Mohd Noh, Nur Zety

Mohd Saffian, Shamin

Nik Mhd Abdul Nasser, Nik Fatin Sarah

Noor, Erni

The International Islamic University Malaysia Repository

Copyright © 2020 N.F.S. Nik Mhd Abdul Nasser, N.Z. Mohd noh, S. Mohd Saffian, E. Noor.erninoor@gmail.comThe use of concentrated growth factor (CGF) in periodontal osseous surgery and periodontal plastic surgery: A systematic reviewBACKGROUND & AIMAutologous platelet concentrates have been extensivelystudied due to their biocompatibility beneficial for possibleregeneration. Due to the fibrin matrix, platelets, leukocytes,and high concentration of multiple growth factors inconcentrated growth factor (CGF), bone marrow cellproliferation and osteoblast differentiation for new boneformation, and wound healing can be stimulated. Thus, the aimof this review is to evaluate on CGF's prospective usage inperiodontal osseous surgery and periodontal plastic surgery.METHODSRESULTSThe search results are presented in Figure 1. Total of sevenstudies were included in this systematic review and thesummary of findings for periodontal intrabony defects andmucogingival defects are presented in Table 1 and 2. All RCTstudies presented with high risk of bias based on RevisedCochrane risk-of-bias tool for randomized trials (RoB 2) exceptfor one study presented with some concern (Qiao et al., 2016).A study by Lei et al. (2020) presented with moderate risk of biasbased on the Risk Of Bias In Non-randomized Studies- ofInterventions (ROBINS-I) assessment tool for cohort-typestudies.Figure 1: Literature search process and results.DISCUSSIONPerodontal intrabony defect:• The adjunctive use of CGF enhanced clinical outcome whichmight be attributed to its biological properties and scaffoldstructure (Masuki et al., 2016; Kang et al., 2011).• The contradictory results of CGF in combination with BPBMin two trials might be attributed to the different types ofintrabony defects investigated, which may have influencedthe outcome of regenerative surgery.• Despite the limitation of retrospective study, CGF and A-PRFmay have the potential to be beneficial GTR biomaterials bypromoting bone formation and early soft tissue healing.Periodontal plastic surgery:• The significant improvement in CRC and MRC favouring CTGover CGF may be due to the CGF resorption, which causeinadequate time for cells to repopulate the area (Isler et al.,2018).• The considerably higher KTW and GT in the CAF+CGF groupcompared to the CAF group might be explained by CGFbiological characteristics of large, dense, and rich in growthfactors fibrin matrix. (Rodella et al., 2011). Thus, providinglong-term stability of root coverage.• Significant increased of KTW in the CTG group could beexplained by the ability of CTG to induce keratinization of theepithelium (Karing et al., 1975a).N.F.S. Nik Mhd Abdul Nasser1,2, N.Z. Mohd Noh1,3, S. Mohd Saffian4, E. Noor1*1Universiti Teknologi MARA, Center for Periodontology Studies, Sungai Buloh, Malaysia, 2Universiti Kebangsaan Malaysia, Department of Restorative Dentistry, Kuala Lumpur, Malaysia, 3International IslamicUniversity Malaysia, Department of Restorative Dentistry, Kuantan, Malaysia, 4Universiti Kebangsaan Malaysia, Center for Quality Management and Medicines, Kuala Lumpur, Malaysia, *Corresponding author.CONCLUSIONCGF may have beneficial effect on clinical improvement of intrabony defects. WhereasCTG provide superior outcome compared to CGF in root coverage. Further studies withappropriate study design and standardized defect characteristic are needed.REFERENCES:1. Bozkurt Doğan, Ş., Öngöz Dede, F., Ballı, U., Atalay, E. N., & Durmuşlar, M. C. (2015). Concentrated growth factor in the treatment ofadjacent multiple gingival recessions: a split-mouth randomized clinical trial. Journal of clinical periodontology, 42(9), 868–875.2. Lei, L., Yu, Y., Han, J., Shi, D., Sun, W., Zhang, D., & Chen, L. (2020). Quantification of growth factors in advanced platelet-rich fibrinand concentrated growth factors and their clinical efficacy as adjunctive to the GTR procedure in periodontal intrabonydefects. Journal of periodontology, 91(4), 462–472.3. Masuki, H., Okudera, T., Watanebe, T., Suzuki, M., Nishiyama, K., Okudera, H., Nakata, K., Uematsu, K., Su, C. Y., & Kawase, T. (2016).Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advancedplatelet-rich fibrin (A-PRF), and concentrated growth factors (CGF). International journal of implant dentistry, 2(1), 19.Table 1: Summary of findings for periodontal intrabony defects.Table 2: Summary of findings for mucogingival defects.Defining the review questionEligibility criteriaSearching for studies Study selection & data extractionData synthesis & risk of biasFocused question:“Does adjunctive use of CGF inperiodontal osseous surgery andperiodontal plastic surgery provideclinical benefits to periodontaloutcomes?”PPatients with periodontal osseousdefects and mucogingival defect.IPeriodontal surgery with CGF; withor without other regenerativebiomaterials.CPeriodontal surgery with or without regenerative biomaterials.OPeriodontal osseous defect: CALgain, PD reduction and radiographicbone gain.Periodontal plastic surgery: CRC,MRCS RCT, Non-RCT & cohort studies.

The use of concentrated growth factor (CGF) in periodontal osseous surgery and periodontal plastic surgery: A systematic review

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The use of concentrated growth factor (CGF) in periodontal osseous surgery and periodontal plastic surgery: A systematic review

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