Prognostic factors affecting periodontal regenerative therapy using recombinant human fibroblast growth factor-2: A 3-year cohort study

Abstract

Introduction: Fibroblast growth factor-2 (FGF-2) has been reported to promote periodontal tissue regeneration. However, no study has investigated the long-term prognosis of periodontal regenerative therapy using FGF-2 to date. The aim of this study was to observe the long-term outcomes as well as to investigate the factors affecting the prognosis of periodontal regenerative therapy using FGF-2.

Methods: Sixty intrabony defects were prospectively investigated for three years after periodontal regenerative therapy with recombinant human FGF-2 (rhFGF-2) by evaluating probing pocket depth (PPD) and radiographic bone defect depth (RBD). The factors influencing RBD were assessed by conducting a multivariate linear regression analysis after adjusting for confounders.

Results: The mean age of the participants was 62.4 ± 13.4 years, and baseline PPD and RBD were 6.1 ± 1.9 mm and 4.5 ± 1.8 mm, respectively. At six months, one year, and three years after surgery, PPD and RBD had significantly improved to 4.2 ± 1.7, 3.7 ± 1.4, 4.0 ± 1.9 mm and to 3.08 ± 2.05, 2.73 ± 1.90, 2.51 ± 2.15 mm, respectively. At the three-year examination, a significant positive association was deteced between RBD reduction and RBD at baseline, while the association was not significant between RBD reduction and the radiographic bony angle, number of bony walls of the defect, or the furcation involvement at baseline.

Conclusions: rhFGF-2 was effective for alveolar bone regeneration in patients with periodontitis and maintained the improved parameters over the three-year observation period. The radiographic bone defect depth at baseline was found to be the factor affecting the periodontal regenerative therapy using rhFGF-2 in the intrabony defects.

Trial registration number: UMIN000027979.

Keywords: Fibroblast growth factor-2; Periodontal regenerative therapy; Periodontitis; rhFGF-2.

Fig. 1

Postoperative change in PPD and RBD for three years. Black dots indicate the values that are more than 1.5 quarter deviations away from the 25th and 75th %tile. (a) PPDs were significantly reduced compared to baseline at each time point (p < 0.001). (b) RBDs were decreased significantly compared to baseline at each time point (p < 0.001). RBDs subsequently decreased at 3 years compared with at 6 months (p = 0.094).

Fig. 2

Correlation between RBD at baseline and RBD reduction at 3-year examination (a) they have significant and positive correlation (Spearman's rho = 0.27, p = 0.038). Correlation between RBA at baseline and RBD reduction at 3-year examination (b) a trend of negative correlation was observed but not significant (Spearman's rho = −0.24, p = 0.08).