The Effect of Concentrated Growth Factor(CGF) on healing outcome in maxillary sinus graft(histological examination)

Abstract

Introduction In order to place dental implants with standard length in the atrophic posterior maxilla, the maxillary sinus floor augmentation surgery is performed along with the autogenous bone graft or different bone substitute materials. Concentrated Growth Factor (CGF) is full of the growth factors and can accelerate newly bone formation. In this clinical trial study, the effect of CGF on healing outcome of maxillary sinus floor augmentation was histologically examined. Materials and method This double-blind clinical trial study (patient – laboratory technician) was registered in the Ethics Committee of Tabriz University of Medical Sciences with code IR.TBZMED.REC.1399.845 and also in www.irct.ir with code IRCT20201215049728N1 .The present study was conducted in Split-mouth technique on 9 patient aging 30-80 years old suffering bilateral posterior partial edentulous or edentulous maxilla who had referred to the Tabriz Faculty of Dentistry and met all inclusion and exclusion criteria. Immediately before the surgery, CGF was provided using the intravenous blood. All surgeries was performed only by one surgeon. lateral windows sinus lift surgical procedure was used for treatment. In the control group, xenograft was used and in the test group CGF was applied. 6 months later, CBCT radiography was carried out; Then, at the time of operation, osteotomy area was specified and the tissue sample was taken. microscopic slides were prepared using the routine and specialized staining methods (i.e. hematoxylin eosin and alizarin red staining) and by using Motic Images 2 software, the amount of recently-formed living bone, formed connective tissue and remaining materials were analized and measured in mm2. The histologist was not aware of the type of sampling material as well as the studied groups. Results In the alizarin red staining method, percentage of bone formed in CGF group (112.41±26.34%) was significantly higher than the control group (64.99±24.96%) (P < 0.05). In hematoxylin eosin method, this percentage in CGF group (96.16±24.49%) was also significantly higher than the control group (60.16±16.39%) (P < 0.05). There was no significant difference in the amount of formed connective tissue, as assessed by both alizarin red (P=0.468) and hematoxylin eosin (P=0.155) methods, between the CGF and xenograft groups. After 6 months, results of both staining techniques (i.e. alizarin red and hematoxylin eosin) showed that the amount of remaining materials in control group (xenograft) is significantly higher than CGF group (P < 0.05). Conclusion Open sinus lift (augmentation) surgery using the CGF is reliable for placing dental implants.