Efficacy of concentrated growth factor combined with grafting materials

Background: Concentrated growth factor (CGF) is a novel biomaterial that can effectively promote tissue growth, but it is uncertain whether adding CGF can product additional effects in the periodontal tissue growth. The purpose of this meta-analysis was to assess the efficacy of CGF combined with grafting materials versus grafting materials alone for the treatment of periodontal intrabony defects. Methods: The PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine Disc (CBM), Wanfang, and VIP databases were searched from inception date to June 2022. The inclusion criteria were: (I) randomized controlled trials (RCTs) comparing CGF combined with grafting materials with the single use of grafting materials for the treatment of periodontal intrabony defects, (II) studies providing outcomes of probing depth (PD) and clinical attachment loss (CAL). The literature searches and screening, data extraction, and quality assessment were performed by two reviewers, respectively. The Cochrane bias risk assessment tool was used to assess the quality of the literature. Meta-analysis was performed using Stata 15.0. Results: A total of 8 randomized controlled trials (RCTs) were obtained, including 150 intrabony defect sites in the combination groups and 153 sites in the control groups. Meta-analysis showed that the combination groups was more effective than the control groups in PD [weighted mean difference (WMD) =-0.73, 95% confidence interval (CI): -0.94, -0.51, P=0.005], CAL (WMD =-0.56, 95% CI: -0.94, -0.19, P=0.003), and bone filling (BF) (WMD =-0.43, 95% CI: -0.65, -0.21, P=0.001), but the difference was not statistically significant between two groups in the change of gingival recession (REC) (WMD =-0.15, 95% CI: -0.44, 0.14, P=0.312). One study presented a high risk of bias due to lost follow-up, and the rest were unclear risk of bias. Conclusions: For the treatment of periodontal intrabony defects, our meta-analysis showed that CGF combined with grafting materials was more effective than the use of grafting materials alone. However, the findings should be interpreted with caution due to the average quality of RCTs.