Efficacy of Bu-Shen Gu-Chi-Wan Combined with Collagen Sponge-Loaded Basic Fibroblast Growth Factor on Periodontal Bone Defects and Gingival Papillae Loss

Abstract

The study aimed to evaluate the efficacy and molecular mechanisms of Bu-Shen Gu-Chi-Wan (BSGC) combined with a collagen sponge loaded with basic fibroblast growth factor (bFGF) in treating severe periodontitis. Sixty patients with severe periodontitis were enrolled and randomly assigned to either the bFGF-collagen sponge group (BFGF group) or the BSGC + bFGF-collagen sponge group (BSGC-BFGF group). Both groups underwent open-flap debridement and implantation of a bFGF-collagen sponge; the BSGC-BFGF group additionally received oral BSGC 4 g twice daily for 3 months. Periodontal pocket depth (PD), clinical attachment loss (CAL), gingival index (GI), cone-beam CT bone density (BD), bone height (BH), gingival papilla height (GPH), black-triangle area (BTA), as well as osteocalcin (OCN) and osteoprotegerin (OPG) levels in gingival crevicular fluid were assessed at baseline and at 6 and 12 months post-surgery. The study found that all postoperative parameters improved significantly compared with baseline in both groups (P < 0.05). The BSGC-BFGF group exhibited significantly greater reductions in PD, CAL, and GI, and greater increases in BD, BH, and GPH, along with a more pronounced reduction in BTA, than the BFGF group at both 6 and 12 months (P < 0.05). OCN and OPG levels peaked at 6 months and remained elevated at 12 months, with levels in the combined group consistently higher than those in the control group (P < 0.05). The study concluded that BSGC synergizes with bFGF by suppressing inflammation and activating osteogenic signaling pathways, markedly promoting regeneration of severe periodontal bone defects and reconstruction of the gingival papilla, thus providing a novel strategy for integrative periodontal regenerative therapy.