The Affect Of Concentrated Growth Factor Gel On Repair Of Bone Defect From Jaw Cyst

Objectives:Jaw cyst is one of the most common diseases in oral and maxillofacial region and surgical curettage is used to treat jaw cyst. The pathological bone cavity was left post operation. The smaller bone cavity could heal itself while the larger bone cavity healed slowly and it was necessary that the biological materials were implanted into the bone cavity. Most of the biological materials are expensive while the CGF gel was low-cost blood product, which included a lot of growth factors. In recent years, the CGF gel was applied in tissue repair since it could accelerate the recovery of the bone defect. The study aim at observing the effect of CGF gel on the bone defect post jaw cyst curettage and providing a guide for the clinical application.Method:Selection and group of patients: 51 patients with jaw cyst were enrolled from Stomatology Hospital, Hebei Medical University from Feb. 2013 to Nov. 2014. They were selected according to criteria, which the maximum diameter of the jaw cyst is not less than 1.5 cm. The patients were randomly divided into CGF group and control group. CGF gel was implanted into the bone defect of jaw cyst in CGF group while anything was not implanted into the bone defect of jaw cyst in the control group. The CGF group included 23 patients(17 male and 6 female) with age ranging from 6 to 75 years(mean 36.5 years). The CGF group included 9 maxillary cyst cases and 14 mandibular cyst cases. There were 9 radicular cysts, 6 dentigerous cysts, 5 odontogenic keratocysts, and 3 nasopalatine duct cysts in CGF group. The size of cysts in CGF group ranged from 2.25 cm2 to 24 cm2(mean 8.43±5.36 cm2). The control group included 28 patients(19 male and 9 female) with age ranging from 6 to 64 years(mean 33.3 years). The control group included 16 maxillary cyst cases and 12 mandibular cyst cases. There were 13 radicular cysts, 10 dentigerous cysts, 3 odontogenic keratocysts, and 2 nasopalatine duct cysts in control group. The size of cysts in control group ranged from 1.5 cm2 to 24 cm2(mean 8.68 ±7.62cm2).Experiment methods: preoperative OPG and CBCT of all patients were taken. Cyst curettage was performed under local anesthesia or general anesthesia. The autologous venous blood was collected and made into CGF gel by differential centrifugation for 13 minutes. CGF gel was implanted into the bone defect of jaw cyst in CGF group while anything was not implanted into the bone defect of jaw cyst in the control group. All patients were followed up at 3 months and 6 months post operation and taken with OPG and CBCT.Imaging analysis: the Motic Medical 6.0 system was used to measure the mean grey value of the bone defect area of OPG and CBCT. The Selected planes on CBCT included sagittal plane, coronal plane and transverse plane of the longest diameter of bone defect. All images of OPG and CBCT were input into the Motic medical system. The manual analysis was used to draw arbitrary shaped curve in bone defect area. The system could automatically calculate the mean grey value of the selected area. The MGV of bone defect and blank area were measured, respectively. The final MGV is the value of bone defect taking away the value of blank area. Every image should be measured for three times and the average value was the final measure results.Statistical analysis:Statistical software 21.0 was used. The differences of gender, location, type between CGF group and control group were compared by using Chi-square Test. The differences of age and size between CGF group and control group were compared by using nonparametric rank-sum test. Normal test was used before analyzing data. The independent sample t test was applied if condition was satisfied normality. The nonparametric rank-sum test was applied if condition was not satisfied normality. P < 0.05 was regarded as statistical significance.Results:1 Analysis of clinical dataThere was no significant difference between CGF group and control group on gender, age, cyst location, cyst type, and cyst size(P>0.05).2 Measurement results of OPGMean grey value of CGF group(71.88±8.87) was higher than that of control group(66.79±7.40) at 3 months post operation but there was no significant difference between CGF group and control group(P>0.05). Mean grey value of CGF group(88.06±9.31) was higher than that of control group(72.00±8.79) at 6 months post operation and there was significant difference between CGF group and control group(P<0.05).3 Measurement results of CBCTSagittal section of CBCT: mean grey value of CGF group(71.49±7.69) was higher than that of control group(65.55±6.24) at 3 months post operation but there was significant difference between CGF group and control group(P<0.05). Mean grey value of CGF group(86.64±9.42) was higher than that of control group(78.11±7.39) at 6 months post operation and there was significant difference between CGF group and control group(P<0.05).Coronal section of CBCT: mean grey value of CGF group(74.97±8.43) was higher than that of control group(68.53±6.25) at 3 months post operation but there was significant difference between CGF group and control group(P<0.05). Mean grey value of CGF group(86.72±8.73) was higher than that of control group(78.85±8.06) at 6 months post operation and there was significant difference between CGF group and control group(P<0.05).Transverse section of CBCT: mean grey value of CGF group(72.68±9.14) was higher than that of control group(65.81±6.67) at 3 months post operation but there was significant difference between CGF group and control group(P<0.05). Mean grey value of CGF group(87.92±9.41) was higher than that of control group(79.64±8.62) at 6 months post operation and there was significant difference between CGF group and control group(P<0.05).Conclusions:1 Concentrated growth factors(CGF) gel can promote the repair of the bone defect post the curettage of jaw cyst.2 The combined quantitative analysis of OPG and CBCT can display well the recovery of the bone defect post the curettage of jaw cyst.