A prospective randomized control study to compare the effiacacy of concentrated growth factor following surgical removal of impacted mandibular Third molar

BACK GROUND: Tissue regeneration is the biggest goal of rehabilitation therapies today, for which many products and techniques have been used (Tissucol, PRP, PDGF, PRF etc). Though none of the systems proved to be successful for an appropriate bio stimulation, as these techniques do not exploit the regenerative potential of the components of the whole blood. The concentrated growth factor technique envisages the use of all the separated blood phases which can be disposed individually in order to obtain the bio stimulation of related cells or tissues. The Concentrated Growth Factor as a regenerative tool for accelerated wound healing was developed by Sacco in 2006, taking advantage of presence of adult stem cells and growth factors when whole blood is processed in a specific cycle. This presentation is about the role of CGF in early accelerated tissue healing in minor oral surgical procedures of a health individual. Extraction of an impacted mandibular third molar is a common surgical procedure, although it still leads to several postoperative symptoms and complications. The study assessed the efficacy of concentrated growth factors in the healing process by checking the difference of tissue cytokines and other healing factors produced by the mucosa after extraction between sites treated with CGF and control sites and, at the same time, by evaluating the clinical efficacy of CGF in terms of reduced pain and facial swelling. This study was a split-mouth study, in which the patient becomes his/her own control, to eliminate any individual response differences toward CGF treatment. The parameters regarding inflammation and subsequent wound healing were all significantly higher at CGF sites than at control sites. The increase at PRGF sites of the two proinflammatory cytokines evaluated, interleukin (IL)-1β and IL-6, is accompanied by the increase of two anti-inflammatory cytokines, IL-10 and transforming growth factor-β. Furthermore, IL-1β and IL-6 induce fibroblast and keratinocyte proliferation, important events in wound healing. Postoperative pain and the swelling, measured at all experimental times, were reduced in the presence of CGF. AIM AND OBJECTIVES: The purpose of this study is to evaluate and compare utility and efficacy of concentrated growth factor on soft t issue healing and bone healing following surgical removal of a mandibular impacted 3 rd molar with the control group. MATERIALS AND METHODS: Sampling procedure: Random selection of population. No. of Groups: Two. Control group (Group 1) & Experimental group (Group 2). Sample size: 15 + 15 = 30. Patient selection: Patients were selected by means of volunteers’ recruitment process. Patients interested in the surgical removal of mandibular 3 rd molars were included in the study. Symptomatic and asymptomatic patients were selected and inform consent form signed. This prospective randomized control blind study was carried out to evaluate and compare utility and efficacy of concentrated growth factor on soft tissue healing and bone healing following surgical removal of mandibular impacted 3 rd molar in 15 patients by fulfilling the inclusion and indication criteria. All patients had moderately difficult impacted lower third molar according to modified Pederson’ s index. CONCLUSION: The results of this study indicates that CGF is significantly better in regeneration of bone around the surgical removal of mandibular molar when comparing with non-CGF groups. Although, CGF showed improvement in both soft tissue healing and bone formation, there is much differences in bone level changes on mesial and distal side of the surgical removal of impacted teeth between two groups. CGF did attribute to be a much simpler and a better platelet concentrate, in promoting osseous regeneration. CGF also aided in increasing the density of bone around the surgical removal of impacted 3 rd molar teeth from baseline to a much higher level. This attribute could be used in cases where bone mineralization is compromised. But the exact action of CGF on bone mineralization needs to be studied further