Considerations for Clinical Use of Concentrated Growth Factor in Maxillofacial Regenerative Medicine

Abstract

Different strategies have been utilized to facilitate mineralized/soft tissues. Concentrated growth factor (CGF) emerges as a promising biomaterial for regenerative therapy due to high levels of platelets, growth factors, and nucleated cells entrapped in the fibrin scaffold. This review aimed to collect extensive studies on CGF used in maxillofacial regenerative medicine, discussing current obstacles, and expressing some considerations of CGF use. Articles were retrieved systematically without time limitation. In total, 27 human studies were included and separated accordingly. In general, CGF has been most evaluated in implant related therapy and maxillofacial bone regeneration where a majority of articles have revealed favorable outcomes. Little studies have supported the effects on improving probing periodontal depth reductions and clinical attachment level gains for intrabony and furcation defect regeneration. Very little data with high-level evidence was available directly to investigate its effects on the soft tissue regeneration and postoperative complications reduction. The evidence supporting the clinical efficacy of CGF in maxillofacial regenerative medicine is limited. Some conflicting results are worrisome. In addition, the characterization of CGF preparation protocols and CGF's components was not performed in most studies. Further studies should make a consensus on standardized end-product of CGF including characterization of protocols and optimal ratio of CGF' components. Defined algorithms and evidence-based protocols for the clinical use of CGF should be also available.

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

“…Many methods have been used to help bone regeneration in clinical therapy, including bone graft, 6 growth factors materials 10 and photodynamics therapy 14 . Researchers have begun to use low‐level lasers to treat disorders since 1980 because these lasers do not produce heat during their work 35 .…”

“…Deep periodontal pockets and bone defects formed in the distal side of the second molar after the operation were currently treated by the placement of autogenous or xenogeneic bone grafts, 6 artificial bone material, guided tissue regeneration 7,8 or tissue engineering 9 . All of these methods have shown significant curative effects; however, their drawbacks of being expensive or technically sensitive limited their uses 10 . Recently, it has been found that concentrated growth factor (CGF)‐like growth factor gel, which is extracted from venous blood by centrifugation, and rich in a variety of biological factors important for growth and development, as it can accelerate the formation of healed new bone, promotes the repair of bone defects by providing scaffolds and high concentrations of growth factors 11 .…”

Effect on implant drills and postoperative reactions for pre-extraction interradicular implant bed preparation during the COVID-19 pandemic and beyond

“…Some studies have reported that CGF could not only accelerate soft-tissue healing and early bone formation but also reduce post-surgical edema, pain, trismus, and discomfort. [ 36 , 37 ] Other literatures have shown that new bone formation was significantly increased in the defective bone region filled with CGF and Bio-Oss compared to Bio-Oss only. [ 38 , 39 ]…”

Preoperative CBCT Guided Bone Regeneration Combined with Concentrated Growth Factor Applied in the Implantation of Maxillary Teeth with Insufficient Bone Mass

“…Li et al (2021) (21) elaborated on the role and potential application of CGF in the regeneration of the dentin-pulp complex, many in vitro studies have shown that CGF can promote the proliferation and migration of dental stem cells. Chen et al (2021) (22) stated that CGF has been most evaluated in implant-related therapies and maxillofacial bone regeneration, and most of these articles showed good results. CGF is the latest generation of concentrated platelets, and Chen and Jiang (2020) (23) elaborated that CGF has a good application in facial rejuvenation, cartilage transplantation, facial bone defects, facial peripheral nerve injury and trauma.…”