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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (1): 42-50. doi: 10.19723/j.issn.1671-167X.2025.01.007

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Therapeutic effect of concentrated growth factors combined with self-curing calcium phosphate cement on periodontal intrabony defects: Clinical and radiographic evaluation

Xinying WANG1, Xueyuan CHENG2, Yong ZHANG2, Fei LI2, Jinyu DUAN2, Jing QIAO2,*()   

  1. 1. Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Enginee-ring Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
    2. First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Enginee-ring Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
  • Received:2024-10-09 Online:2025-02-18 Published:2025-01-25
  • Contact: Jing QIAO E-mail:donaldshushu@aliyun.com
  • Supported by:
    the Program of New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-21G02)

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Abstract:

Objective: To clarify the role of concentrated growth factors (CGF) in the treatment of periodontal cement defects using calcium phosphate cement (CPC) with self-curing properties. Methods: Thirty-six intrabony defects were randomly divided into two groups. The experimental group received CGF+CPC treatment (n=18), while the control group received CPC treatment alone (n=18). The probing depth, clinical attachment loss, and hard tissue filling as measured by cone beam CT (CBCT) were evaluated at baseline and 1 year postoperatively in both groups, and the levels of major growth factors in CGF and serum were compared [platelet-derived growth factor-BB (PDGF-BB), transforming growth factor-β1 (TGF-β1), insulin-like growth factor-1 (IGF-1), and vascular endothelial growth factor (VEGF)]. Results: At baseline, there were no statistically significant differences in probing depth, clinical attachment loss and CBCT measurements between the two groups (P>0.05). At 1 year postoperatively, significant improvements were observed in parameters mentioned above in both groups (P < 0.05). The CGF+CPC group seemed more effective compared with the CPC group in reduction of probing depth [(4.5±1.3) mm vs. (3.2±1.1) mm] and clinical attachment gain [(3.8±0.9) mm vs. (2.0±0.5) mm, P < 0.05]. Compared with the group treated with CPC alone, the hard tissue filling degree shown by CBCT in the CGF+CPC group was significantly increased [the reduction of the depth of the intrabony defects was (3.9±1.2) mm vs. (2.1±0.7) mm, respectively, P < 0.01]. At 1 year post-operatively, the volume of the intrabony defects shown by CBCT in the CGF+CPC group was reduced by (0.031 8±0.004 1) mL, which was significantly more than that in the CPC group [(0.019 7±0.001 2) mL, P < 0.05]. In addition, the concentration of the main growth factors (PDGF-BB, TGF-β1, IGF-1, and VEGF) in CGF were higher than those in serum (P < 0.001). Conclusion: After 1 year of follow-up, the results of the present study indicated that CGF could significantly improve the clinical and radiological effects of CPC on the treatment of periodontal intrabony defects.

Key words: Concentrated growth factors, Calcium phosphate cement, Periodontal regeneration, Intrabony defect, Cone beam computed tomography

CLC Number: 

  • R781.4

Figure 1

Diagram of marking points of CBCT for intrabony defect CEJ, cementoenamel junction; AC, alveolar crest; BD, base of the defect; AC', alveolar crest'; CBCT, cone beam CT."

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. CGF, concentrated growth factors."

Figure 3

The baseline, in surgery and post-surgery of patient No. 4 in the experimental group A, baseline; B, intrasurgical findings; C, sticky bone: CGF mixed with CPC; D, mixture in site; E, CGF membrane in site; F, wound closed; G, 1 year post-surgery. CGF, concentrated growth factors; CPC, calcium phosphate cement."

Table 1

Distribution and type of treated intrabony defects in the two groups"

ItemsCGF+CPC (n=18)CPC (n=18)
Maxilla89
Mandible109
Anterior teeth57
Premolars85
Molars56
2 walls54
2-3 walls87
3 walls57
AC’-BD in surgery/mm, ${\bar x}$±s5.2±1.85.3±1.6

Table 2

Mean plaque index and bleeding index at baseline and 1 year post-surgery in the two groups"

ItemsCGF+CPC (n=18)CPC (n=18)
Plaque index, ${\bar x}$±s
   Baseline0.6±0.20.8±0.4
   1 year post-surgery0.8±0.30.9±0.3
Bleeding index, ${\bar x}$±s
   Baseline0.9±0.61.0±0.4
   1 year post-surgery1.1±0.71.3±0.5

Table 3

Clinical measurements at baseline and 1 year post-surgery in the two groups"

ItemsCGF+CPC (n=18)CPC (n=18)P value
Probing depth/mm, ${\bar x}$±s
   Baseline7.2±1.87.6±2.00.837
   1 year post-surgery2.7±0.84.4±1.20.003
   Reduction4.5±1.33.2±1.10.012
   P value< 0.001< 0.001
Gingival recession/mm, ${\bar x}$±s
   Baseline1.1±0.30.9±0.20.612
   1 year post-surgery1.9±0.71.6±0.60.718
   Increase0.8±0.30.7±0.40.524
   P value0.0170.023
Clinical attachment loss/mm, ${\bar x}$±s
   Baseline8.3±2.08.5±2.6>0.999
   1 year post-surgery4.5±1.76.3±2.10.022
   Reduction3.8±0.92.0±0.50.019
   P value0.0380.017

Table 4

CBCT data at baseline and 1 year post-surgery in the two groups"

ItemsCGF+CPC (n=18)CPC (n=18)P value
CEJ-AC’/mm, ${\bar x}$±s
   Baseline4.3±0.84.5±1.00.965
   1 year post-surgery4.8±0.94.9±1.1>0.999
   Change0.5±0.10.4±0.2>0.999
   P value0.8760.933
CEJ-BD/mm, ${\bar x}$±s
   Baseline9.4±2.69.8±3.00.892
   1 year post-surgery6.0±1.88.1±2.70.002
   Decrease3.4±1.01.7±0.50.004
   P value< 0.001< 0.001
BD-AC’/mm, ${\bar x}$±s
   Baseline5.1±1.65.3±1.9>0.999
   1 year post-surgery1.2±0.63.2±0.90.007
   Decrease3.9±1.22.1±0.70.005
   P value< 0.001< 0.001

Figure 4

CBCT images of patient No. 4 of the experimental group A, baseline (arrow: intrabony defect); B, 1 year post-surgery (arrow: radiographic bone fill). CBCT, cone beam CT."

Figure 5

Change of volume of intrabony defect of patient No.4 of the experimental group A, 3D reconstruction of intrabony defect at baseline in CBCT bone (green area); B, 3D reconstruction of the volume of intrabony defect at baseline (0.052 01 mL); C, 3D reconstruction of intrabony defect at 1 year post-surgery in CBCT bone (yellow area); D, 3D reconstruction of the volume of intrabony defect at 1 year post-surgery (0.023 05 mL). 3D, 3 dimensions; CBCT, cone beam CT."

Table 5

Comparison of CGF and serum growth factor levels"

ItemsCGFSerumP value
PDGF-BB/(μg/L), ${\bar x}$±s47.58±16.19182.65±62.37< 0.001
TGF-β1/(μg/L), ${\bar x}$±s67.89±22.38780.09±152.78< 0.001
IGF-1/(μg/L), ${\bar x}$±s88.90±25.28569.87±82.37< 0.001
VEGF/(ng/L), ${\bar x}$±s42.06±20.28264.48±52.57< 0.001
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