The aim of this study was to investigate the effects of fibroblast growth factor (FGF)-2 used in combination with deproteinized bovine bone mineral (DBBM) on the healing of experimental periodontal defects. Periodontal defects created in rats were treated by FGF-2, DBBM, FGF-2 + DBBM, or left unfilled. Microcomputed tomography, histological, and immunohistochemical examinations were used to evaluate healing. In vitro cell viability/proliferation on DBBM with/without FGF-2 was assessed by WST-1. Cell behavior was analyzed using scanning electron and confocal laser scanning microscopy. Osteogenic differentiation was evaluated by staining with alkaline phosphatase and alizarin red. Bone volume fraction was significantly greater in FGF-2 and FGF-2 + DBBM groups than in other groups at 2 and 4 weeks postoperatively. In histological assessment, newly formed bone in FGF-2 and FGF-2 + DBBM groups appeared to be greater than other groups. Significantly greater levels of proliferating cell nuclear antigen-, vascular endothelial growth factor-, and osterix-positive cells were observed in FGF-2 and FGF-2 + DBBM groups compared to Unfilled group. In vitro, addition of FGF-2 to DBBM promoted cell viability/proliferation, attachment/spreading, and osteogenic differentiation. The combination therapy using FGF-2 and DBBM was similarly effective as FGF-2 alone in the healing of experimental periodontal defects. In certain bone defect configurations, the combined use of FGF-2 and DBBM may enhance healing via promotion of cell proliferation, angiogenesis, and osteogenic differentiation.

Each growth factor (GF) has different effects and targets, and plays a critical role in periodontal healing. Dehydrated human amnion-chorion membrane (dHACM) contains various GFs and has been used to enhance wound healing. The purpose of this study was to evaluate the effects of dHACM on periodontal healing, using in vitro and in vivo experimental approaches. Standardized periodontal defects were created in rats. The defects were randomly divided into three groups: Unfilled, filled with hydroxypropyl cellulose (HPC), and dHACM+HPC. At 2 and 4 weeks postoperatively, periodontal healing was analyzed by microcomputed tomography (micro-CT), and histological and immunohistochemical analyses. In vitro, periodontal ligament-derived cells (PDLCs) isolated from rat incisors were incubated with dHACM extract. Cell proliferation and migration were evaluated by WST-1 and wound healing assay. In vivo, micro-CT examination at 2 weeks revealed enhanced formation of new bone in the dHACM+HPC group. At 4 weeks, the proportions of vascular endothelial growth factor (VEGF)-positive cells and α-smooth muscle actin (α-SMA)-positive blood vessels in the dHACM+HPC group were significantly greater than those in the Unfilled group. In vitro, dHACM extracts at 100 µg/mL significantly increased cell proliferation and migration compared with control. These findings suggest that GFs contained in dHACM promote proliferation and migration of PDLCs and angiogenesis, which lead to enhanced periodontal healing.

The aim of this study was to investigate in vivo and in vitro the effectiveness of the use of fibroblast growth factor (FGF)-2 with carbonate apatite (CO₃Ap) on periodontal healing. Periodontal defects created in the maxillary first molars in rats were treated with FGF-2, CO₃Ap, FGF-2 + CO₃Ap or left unfilled. Healing was evaluated using microcomputed tomography, histological, and immunohistochemical analyses. In vitro experiments were performed to assess cellular behaviors and the expression of osteoblastic differentiation markers in MC3T3-E1 cells. At 4 weeks, the bone volume fraction in the FGF-2 + CO₃Ap group was significantly greater than that in the CO₃Ap group, but there was no significant difference from the FGF-2 group. The FGF-2 + CO₃Ap group demonstrated greater new bone compared with the FGF-2 or CO₃Ap group. The FGF-2 + CO₃Ap group showed greater levels of osteocalcin-positive cells compared with the CO₃Ap group, but there was no significant difference from the FGF-2 group. In vitro, the FGF-2 + CO₃Ap group exhibited a greater extent of cell attachment and more elongated cells compared with the CO₃Ap group. Compared with the CO₃Ap group, the FGF-2 + CO₃Ap group showed significantly higher viability/proliferation, but the expressions of Runx2 and Sp7 were reduced. The results indicated that the use of FGF-2 with CO₃Ap enhanced healing in the periodontal defects. FGF-2 promoted cell attachment to and proliferation on CO₃Ap and regulated osteoblastic differentiation, thereby contributing to novel bone formation.

This report describes a case of generalized chronic periodontitis requiring periodontal treatment including regenerative therapy. The patient was a 60-year-old woman who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of tooth mobility and pain in tooth #26. Periodontal examination at the first visit revealed that 32.0% of sites had a probing depth of ≥4 mm and 43.8% bleeding on probing. Radiographic examination revealed vertical bone resorption in #17. Horizontal resorption was noted in other areas. Initial periodontal therapy consisting of plaque control, scaling and root planing, and caries treatment was performed based on a clinical diagnosis of Stage III Grade B periodontitis. Tooth #26 was extracted due to bone resorption extending as far as the root apex. After reevaluation, periodontal regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2) in combination with carbonate apatite (CO₃Ap) granules was performed for #17. Following reevaluation, a zirconia crown (#16) and zirconia bridge (#24–27) were placed. Following further reevaluation, the patient was placed on supportive periodontal therapy (SPT). The periodontal regenerative therapy using rhFGF-2 with CO₃Ap granules yielded an improvement in the vertical bone resorption observed in #17. This improvement has been adequately maintained over a 1-year period postoperatively. Continued SPT is needed to maintain stable periodontal conditions.