Search Results (29)

The rising prevalence of antibiotic resistance underscores the need for localized drug delivery systems that minimize systemic exposure. Autologous platelet concentrates (APCs), including concentrated platelet-rich fibrin (c-PRF) and liquid-phase concentrated growth factors (LPCGFs), have emerged as potential carriers for antimicrobial agents. This study aimed to evaluate the efficacy of c-PRF and LPCGF as carriers for three antibiotic formulations—amoxicillin with clavulanic acid, clindamycin, and a combination of amoxicillin with metronidazole—against methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), and Enterococcus faecalis (low-level natural resistance). The disk diffusion method was employed to incorporate antibiotics into both APC types, which were then applied to disks placed on bacterial cultures. The size of the inhibition zones was measured at 20-, 40-, 60-, and 80-h intervals. Every 20 h, the disks were transferred to a new Petri dish. Statistical analysis included Welch’s t-test and two-way ANOVA. c-PRF demonstrated superior performance as a carrier for amoxicillin and clindamycin, showing the presence of inhibition zones for up to 60 h. In contrast, LPCGF exhibited greater efficacy when used with the amoxicillin–metronidazole combination, particularly at higher concentrations. Both APCs showed limited effectiveness against E. faecalis when combined with clindamycin. The study confirms the suitability of autologous platelet concentrates as localized antibiotic delivery systems. The choice between c-PRF and LPCGF should be guided by the drug’s physicochemical properties and clinical application. APCs offer a promising alternative for targeted antimicrobial therapy in dental and surgical settings. Full article

Aim: This review aims to explore the clinical applications, biological mechanisms, and potential benefits of concentrated growth factors (CGFs), autologous materials, and xenografts in bone regeneration, particularly in dental treatments such as alveolar ridge preservation, mandibular osteonecrosis, and peri-implantitis. Materials and Methods. A systematic literature search was conducted using databases like PubMed, Scopus, and Web of Science, with keywords such as “bone regeneration” and “CGF” from 2014 to 2024. Only English-language clinical studies involving human subjects were included. A total of 10 studies were selected for qualitative analysis. Data were processed through multiple stages, including title and abstract screening and full-text evaluation. Conclusion: The findings of the reviewed studies underscore the potential of the CGF in enhancing bone regeneration through stimulating cell proliferation, angiogenesis, and extracellular matrix mineralization. Autologous materials have also demonstrated promising results due to their biocompatibility and capacity for seamless integration with natural bone tissue. When combined with xenografts, these materials show synergistic effects in improving bone quantity and quality, which are crucial for dental implant success. Future research should focus on direct comparisons of different techniques, the optimization of protocols, and broader applications beyond dental medicine. The integration of CGFs and autologous materials into routine clinical practice represents a significant advancement in regenerative dental medicine, with the potential for improved patient outcomes and satisfaction. Full article

The goal of regenerative medicine is to achieve tissue regeneration. In the past, commonly used techniques included autologous or allogeneic transplantation and stem cell therapy, which have limitations, such as a lack of donor sites in the case of autologous transplantation and the invasiveness of stem cell harvesting. In recent years, research has, therefore, focused on new and less invasive strategies to achieve tissue regeneration. A step forward in this direction has been made with the development of autologous platelet concentrates (APCs), which are derived from the patient’s own blood. They can be classified into three generations: platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factors (CGFs). These APCs have different structural characteristics, depending on the distinctive preparation method, and contain platelets, leukocytes, and multiple growth factors, including those most involved in regenerative processes. The purpose of this review is to clarify the most used techniques in the field of regenerative medicine in recent years, comparing the different types of APCs and analyzing the preparation protocols, the composition of the growth factors, the level of characterization achieved, and their clinical applications to date. Full article

Aims: Medication-related osteonecrosis of the jaw (MRONJ) is a drug-related adverse reaction characterized by bone destruction and necrosis in the jaw. This case series aims to evaluate the treatment approaches and outcomes in MRONJ patients. Materials and methods: The retrospective study was conducted at the Dental Unit of the University of Bari, Italy. Patients with MRONJ were treated and followed up for 60 months. The treatment approach involved piezosurgery and concentrated growth factor (CGF). Six clinical cases from this group are described in detail. Results: None of the patients showed recurrence of necrotic MRONJ lesions during the follow-up period. The surgical interventions, including bone resections and the application of CGF, resulted in successful mucosal healing and the prevention of disease progression. Conclusions: This study highlights the complexity of managing MRONJ and the importance of a multidisciplinary approach. Conservative treatment options and minimally invasive surgery have shown efficacy in controlling symptoms and improving patients’ quality of life. However, the optimal treatment approach remains a challenge, and further studies are needed to evaluate alternative therapies and resective surgery. A comprehensive preoperative evaluation and collaboration among dental, endocrinology, and oncology specialists are crucial for personalized and multidisciplinary management. Ongoing research efforts are necessary to explore new therapeutic modalities and improve our understanding of MRONJ management, providing better support to patients dealing with this complex condition. Full article

Periodontal diseases significantly impact about half of the global population, and their treatment often encompasses relieving symptoms as well as regenerating the destroyed tissues. Revolutionary research in the management of periodontal disease includes biomaterials, a boon to re-generative dentistry owing to their excellent biological properties: non-toxicity, anti-inflammatory, biocompatibility, biodegradability, and adhesion. This study aimed to fabricate an injectable fucoidan containing chitosan hydrogel and prove its effectiveness in periodontal bone regeneration. The injectable hydrogel was prepared using the sol-gel method and was subjected to various physical, chemical, and biological characterizations to understand its efficacy in formation of new bone. The effectiveness of the developed hydrogel was assessed in periodontal bony defects to study the soft and hard tissue changes. A total of 40 periodontitis patients with bony defects were recruited and randomized into two groups to receive fucoidan-chitosan hydrogel and concentrated growth factor, respectively. Customized acrylic stents were used to guide the hydrogel placement into the defect site. Post-surgical changes in clinical parameters were assessed at 3, 6, and 9 months to appreciate the soft and hard tissue changes using repeated measures analysis of variance and Bonferroni’s post hoc test. Significance was kept at 5%. The porosity, water uptake of the prepared hydrogel showed good efficacy, with particle size of the fucoidan containing chitosan hydrogel of 6.000 nm. The MG-63 osteoblasts cell line revealed biocompatibility, biodegradability and showed slow and sustained drug release, increased cell proliferation, and enhanced alkaline phosphatase secretion. Mineralization assay was greatest in the fucoidan containing chitosan hydrogel. Clinically, it exhibited significantly lower probing depth values and a higher mean improvement in clinical attachment level as compared to the concentrated growth factor (CGF) group at the end of 3 and 6 months (p < 0.05). The mean of the defect fills in the fucoidan containing chitosan group was 1.20 at the end of 9 months (p < 0.001) as compared with defect fills observed in the CGF group. The presence of fucoidan in the hydrogel significantly contributed to bone regeneration in humans, thus strengthening its potential in tissue engineering. Fucoidan-chitosan will be a promising biomaterial for bone tissue regeneration. Full article

Background: The current review aims to provide an overview of the most recent research on the potentials of concentrated growth factors used in the maxillary sinus lift technique. Materials and methods: “PRP”, “PRF”, “L-PRF”, “CGF”, “oral surgery”, “sticky bone”, “sinus lift” were the search terms utilized in the databases Scopus, Web of Science, and Pubmed, with the Boolean operator “AND” and “OR”. Results: Of these 1534 studies, 22 publications were included for this review. Discussion: The autologous growth factors released from platelet concentrates can help to promote bone remodeling and cell proliferation, and the application of platelet concentrates appears to reduce the amount of autologous bone required during regenerative surgery. Many authors agree that growth factors considerably enhance early vascularization in bone grafts and have a significantly positive pro-angiogenic influence in vivo when combined with alloplastic and xenogeneic materials, reducing inflammation and postoperative pain and stimulating the regeneration of injured tissues and accelerating their healing. Conclusions: Even if further studies are still needed, the use of autologous platelet concentrates can improve clinical results where a large elevation of the sinus is needed by improving bone height, thickness and vascularization of surgical sites, and post-operative healing. Full article

Concentrated growth factors (CGFs) are widely used in surgery with bone grafting, but the release of growth factors from CGFs is rapid. RADA16, a self-assembling peptide, can form a scaffold that is similar to the extracellular matrix. Based on the properties of RADA16 and CGF, we hypothesized that the RADA16 nanofiber scaffold hydrogel could enhance the function of CGFs and that the RADA16 nanofiber scaffold hydrogel-wrapped CGFs (RADA16-CGFs) would perform a good osteoinductive function. This study aimed to investigate the osteoinductive function of RADA16-CGFs. Scanning electron microscopy, rheometry, and ELISA were performed, and MC3T3-E1 cells were used to test cell adhesion, cytotoxicity, and mineralization after administration with RADA16-CGFs. We found that RADA16 endowed with the sustained release of growth factors from CGFs, which can help maximize the function of CGFs in osteoinduction. The application of the atoxic RADA16 nanofiber scaffold hydrogel with CGFs can be a new therapeutic strategy for the treatment of alveolar bone loss and other problems that require bone regeneration. Full article

Concentrated growth factors (CGF) is the newest generation platelet concentrate product, which has been reported to promote the proliferation and differentiation of human dental pulp cells (hDPCs). However, the effect of liquid phase of CGF (LPCGF) has not been reported. This study was aimed to evaluate the influence of LPCGF on the biological properties of hDPCs, and to explore the in vivo mechanism of dental pulp regeneration based on the hDPCs-LPCGF complex transplantation. It was found that LPCGF could promote the proliferation, migration and odontogenic differentiation of hDPCs, and 25% LPCGF induced the most mineralization nodule formation and the highest DSPP gene expression. The heterotopic transplantation of the hDPCs-LPCGF complex resulted in the formation of regenerative pulp tissue with newly formed dentin, neovascularization and nerve-like tissue. Together, these findings provide key data on the effect of LPCGF on the proliferation, migration, odontogenic/osteogenic differentiation of hDPCs, and the in vivo mechanism of hDPCs-LPCGF complex autologous transplantation in pulp regeneration therapy. Full article

The application of scaffolding materials together with stem cell technologies plays a key role in tissue regeneration. Therefore, in this study, CGF (concentrated growth factor), which represents an autologous and biocompatible blood-derived product rich in growth factors and multipotent stem cells, was used together with a hydroxyapatite and silicon (HA-Si) scaffold, which represents a very interesting material in the field of bone reconstructive surgery. The aim of this work was to evaluate the potential osteogenic differentiation of CGF primary cells induced by HA-Si scaffolds. The cellular viability of CGF primary cells cultured on HA-Si scaffolds and their structural characterization were performed by MTT assay and SEM analysis, respectively. Moreover, the matrix mineralization of CGF primary cells on the HA-Si scaffold was evaluated through Alizarin red staining. The expression of osteogenic differentiation markers was investigated through mRNA quantification by real-time PCR. We found that the HA-Si scaffold was not cytotoxic for CGF primary cells, allowing their growth and proliferation. Furthermore, the HA-Si scaffold was able to induce increased levels of osteogenic markers, decreased levels of stemness markers in these cells, and the formation of a mineralized matrix. In conclusion, our results suggest that HA-Si scaffolds can be used as a biomaterial support for CGF application in the field of tissue regeneration. Full article

Tooth extractions, especially of impacted lower third molars, are among the most common procedures performed in dental practices. The continuity of the patient’s oral mucosa, which is interrupted during them, can manifest itself in general discomfort, pain, swelling, and even trismus. In the age of cosmetic dentistry, when lost teeth are restored through implant, prosthetic, and orthodontic treatment, each tooth extraction actually reduces the amount of available alveolar bone. This has prompted researchers to develop extraction sockets treatment procedures that reduce the negative consequences of surgical intervention while also enhancing the rate of alveolar bone and soft tissue regeneration using minimally invasive approaches. This is expected to enable or significantly facilitate further stages of treatment. The aim of this paper is to review the literature on the use of autologous blood preparations, which are considered to aid regenerative processes when applied to extraction sockets. Full article

Edentulism is the condition of having lost natural teeth, and has serious social, psychological, and emotional consequences. The need for implant services in edentulous patients has dramatically increased during the last decades. In this study, the effects of concentrated growth factor (CGF), an autologous blood-derived biomaterial, in improving the process of osseointegration of dental implants have been evaluated. Here, permeation of dental implants with CGF has been obtained by using a Round up device. These CGF-coated dental implants retained a complex internal structure capable of releasing growth factors (VEGF, TGF-β1, and BMP-2) and matrix metalloproteinases (MMP-2 and MMP-9) over time. The CGF-permeated implants induced the osteogenic differentiation of human bone marrow stem cells (hBMSC) as confirmed by matrix mineralization and the expression of osteogenic differentiation markers. Moreover, CGF provided dental implants with a biocompatible and biologically active surface that significantly improved adhesion of endothelial cells on CGF-coated implants compared to control implants (without CGF). Finally, data obtained from surgical interventions with CGF-permeated dental implants presented better results in terms of optimal osseointegration and reduced post-surgical complications. These data, taken together, highlight new and interesting perspectives in the use of CGF in the dental implantology field to improve osseointegration and promote the healing process. Full article

Over recent years, the usage of autologous platelet concentrates (APCs) has risen in hard tissue regeneration and oral implantology. The purpose of the present review is to offer an overview of the use of three APC techniques in dentistry: platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF). A narrative summary of articles published between January 2011 and April 2022 is provided. The PubMed, Cochrane Library, Scopus, and Embase databases were used to conduct the search. The following keywords were used in the preliminary: “VEGF”, “TGF-b1”, “PRP”, “PRF”, “CGF”, AND “sinus augmentation” OR “implants” OR “peri-implantitis” OR “socket preservation” OR “MRONJ”. A total of 82 articles was finally included. The review then takes into account the application of the three techniques in different areas of treatment—including oral implantology, sinus floor elevation, peri-implantitis, socket preservation, and medication-related osteonecrosis of the jaw (MRONJ)—as well as their advantages and disadvantages. Full article

The involvement of platelets in immune and inflammatory processes is generally recognized; nevertheless, in psoriasis, their role is not clearly understood. We studied the in vitro growth factor release from a platelet-rich plasma preparation, the concentrated growth factors (CGF), in a case of a psoriasis subject three days before the onset of the papule. The CGF clots were incubated in a cell culture medium without growth supplements for 5 h and 1, 3, 6, 7, and 8 days, and the release kinetics of PDGF-AB, VEGF, TNF-α, and TGF-β1 were evaluated. The data, based on the results obtained during the case study, report a general increase in growth factor release in the psoriasis subject with respect to the healthy control, indicating an imbalance of growth factor production from blood cells. Although the results should be validated in the future, they show new aspects of this dermatological pathology, opening new possibilities both as the method of study, using CGF, and the involvement of platelets and growth factors in its development and maintenance. Full article

Background: tooth extraction is a common procedure in oral surgery. The socket healing process involves hard and soft tissues and is characterized by intense remodeling, which may determine consistent dimension changes. Several autologous platelet concentrates (APCs) proved to be effective for enhancing alveolar socket healing after tooth extraction, accelerating socket closure and countering alveolar bone resorption. Concentrated growth factors (CGFs) are one of the most recently developed APCs, and their effect on the socket healing process still needs to be confirmed. Aim: The aim of the present split-mouth study was to evaluate the effectiveness of CGFs in enhancing the healing process in the postextraction alveolar socket and reducing postoperative pain. Methods: One hundred and fifty-four extractions were performed. One of the extraction sockets of each patient was treated with CGFs (test site), and the other socket was unfilled (control site). The main outcomes were: healing index, alveolar dimensions at the crestal level, socket closure, and pain perception. Descriptive statistics of the results were analyzed. Follow-up data were compared to baseline using paired tests. Results: The healing index on day 7 was significantly better (p < 0.001) in the test group (5.01 ± 1.30) as compared to the control group (6.65 ± 1.41). The mean visual analog scale for pain (VAS) was significantly higher for the control group when compared to the CGF group in the first 5 days postextraction. There was a trend toward greater socket closure in the CGF group, indicating faster healing, as compared to the control group at 7, 14, and 21 days. Conclusions: CGFs can represent a useful adjunctive tool, considering their mechanical and biological properties, for improving alveolar socket healing and reducing postoperative patient discomfort. Full article

During implant restorative dentistry, common and crippling postoperative complications are pain and swelling of perioral soft tissues which engraving on patient quality of life. Concentrated growth factors (CGF), a novel generation of autologous platelet concentrate, and melatonin, endogenous indoleamine with also bone regenerative properties, may be useful for reconstruction of bony defects as well as in prosthetic and esthetic rehabilitation. We report a clinical case in which guided bone regeneration was performed combining CGF, melatonin and heterologous biomaterial. Great postoperative recovery without any complications was reported. In conclusion, in restorative dentistry the combined use of CGF and melatonin may have important roles in restoring bone defect, in improving implant osteointegration and, not less important, in preventing postoperative complications. Full article