Autologous concentrated growth factor mediated accelerated bone healing in root-end microsurgery: A multicenter randomized clinical trial

Yoshio Yahata; Keisuke Handa; Naoto Ohkura; Motoki Okamoto; Jun Ohshima; Shusaku Itoh; Nobuyuki Kawashima; Toshinori Tanaka; Nobuya Sato; Yuichiro Noiri; Mikako Hayashi; Takashi Okiji; Masahiro Saito

doi:10.1016/j.reth.2023.08.006

Autologous concentrated growth factor mediated accelerated bone healing in root-end microsurgery: A multicenter randomized clinical trial

Regen Ther. 2023 Sep 6:24:377-384. doi: 10.1016/j.reth.2023.08.006. eCollection 2023 Dec.

Authors

Affiliations

¹ Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
² Division of Molecular Biology and Oral Biochemistry, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan.
³ Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
⁴ Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka 565-0871, Japan.
⁵ Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Medical and Dental Sciences Track, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.

Abstract

Introduction: Concentrated growth factor (CGF) is a new-generation autologous platelet concentrate that promotes tissue regeneration and has anti-inflammatory properties. This randomized multicenter trial aimed to evaluate the effects of CGF on bone healing in combination with root-end microsurgery.

Methods: Healthy adult patients indicated for root-end microsurgery were randomly assigned to either the CGF or control (no CGF implantation) groups. CGF was implanted into the bone cavity after root-end filling with mineral trioxide aggregate. Clinical and periapical radiographic evaluations were conducted at 1, 3, 6, and 12 months postoperatively, with follow-up cone-beam computed tomography (CBCT) at 6 months. The lesion volume reduction rate was calculated based on data from the preoperative and follow-up CBCT images.

Results: A total of 24 patients were enrolled. The treatment success rate was 91.7% and 83.3% on 12-month periapical radiography and 6-month CBCT, respectively, without a significant difference between the two groups. The lesion volume reduction rate in the CGF group (75.6%) was significantly higher than that in the control (61.0%) group.

Conclusions: Autologous CGF in conjunction with root-end microsurgery accelerated lesion reduction as observed on CBCT. Administering autologous blood products to stimulate healing in addition to removing the source of infection appears to be a promising treatment option for root-end microsurgery.

Keywords: Concentrated growth factor; Multicenter clinical trial; Periapical; Regenerative medicine; Root-end microsurgery.