title: A systematic review of the use of growth factors in human periodontal regeneration.
abstract: BACKGROUND
  There is a large body of evidence using cells and animal models demonstrating the effectiveness of growth factors in periodontal regeneration. However, there appears to be minimal literature comparing the efficacy of growth factors in human periodontal regeneration compared to other techniques and procedures. Therefore, the aim of this study is to perform a systematic review of human studies using growth factors for periodontal regeneration and to compare the efficacy of these growth factors to other accepted techniques for periodontal regeneration.
  
  
  METHODS
  An electronic and manual search based on agreed search phrases between the primary investigator and a secondary investigator was performed to identify the use of growth factors in periodontics for the literature review. The articles that were identified by this systematic review were analyzed in detail, which included the study of their inclusion and exclusion criteria, outcome measures determination and analysis, risk of bias, adverse events, and conclusions or inference of the efficacy of growth factors to the general population.
  
  
  RESULTS
  Five papers fulfilled the inclusion criteria. Two papers were identified that had sufficiently similar study design that a meta-analysis of their outcomes was possible. Most of the reported outcomes from the selected papers were descriptive. The articles demonstrated periodontal regeneration at least comparable to their respective positive controls, with only a couple of articles demonstrating significantly greater outcomes compared to their respective positive controls. Histologic evidence demonstrated greater periodontal regeneration when using growth factors compared to other regenerative techniques and an increased healing and bone maturation rate compared to other regenerative and bone augmentation techniques in these human studies.
  
  
  CONCLUSIONS
  Within the limits of this systematic review, the use of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) led to greater clinical attachment level gain of ≈1 mm compared to an osteoconductive control, β-tricalcium phosphate (β-TCP). The use of rhPDGF-BB led to greater percentage bone fill of ≈40% compared to the osseoconductive control, β-TCP. Last, the use of rhPDGF-BB led to an increased rate of bone growth of ≈2 mm compared to the osseoconductive control, β-TCP.
authors.affiliation: Periodontics, Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia. idarby@unimelb.edu.au
authors.forename: Ivan B
authors.initials: IB
authors.lastname: Darby
authors.forename: Kevin H
authors.initials: KH
authors.lastname: Morris
mesh_terms: D016301:Alveolar Bone Loss / Q000188:drug therapy*; D000540:Alveolar Ridge Augmentation / Q000379:methods; D000077214:Becaplermin; D001861:Bone Regeneration / Q000187:drug effects*; D002130:Calcium Phosphates / Q000627:therapeutic use; D004337:Drug Carriers / Q000494:pharmacology; D017823:Furcation Defects / Q000188:drug therapy; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D010982:Platelet-Derived Growth Factor / Q000494:pharmacology* / Q000627:therapeutic use*; D020574:Proto-Oncogene Proteins c-sis / Q000494:pharmacology / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D002130:Calcium Phosphates; D004337:Drug Carriers; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; D000077214:Becaplermin; C018392:tricalcium phosphate