Quantification of growth factors in advanced platelet-rich fibrin and concentrated growth factors and their clinical efficacy as adjunctive to the GTR procedure in periodontal intrabony defects.

Abstract

The development of platelet concentrated biomaterials has gained increasing awareness for regenerative medicine. With different protocol, derivatives such as advanced platelet-rich fibrin (A-PRF), injected platelet-rich fibrin, and concentrated growth factor (CGF) have been demonstrated effectively in preclinical and clinical studies. The aim of this study was to compare the level of growth factors releasing from A-PRF and CGF, and their clinical efficacy in the regenerative management of intrabony defects (IBDs). Thirty-two blood samples were collected from eight healthy donors and assessed for platelet-derived growth factor-αβ, vascular endothelial growth factor, bone morphogenetic protein-2, and transforming growth factor-β1 release at indicated times. In addition, the clinical records of 45 patients (15 per group) who had undergone guided tissue regeneration (GTR) with or without A-PRF/CGF were retrieved. The probing depth (PD) and clinical attachment level (CAL) were recorded preoperatively and 6 months postoperatively. Intrabony component (IC) depth, radiographic bone level (RBL), and bone defect filling were assessed radiographically. A-PRF had a looser fibrin network than the CGF but presented larger amounts of growth factors with a more sustained release period. Although there was no difference in PD reduction, CAL gain, RBL height change and defect filling (%) between A-PRF and CGF group, both achieved a more favorable clinical result in IC height reduction and defect filling (%) than the control. A-PRF and CGF have the ability to stimulate a continual and steady release of total growth factors over a 14-day period. A-PRF and CGF show a similar effectiveness in periodontal bone regeneration with a potential benefit of improving GTR outcomes in IBD treatment.