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engineering (2)
Applications of Concentrated Growth
Factor(CGF) to Enhance Osteogenesis
ASSOC.PROF. THONGNARD KUMCHAI
Tissue Engineering Triad
Scaffold
Time
Tissue regeneration
Conducive environment
Stem cells Growth factors
Platelet
Concentrates
Platelet concentrates
Platelet is known to contain high quantities of growth
factors,such as transforming growth factors β‐1(TGF β‐1),
platelet‐ derived growth factors (PDGF), epithelial growth
factor (EGF), insulin growth factor‐l (IFG‐l) and vascular
endothelial growth factors (VEGF), which stimulates cell
proliferation and up regulates angiogenesis.
Platelet concentrates
Platelet Rich Plasma(PRP) and Plasma Rich in
Growth Factors(PRGF)…as first generation
Platelet Rich Fibrin(PRF) and Concentrated Growth
Factors(CGF)…as second generation
Seventy percent of growth factors in
PRP are released within
10 min,and almost 100% are
released within 1 h after activation.
CGF
CGF was first developed by Sacco(2006).
CGF has recently received a great deal of interest
as the growth factors in CGF can be locally released
into tissue to enhance wound healing.
CGF can released growth factors slowly for at least
7‐10 days.
CGF
It also provides as scaffold supporting cytokine
attachment and cellular migration.
CGF can be used as barrier membrane over bone graft.
Literature review
“These growth factors have functions in accelerating the revascularization of
injured tissues and inducing the migration, proliferation, and differentiation
of fibroblasts and osteoblasts.”
Park HC, Kim SG, Oh JS,et al Early bone formation at a femur defect using CGF
and PRF graft in adult dogs: A comparative study, Implant Dent.2016;25:387‐393
Literature review
“Borsani,et al have ascertained that CGF addition enhanced cell
proliferation of fibroblasts, endothelial cells, and osteoblasts which are
involved in angiogenesis,tissue remodeling and regeneration.”
E. Borsani,et al “Biological characterization and in vitro effects of human concentrated growth factor preparation
:an innovative approach to tissue regeneration,” Biology and Medicine,vol 7, no 5,p 726,2015
Literature review
“CGF also serves as a resorbable interpositional membrane. Avoids the early
invigilation of the gingival epithelium is inhibited by the CGF layer results as a
barrier to epithelium migration.”
Yu b,Wang Z. Effect of CGF on beagle periodontal ligament stem cells
in vitro. Mol Med Rep.2014;9:235‐242
Literature review
“CGF can be used to promote periodontal tissue regeneration and osteogenic
differentiation.”
Silica coated tube
Then Centrifuged at 2400‐2700 rpm for 12 minutes stopped after 2 minutes centrifugation
and take AFG tube out of the centrifuge
The upper layer : Autologous fibrin glue (AFG)
The lower layer : Red blood cell
AFTER 1ST CENTRIFUGATION
The vacant slot is filled with water‐filled test tube for weighing balance and
then centrifugation is continued to prepare CGF membrane.
Sticky Bone
The most upper layer is platelet poor plasma
the middle layer is fibrin buffy coat layer , which containing
the Concentrated Growth Factors (CGF)
The bottom layer is red blood cell layer
AFTER 2ND CENTRIFUGATION
CGF membrane
Case report 1
Contour augmentation and implant placement
3 M post‐op
3 M post‐op
3 M post‐op
Case report 2
Sinus augmentation and implant placement
2 months post‐extraction
Case report 3
Contour augmentation and implant placement 12,25 and
Nasopalatine implant
Case report 4
Ridge augmentation for orthodontic tooth movement
CHIEF COMPLAINT
Would like to have
implant on 34,44 area
25 Y, Male
34,44 were extracted for
second orthodontic
retreatment 3 years ago
25 Y, Male
34,44 were extracted for
second orthodontic
retreatment 3 years ago
34,44 Ext 3 yrs ago
Ridge Atrophy with buccal concavity
Bone splitting
CGF membrane
Sticky bone
Fill with Sticky bone Cover with CGF membrane
24/10/18
12/11/18
2 wk after surgery
Distalize 33 43
initial
2 wks after surgery
Initial
04/10/17
8 mo after surgery
12/06/19
initial 8 months after surgery
initial 8 months
43
34
Initial
04/10/17
8 mo after surgery
12/06/19
1.It was observed that the concentrated growth
factor had positive effects on tissue remodeling
and regeneration.
2.CGF membrane and sticky bone is easy to
Conclusions make and they are a very effective material for
treatment of different types of bone defects.
3.CGF is now widely used to shorten the
interval between bone graft placement and
implant insertion and increases the success rate
of bone grafting and implant therapy.