# A comprehensive evaluation of the antimicrobial efficacy of concentrated growth factor against biofilms associated with endodontic diseases: An in vitro study

## TL;DR

This study shows that concentrated growth factor (CGF) can reduce biofilms of bacteria and fungi linked to dental infections, suggesting it could improve regenerative treatments.

## Contribution

The study is the first to evaluate CGF's antibiofilm activity against endodontic pathogens in vitro.

## Key findings

- CGF significantly reduced viable microbial cells in biofilms of E. faecalis and C. albicans.
- Scanning electron microscopy confirmed a notable decrease in fungal and bacterial cell concentration after CGF treatment.

## Abstract

Concentrated Growth Factor (CGF), derived from a specific centrifugation protocol designed to optimize the concentration of growth factors and platelet-derived cytokines, has been investigated in the context of regenerative treatments. However, the potential antibiofilm properties of CGF against endodontic pathogens remain to be clarified. This in vitro study evaluated the antimicrobial effectiveness of CGF against the biofilms of Enterococcus faecalis and Candida albicans.

Blood samples were collected from otherwise healthy volunteers. A dedicated centrifugation device and protocol were used for CGF preparation. The antimicrobial activity of the CGF was observed and recorded against standard strains of E. faecalis and C. albicans using a disc agar diffusion method to determine the inhibition zone, and broth microdilution to measure the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). A crystal violet assay and colony-forming unit (CFU) counts were conducted for biofilm assessment, using sodium hypochlorite (NaOCl) 5.25% as a positive control. This was followed by scanning electron microscopy (SEM) to analyze the morphology of the biofilm formed on the dentinal surface. A statistical analysis was performed using one-way ANOVA followed by Tukey's multiple comparison test with GraphPad Prism (version 8.4.3).

An inhibition zone was observed in both the CGF and NaOCl groups against both microorganisms. MIC was found for CGF against both microorganisms at a concentration of 50% v/v, while MBC and MFC were obtained at a concentration of 100% v/v. CFU counting revealed a significant reduction in viable microbial cells following the treatment of E. faecalis and C. albicans biofilms with NaOCl and CGF compared to the control group (P<0.05). NaOCl resulted in the most pronounced reduction of the biofilms (76.86% for E. faecalis and 86.52% for C. albicans). However, there was a 32.97% reduction of the viable microbial cells of E. faecalis and a 35.97% reduction of the viable microbial cells of C. albicans in biofilm treated with CGF. The SEM results also showed a notable decrease in the concentration of fungal and bacterial cells.

The present study demonstrated that CGF may exhibit antimicrobial and antibiofilm properties against endodontic pathogens. Hence, CGF may contribute to reducing microbial load and enhancing the outcome of regenerative treatments within infected root canal systems.