The Use of Concentrated Growth Factors in Guiding Bone Regeneration After Microsurgical Endodontic Surgery for Periapical Lesions

Abstract Concentrated growth factors (CGFs) hold great potentials for postoperative bone regeneration. This study attempted to investigate the effect of CGF scaffolds on guided bone regeneration after microsurgical endodontic surgery on teeth with periapical lesions. Microsurgical endodontic surgery was performed on 68 teeth with periapical lesions after complete root canal therapy. Autologous CGFs were administered to 38 teeth (the experimental group) while the remaining teeth received no CGF (the control group). The patients were followed for an average of 18 months. Postoperative pain, swelling, and the duration were compared between the two groups. The bone volume ratios were quantitatively measured and statistically analyzed with Mimics software. Compared with the control group, the experimental group reported a lower incidence and shorter duration of postoperative pain and swelling, with mild to moderate swelling in the former and mild swelling in the latter. Both groups demonstrated good postoperative wound healing. The experimental group reported a significant reduction in bone volume ratio at postoperative month 3 (P < 0.05). Both groups reported a most active period of new bone formation between 3 and 6 postoperative months, after which the formation rate stabilized, and an insignificant decrease in bone volume ratio from 6 to 18 postoperative months. By 18 postoperative months, the bone defects were minimized, with the experimental group showing faster new bone formation. Marked differences in bone volume reduction and volume reduction rate were found between the two groups, with more significant bone defect repair and bone regeneration in the experimental group. These results evidence that in guided bone regeneration, the use of CGF scaffolds for teeth with periapical lesions can alleviate postoperative pain and swelling, promote faster bone defect repair, and ensure satisfactory incision healing, highlighting it as a promising clinical approach.