Clinical & Radiographic Evaluation of Concentrated Growth Factors (CGF) With Auto Transplanted Closed Apex Teeth

Clinical & Radiographic Evaluation of Concentrated Growth Factors (CGF) With Auto Transplanted Closed Apex Teeth (A Case Series Study).

This study aims to clinically and radiographically evaluate the effect of Concentrated Growth Factors (CGF) on the outcomes of autotransplantation of closed apex teeth. Tooth autotransplantation is considered a viable treatment option for replacing missing teeth; however, its success may be influenced by factors such as periodontal healing and pulpal revascularization, especially in teeth with closed apices.

Concentrated Growth Factors (CGF), as an advanced generation of platelet concentrates, are rich in growth factors that may enhance tissue regeneration, promote healing, and improve the success rate of transplanted teeth.

In this study, patients requiring tooth autotransplantation will be treated using CGF at the recipient site. Clinical outcomes, including tooth stability, periodontal health, and presence of complications, will be assessed. Radiographic evaluation will be performed to monitor bone healing, root resorption, and periodontal ligament integrity over a defined follow-up period.

The findings of this study are expected to provide evidence regarding the potential benefits of CGF in improving the success and prognosis of autotransplanted closed apex teeth.

Tooth autotransplantation is a well-established treatment modality for replacing missing teeth, particularly in young patients. However, the success of this procedure depends on multiple biological factors, including the preservation of the periodontal ligament, prevention of root resorption, and the potential for pulpal healing. In teeth with closed apices, pulpal revascularization is limited, which may negatively affect the long-term prognosis of the transplanted tooth.

Recently, platelet concentrates have gained increasing attention in regenerative dentistry due to their ability to enhance wound healing and tissue regeneration. Concentrated Growth Factors (CGF) represent an advanced generation of autologous platelet concentrates characterized by a dense fibrin matrix rich in growth factors such as transforming growth factor-beta (TGF-β), vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF). These biological mediators play a critical role in angiogenesis, cell proliferation, and tissue regeneration.

The present study is designed to evaluate the clinical and radiographic outcomes of using CGF in autotransplantation of teeth with closed apices. The hypothesis is that the application of CGF at the recipient site may enhance healing, improve periodontal ligament regeneration, and reduce the incidence of complications such as inflammatory or replacement root resorption.

Eligible patients requiring tooth autotransplantation will be recruited according to predefined inclusion and exclusion criteria. The surgical procedure will be performed following standard protocols, with careful atraumatic extraction of the donor tooth and proper preparation of the recipient socket. CGF will be prepared from the patient's own blood using a standardized centrifugation protocol and applied to the recipient site prior to transplantation.

Postoperative follow-up will be conducted at specific intervals to assess both clinical and radiographic outcomes. Clinical evaluation will include parameters such as tooth mobility, periodontal probing depth, gingival condition, pain, and presence of infection or ankylosis. Radiographic assessment will include evaluation of bone healing, periodontal ligament space, root resorption (inflammatory or replacement), and periapical status.

Data will be collected and analyzed to compare outcomes and determine the effectiveness of CGF in improving the success rate of autotransplanted closed apex teeth. The results of this study may contribute to establishing evidence-based protocols for enhancing regenerative outcomes in tooth autotransplantation procedures.

Inclusion Criteria:

• Donor Tooth : any 3rd molar tooth with fully developed roots (confirmed radiographically) and not functionally used (semi impacted, impacted but easily to be extracted, absence of the opposing etc…) .
• Recipient Site : Recipient 1st or 2nd molar region (either upper or lower) with adequate bone volume to receive the auto transplanted tooth.
• Oral Health: Good general oral hygiene and absence of active periodontal disease.
• Systemic Health: patients with no contraindications for minor oral surgery.

Exclusion Criteria:

• Poor Oral Hygiene: Presence of uncontrolled gingivitis or periodontitis.
• Systemic Conditions: Patients with systemic diseases that may impair healing (e.g., uncontrolled diabetes, immunosuppression, bleeding disorders or bone metabolic diseases ).
• Smoking: Active smokers or tobacco users.
• Pregnancy or Lactation: Female patients who are pregnant or breastfeeding