Efficacy of concentrated growth factor compared with other types of regenerative endodontic procedures: a systematic review.

Background: To investigate the regenerative ability of concentrated growth factor (CGF) during endodontic treatment compared with other regenerative procedures.

Methods: The PubMed, Web of Science Core Collection, Scopus, and Ovid MEDLINE databases were systematically searched to identify studies that examined the use of regenerative endodontic therapy (RET) utilizing CGF for patients, animals, or extracted human teeth. The risk of bias was assessed using the JBI tool for clinical studies, QUIN tool for in vitro studies, and SYRCLE tool for animal studies. The study results were qualitatively synthesized.

Results: A total of 311 studies were initially retrieved from the databases. Ultimately, nine studies were included (three randomized clinical trials, two retrospective studies, three in vitro studies, and one in vivo animal study). The risk of bias was low in two studies and moderate in seven studies. Compared with other types of regenerative procedures, CGF has a similar influence on root dentinal thickness and apical foramen width. The clinical success rate was also comparable among the investigated regenerative procedures. The influence of CGF on human pulpal/apical papilla stem cells was similar to that of other types of regenerative procedures. However, the effect of CGF was enhanced when it was combined with transforming growth factor beta 1. The use of CGF in animals also exerted radiographic, histological, and immunohistochemical effects similar to those of exerted by other regenerative procedures.

Conclusions: Compared with other regenerative procedures, CGF resulted in similar radiographic changes after the RET of necrotic permanent teeth. Similarly, CGF-conditioned medium enhanced stem cell viability, proliferation, and differentiation, with no apparent differences from other endodontic regenerative procedures. However, the interpretation of these findings is limited by the heterogeneity of included studies, variations in RET protocols, and the lack of long-term clinical outcome data.