Bone regeneration is a complex process regulated by several factors that control overlapping biological processes, coordinating interactions among distinct cell populations. There is a great interest in identifying new strategies for inducing osteogenesis in a safe and efficient manner. Concentrated Growth Factor (CGF) is an autologous blood derived product obtained by centrifugation of venous blood following the procedure set on the Silfradent device. In this study the effects of CGF on osteogenic differentiation of human Bone Marrow Stem Cells (hBMSC) in vitro have been investigated; hBMSC were cultured with CGF or osteogenic medium, for 21 days. The osteogenic differentiation was evaluated measuring alkaline phosphatase (ALP) enzyme activity, matrix mineralization by alizarin red staining and through mRNA and protein quantification of osteogenic differentiation markers by Real-time PCR and Western blotting, respectively. The treatment with CGF stimulated ALP activity and promoted matrix mineralization compared to control and seems to be more effective than osteogenic medium. Also, hBMSC lost mesenchymal markers and showed other osteogenic features. Our study showed for the first time that CGF alone is able to induce osteogenic differentiation in hBMSC. The application of CGF on hBMSC osteoinduction might offer new clinical and biotechnological strategies in the tissue regeneration field.
Concentrated Growth Factors (CGF) represent new autologous (blood-derived biomaterial), attracting growing interest in the field of regenerative medicine. In this study, the chemical, structural, and biological characterization of CGF was carried out. CGF molecular characterization was performed by GC/MS to quantify small metabolites and by ELISA to measure growth factors and matrix metalloproteinases (MMPs) release; structural CGF characterization was carried out by SEM analysis and immunohistochemistry; CGF has been cultured, and its primary cells were isolated for the identification of their surface markers by flow cytometry, Western blot, and real-time PCR; finally, the osteogenic differentiation of CGF primary cells was evaluated through matrix mineralization by alizarin red staining and through mRNA quantification of osteogenic differentiation markers by real-time PCR. We found that CGF has a complex inner structure capable of influencing the release of growth factors, metabolites, and cells. These cells, which could regulate the production and release of the CGF growth factors, show stem features and are able to differentiate into osteoblasts producing a mineralized matrix. These data, taken together, highlight interesting new perspectives for the use of CGF in regenerative medicine.
Edentulism is the condition of having lost natural teeth, and has serious social, psychological, and emotional consequences. The need for implant services in edentulous patients has dramatically increased during the last decades. In this study, the effects of concentrated growth factor (CGF), an autologous blood-derived biomaterial, in improving the process of osseointegration of dental implants have been evaluated. Here, permeation of dental implants with CGF has been obtained by using a Round up device. These CGF-coated dental implants retained a complex internal structure capable of releasing growth factors (VEGF, TGF-β1, and BMP-2) and matrix metalloproteinases (MMP-2 and MMP-9) over time. The CGF-permeated implants induced the osteogenic differentiation of human bone marrow stem cells (hBMSC) as confirmed by matrix mineralization and the expression of osteogenic differentiation markers. Moreover, CGF provided dental implants with a biocompatible and biologically active surface that significantly improved adhesion of endothelial cells on CGF-coated implants compared to control implants (without CGF). Finally, data obtained from surgical interventions with CGF-permeated dental implants presented better results in terms of optimal osseointegration and reduced post-surgical complications. These data, taken together, highlight new and interesting perspectives in the use of CGF in the dental implantology field to improve osseointegration and promote the healing process.
The aim of the study was to evaluate the tooth extracted use as autologous tooth graft after endodontic root canal therapies used for socket preservation. To this purpose, the Tooth Transformer shredding and decontamination machine has been used. The graft obtained in this way, was inserted at the time of the extraction or at a second surgery altogether with the chosen regenerative therapy. This clinical trial enrolled patients with post-estractive defects requiring the restoration bone dimension and shape in the maxillary and mandibular zone. In addition, 98 patients with 119 extraction sockets were enrolled across 10 standardized centers. An innovative preparation method, using the dedicated automated device Tooth Transformer, able to transform autologous teeth in suitable grafting material, has been used. The extracted tooth was cleaned and treated using a Tooth Transformer and made a socket preservation. Thirteen Biopsies were realized to analyze the histologic outcomes at the average time of four months to demonstrate that the autologous tooth graft made from root after endodontic therapy should be used in human bone regeneration as graft for dental implant placement.
This study aimed to evaluate the combined use of the Concentrated Growth Factor (CGF) and the liquid phase of CGF (LPCGF) on dental implant surfaces, using a medical device to determine the migration of growth factors, from the implant surface to the recipient. The implants were permeated by autologous growth factors, using a specific centrifuge device. CGF adhesion on the implant surface was evaluated through a scanning electron microscope analysis. To assess the release of the vascular endothelial growth factor (VEGF) from CGF, LPCGF, and CGF- or LPCGF-permeated implant, an ELISA assay was carried out. The results showed that the concentration of the growth factor VEGF was greater in CGF than in LPCGF. Our innovative technique allowed the incorporation of autologous growth factors on the surface of the dental implants. Moreover, we reported the release of VEGF, over time, by CGF- or LPCGF-permeated implant. On this basis, it was possible to obtain a biologically active implant surface, essential to create intercellular communication and neo-angiogenesis, to facilitate wound healing and tissue regeneration.
Hypopituitarism is a disorder caused by a reduced level of trophic hormones that may be consequent on different destructive processes. The clinical manifestations depend on the type of hormone involved. A deficiency of growth hormone (GH) in children causes the lack of growth known as pituitary dwarfism. The case is reported of a patient with pituitary dwarfism, multiple dental anomalies, functional prosthetic problems, and a revision of the literature. She was subjected to prosthetic rehabilitation without surgical intervention, using zirconium substructures, thus eliminating the potential complications that may require trauma surgery. The therapeutic approach adopted led to excellent results and restored an aesthetic smile.