/mm, $\bar{x}±s$
Baseline 6.01±2.34 6.04±2.58
1 year post-surgery 2.17±1.49* 3.15±1.37*
Vertical radiograph bone gain 3.84±1.68# 2.89±2.03
BL-H/mm, $\bar{x}±s$
Baseline 6.75±2.44 6.73±2.57
1 year post-surgery 2.87±2.02* 4.21±2.07*
Horizontal radiograph bone gain 3.88±2.12# 2.52±2.26
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