The role of rhFGF‐2 in periodontal defect bone fill: A systematic review of the literature

Abstract

Background Growth factors have been used with success in periodontal regeneration, especially in intrabony defects. Among those, the recombined form of fibroblast growth factor‐2 (rhFGF‐2) has been also examined. Objective To address the outcomes of periodontal regeneration using rhFGF‐2 alone or in combination with bone substitutes primarily in terms of Radiographic Bone Fill (RBF%) and secondary Probing Pocket Depth (PPD), and Probing Attachment Levels (PAL). Material and Methods A search in MEDLINE and EMBASE using the Ovid interface was conducted from 2000 up to and including the 12th of November 2022. Starting from the initially identified 1289 articles, 34 studies were selected for further analysis. Following the full‐text screening, 7 of the 34 studies met the inclusion criteria and thus were included in the systematic review after assessing their quality according to the Newcastle‐Ottawa scale (NOS). Clinical and radiographic results (bone gain, pocket depth, and clinical attachment level) after the application of FGF‐2 alone or in combination with different carriers were studied in patients with intrabony defects of at least one wall and pocket depth greater than 4 mm. Results Primary outcomes: RBF% was higher in studies using a combination of rhFGF‐2 and bone substitutes (74.6 ± 20.0%) compared to others using the specific growth factor alone or negative controls (22.7 ± 20.7%). In terms of secondary outcomes, the analysis failed to show an additional benefit from the use of the rhFGF‐2 alone or in combination with bone substitutes. Conclusion rhFGF‐2 can improve RBF% in the treatment of periodontal defects, especially when it is used in combination with a bone substitute.

Tổng Quan Về Sử Dụng Yếu Tố Tăng Trưởng Nguồn Gốc Nguyên Bào Sợi FGF-2 Trong Tái Sinh Mô Quanh Răng

“…Đối với kết quả đánh giá mức tái bám dính lâm sàng (CAL-G), cả nhóm thử nghiệm và nhóm đối chứng ở các nghiên cứu đều cho thấy CAL-G tăng trung bình là 2mm, mặc dù kết quả của nhóm can thiệp cao hơn nhóm chứng tuy nhiên sự khác biệt không có ý nghĩa thống kê. Những kết quả này phù hợp với các đánh tổng quan hệ thống trước đây [5], [6]. Theo Cortellini và Tonetti [7], nên sử dụng kết hợp các vật liệu hỗ trợ hoặc vật liệu ghép xương để điều trị các khuyết hổng xương rộng hoặc khuyết hổng quanh răng còn lại ít thành xương.…”

Insights and Advancements in Periodontal Tissue Engineering and Bone Regeneration

“…Using a barrier membrane serves as a technique to prevent epithelial cell ingress, facilitating the regeneration of periodontal tissues in a manner that maintains the original structure and functionality, rather than restoration with junctional epithelium. During the obstructive phase, several cell types including cementoblasts, osteoblasts, osteoclasts, and mesenchymal cells from the periodontal ligament become activated, aiding in the reconstruction of their respective deficient tissues [35]. A barrier membrane must meet specific criteria, including tissue adhesion without mobility, prevention of soft tissue from growing in the defect, ease of application, maintenance of a defined place, and biocompatibility.…”

“…Von Arx and Buser emphasized the rapid degradation of non-cross-linked collagen membranes as a beneficial aspect in horizontal ridge augmentation procedures. This rapid degradation allows for spontaneous re-epithelialization within 2 to 4 weeks, eliminating the necessity for secondary surgery to remove the membrane [35,36,38].…”

“…The combination of natural and synthetic polymers merges the bioactive properties inherent in natural materials with the superior mechanical characteristics of synthetic materials. Additionally, GTR membranes have been utilized as vehicles for drug delivery to enhance tissue regeneration [3,33,35,36,39].…”

“…The resulting fibers exhibit a large surface area-to-volume ratio and a three-dimensional network structure, enhancing cell adhesion, porosity, and proliferation [41]. Furthermore, multilayered GTR membranes with distinct functionalities in each layer have been devised to amplify the process of periodontal tissue regeneration (Table 1) [3,33,35,36,39]. Advancements in synthetic materials and polymers should be incorporated into the design of barrier membranes to improve future material development.…”