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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (2): 372-379. doi: 10.19723/j.issn.1671-167X.2026.02.023

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Effect of concentrated growth factors in guided tissue regeneration for the treatment of mandibular molar furcation lesions

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

  1. 1. Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Cli-nical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100034, China
  • Received:2025-07-09 Online:2026-04-18 Published:2026-03-12
  • Contact: Jing QIAO
  • Supported by:
    the Program of New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-17G01); Peking University Clinical Medicine Plus X-Youth Scholars Project(PKU2025PKULCXQ007); Beijing Natural Science Foundation-Haidian Original Innovation Joint Fund(L252167)

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Abstract:

Objective: To evaluate the potential of concentrated growth factors (CGF) to enhance the regenerative efficacy of guided tissue regeneration (GTR) when combined with bone graft in the treatment of grade Ⅱ furcation defects in mandibular molars. Methods: This study was approved by the Ethics Committee of Peking University School and Hospital of Stomatology. A total of 16 patients (aged 20-60 years) with chronic periodontitis requiring periodontal surgical intervention were enrolled. All the participants had completed initial periodontal therapy. This involved a total of 20 mandibular molars, which comprised 36 instances of grade Ⅱ furcation lesions located on the buccal or lingual aspects. The 36 furcation lesions were randomly assigned to two groups, with each group containing 18 lesions. The experimental group received treatment with CGF combined with GTR and bone grafting, while the control group was treated with GTR and bone grafting alone. Clinical examinations and cone beam CT (CBCT) assessments were conducted on the affected teeth prior to the surgery, 6 months and 1 year post surgery. Clinical parameters recorded included probing depth (PD), vertical clinical attachment level (CAL-V), horizontal clinical attachment level (CAL-H). CBCT scans were acquired. The radiographic outcomes assessed included bone loss in the vertical direction (BL-V) and horizontal direction (BL-H). Changes in both clinical parameters and CBCT data at baseline and 1 year post surgery were compared between the experimental group and control group. Results: At baseline, no statistically significant differences were observed between the two groups in terms of PD, CAL-V, CAL-H, and BL-V, BL-H as assessed by CBCT (P>0.05), indicating good baseline balance. Six months and 1 year post surgery, both groups demonstrated significant improvements in clinical indicators compared with baseline (P < 0.01). Notably, one year post surgery, the enhancement observed in the experimental group was significantly greater than that of the control group (P < 0.05): the reduction in PD was (4.75±1.87) mm in the experimental group versus (3.43±1.76) mm in the control group; the decrease in CAL-V was (5.55±1.04) mm in the experimental group versus (4.41±1.08) mm in the control group; the decrease in CAL-H was (3.89±1.22) mm in the experimental group versus (3.07±1.02) mm in the control group. One year post surgery, CBCT results demonstrated that the reduction in BL-V was (4.05±1.37) mm in the experimental group compared with (3.17±1.09) mm in the control group, and the reduction in BL-H was (4.02±1.32) mm versus (3.27±1.08) mm. Conclusion: The one-year observational findings demonstrate that CGF enhances the regenerative efficacy of GTR combined with bone graft in the treatment of grade Ⅱ furcation defects in mandibular molars.

Key words: Concentrated growth factors, Furcation defect, Guided tissue regeneration, Molar, Mandible

CLC Number: 

  • R781.4

Figure 1

CGF preparation schematic diagram A, schematic illustration; B, photographic image. CGF, concentrated growth factors."

Figure 2

Bone graft and absorbable biological membranes were immersed in CGF Left: Sticky bone; Right: CGF-soaked collagen membrane. CGF, concentrated growth factors."

Figure 3

Surgical procedure of the experimental group A, preoperative view; B, intraoperative finding: Buccal furcation lesion of the right lower first molar; C, concentrated growth factors mixed with bovine porous bone mineral to form sticky bone; D, sticky bone in furcation lesion; E, placement of Bio-Gide absorbable collagen membrane; F, suturing."

Figure 4

Schematic diagram of marking points of CBCT for furcation involvements CBCT, cone beam CT; 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."

Table 1

The plaque index and bleeding index at baseline, 6 months and 1 year after surgery"

Items GTR+Bone graft+CGF (n=18) GTR+Bone graft (n=18)
Plaque index
  Baseline 0.7±0.2 0.9±0.5
  6 months after surgery 0.7±0.3 1.0±0.6
  1 year after surgery 0.9±0.4 1.1±0.4
Bleeding index
  Baseline 1.0±0.5 1.2±0.6
  6 months after surgery 1.1±0.6 0.9±0.5
  1 year after surgery 0.8±0.6 1.1±0.7

Table 2

Clinical measurements of experimental and control group at baseline, 6 months and 1 year after surgery"

Items GTR+Bone graft+CGF (n=18) GT+Bone graft (n=18) P value
PD/mm
  Baseline 7.95±2.69 7.69±2.74 0.965
  6 months after surgery 3.14±0.95* 4.09±1.37* 0.032
  1 year after surgery 3.20±1.06* 4.26±1.55* 0.004
  Decrease at 1 year after surgery 4.75±1.87 3.43±1.76 0.013
REC/mm
  Baseline 1.87±0.99 1.95±0.96 0.245
  6 months after surgery 0.98±0.58* 1.10±0.42* 0.878
  1 year after surgery 1.07±0.62* 0.97±0.44* 0.327
  Decrease at 1 year after surgery 0.80±0.54 0.98±0.57 0.984
CAL-V/mm
  Baseline 9.82±2.78 9.64±2.53 0.052
  6 months after surgery 4.12±1.83* 5.19±1.94* 0.039
  1 year after surgery 4.27±1.79* 5.23±1.88* 0.034
  Decrease at 1 year after surgery 5.55±1.04 4.41±1.08 0.027
CAL-H/mm
  Baseline 6.32±2.74 6.45±2.87 0.977
  6 months after surgery 2.49±1.03* 3.44±1.35* 0.028
  1 year after surgery 2.43±1.06* 3.38±1.19* 0.009
  Decrase at 1 year after surgery 3.89±1.22 3.07±1.02 0.035

Table 3

CBCT data of experimental and control group at baseline and 1 year after surgery"

Items GTR+Bone graft+CGF (n=18) GTR+Bone graft (n=18) P value
BL-V/mm
  Baseline 7.03±2.86 7.35±2.77 0.684
  1 year after surgery 2.98±1.01* 4.18±1.34* 0.004
  Change of BL-V 4.05±1.37 3.17±1.09 0.009
BL-H/mm
  Baseline 6.94±2.77 6.89±2.87 0.509
  1 year after surgery 2.92±1.15* 3.62±1.09* 0.012
  Change of BL-H 4.02±1.32 3.27±1.08 0.027

Figure 5

CBCT images of experimental group at baseline and 1 year after surgery A, baseline CBCT (the red arrow indicates the buccal furcation lesion of the right lower first molar); B, 1-year post-surgery CBCT (the red arrow indicates the radiographic bone filling condition of the buccal buccal furcation lesion of the right mandibular first molar). CBCT, cone beam CT."

1
Eickholz P , Cordis T , Dannewitz B , et al. Long-term prognosis of teeth with class Ⅱ furcation involvement: A retrospective cohort study[J]. J Clin Periodontol, 2025, 52 (9): 1298- 1305.

doi: 10.1111/jcpe.14186
2
Trombelli L , Farina R . Clinical outcomes with bioactive agents alone or in combination with grafting or guided tissue regeneration[J]. J Clin Periodontol, 2008, 35 (Suppl 8): 117- 135.
3
Stoecklin-Wasmer C , Rutjes AWS , da Costa BR , et al. Absorb-able collagen membranes for periodontal regeneration: A systematic review[J]. J Dent Res, 2013, 92 (9): 773- 781.

doi: 10.1177/0022034513496428
4
Irma J , Kartasasmita AS , Kartiwa A , et al. From growth factors to structure: PDGF and TGF-β in granulation tissue formation. A literature review[J]. J Cell Mol Med, 2025, 29 (11): e70374.

doi: 10.1111/jcmm.70374
5
Chandra P , Faizan M , Porwal M , et al. An overview and review of growth factors in wound healing: Emerging trends and innovations[J]. Curr Diabetes Rev, 2026, 22 (1): e15733998332692.

doi: 10.2174/0115733998332692241202072249
6
Zhou D , Liu ZW , Jie X , et al. Advances in research on concentrated growth factor applications for androgenetic alopecia treatment: A review[J]. Med Sci Monit, 2025, 31, e948054.
7
Kinaia BM , Steiger J , Neely AL , et al. Treatment of class Ⅱ molar furcation involvement: Meta-analyses of reentry results[J]. J Periodontol, 2011, 82 (3): 413- 428.

doi: 10.1902/jop.2010.100306
8
Pajnigara N , Kolte A , Kolte R , et al. Volumetric assessment of regenerative efficacy of demineralized freeze-dried bone allograft with or without amnion membrane in grade Ⅱ furcation defects: A cone beam computed tomography study[J]. Int J Periodontics Restorative Dent, 2017, 37 (2): 255- 262.

doi: 10.11607/prd.2901
9
Jepsen S , Gennai S , Hirschfeld J , et al. Regenerative surgical treatment of furcation defects: A systematic review and Bayesian network meta-analysis of randomized clinical trials[J]. J Clin Periodontol, 2020, 47 (S22): 352- 374.

doi: 10.1111/jcpe.13238
10
Huidrom E , Srivastava V , Meenawat A , et al. Evaluation of the efficacy of concentrated growth factor along with bovine-derived xenograft and collagen membrane in the treatment of Degree Ⅱ mandibular molar furcation defect: A clinicoradiographic study[J]. J Indian Soc Periodontol, 2022, 26 (2): 130- 136.

doi: 10.4103/jisp.jisp_44_21
11
Pradeep AR , Pai S , Garg G , et al. A randomized clinical trial of autologous platelet-rich plasma in the treatment of mandibular degree Ⅱ furcation defects[J]. J Clin Periodontol, 2009, 36 (7): 581- 588.

doi: 10.1111/j.1600-051X.2009.01428.x
12
Sharma A , Pradeep AR . Autologous platelet-rich fibrin in the treatment of mandibular degree Ⅱ furcation defects: A randomized clinical trial[J]. J Periodontol, 2011, 82 (10): 1396- 1403.

doi: 10.1902/jop.2011.100731
13
Gawlak-Socka S , Jeżewska K , Bielecka-Kowalska N , et al. Adjunctive use of platelet-derived concentrates (platelet-rich plasma, platelet-rich fibrin, concentrated growth factor, platelet-poor plasma) in non-surgical periodontal therapy: Current evidence and comparative analysis[J]. J Clin Med, 2026, 15 (2): 554.

doi: 10.3390/jcm15020554
14
Iao S , Ouyang X , Qiao J , et al. Growth factors release in concentrated growth factor and advanced platelet-rich fibrin sticky bone[J]. Oral Dis, 2025, 31 (8): 2531- 2539.

doi: 10.1111/odi.15325
15
Qiao J , An N . Effect of concentrated growth factors on function and Wnt3a expression of human periodontal ligament cells in vitro[J]. Platelets, 2017, 28 (3): 281- 286.

doi: 10.1080/09537104.2016.1213381
16
Kuybu İ , Alan H , Şimşek MS . Comparison of growth factor concentrations in platelet-rich fibrin biomaterial in different systemic diseases[J]. Clin Oral Investig, 2025, 29 (12): 588.

doi: 10.1007/s00784-025-06673-y
17
Panda S , Karanxha L , Goker F , et al. Autologous platelet concentrates in treatment of furcation defects: A systematic review and meta-analysis[J]. Int J Mol Sci, 2019, 20 (6): 1347.

doi: 10.3390/ijms20061347
18
Yu M , Luo D , Qiao J , et al. A hierarchical bilayer architecture for complex tissue regeneration[J]. Bioact Mater, 2022, 10, 93- 106.
19
Tabatabaei F , Aghamohammadi Z , Tayebi L . In vitro and in vivo effects of concentrated growth factor on cells and tissues[J]. J Biomed Mater Res Part A, 2020, 108 (6): 1338- 1350.

doi: 10.1002/jbm.a.36906
20
Rodella LF , Favero G , Boninsegna R , et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction[J]. Microsc Res Tech, 2011, 74 (8): 772- 777.

doi: 10.1002/jemt.20968
21
Yu B , Wang Z . Effect of concentrated growth factors on beagle periodontal ligament stem cells in vitro[J]. Mol Med Rep, 2014, 9 (1): 235- 242.

doi: 10.3892/mmr.2013.1756
22
Li X , Yang H , Zhang Z , et al. Concentrated growth factor exudate enhances the proliferation of human periodontal ligament cells in the presence of TNF-α[J]. Mol Med Rep, 2019, 19 (2): 943- 950.
23
Chen X , Wang J , Yu L , et al. Effect of concentrated growth factor (CGF) on the promotion of osteogenesis in bone marrow stromal cells (BMSC) in vivo[J]. Sci Rep, 2018, 8, 5876.

doi: 10.1038/s41598-018-24364-5
24
Yu M , Wang X , Liu Y , et al. Cytokine release kinetics of concentrated growth factors in different scaffolds[J]. Clin Oral Investig, 2019, 23 (4): 1663- 1671.

doi: 10.1007/s00784-018-2582-z
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