Concentrated Growth Factor and Platelet-Rich Fibrin in Regenerative Endodontic Treatment of Immature Permanent Teeth

Introduction and aims This study aimed to compare the efficacy of concentrated growth factor (CGF) and platelet-rich fibrin (PRF) as scaffold materials in regenerative endodontic treatment (RET) of immature permanent teeth, and to analyse contributing factors to root canal calcification after treatment. Methods A retrospective study was conducted on 50 immature permanent teeth treated with RET between January 2018 and December 2024, including a CGF group ( n = 30) and a PRF group ( n = 20). Quantitative radiographic indicators and clinical efficacy were evaluated at two follow-up intervals: 6 to 24 months and >24 months. Cases were further divided into a calcification group ( n = 33) and a noncalcification group ( n = 17) to identify risk factors associated with canal calcification. Results At 6 to 24 months, no significant intergroup differences were observed in apical closure, root development, success rate, or calcification rate (all P > .05). However, at >24 months, the PRF group showed a significantly greater reduction in apical foramen size than the CGF group ( P = .049). Higher root length increase (OR = 1887.324, P = .031) and female sex (OR = 11.006, P = .013) were independent risk factors for canal calcification. Conclusion Both CGF and PRF are effective short-term scaffolds for RET. Notably, PRF shows superior long-term performance in promoting apical closure. Thus, clinicians should implement targeted monitoring for high-risk patients to balance regenerative benefits and calcification risks. Clinical relevance This study provides clinical evidence that CGF and PRF are effective scaffolds for RET in immature permanent teeth. Importantly, PRF shows superior long-term performance in promoting apical closure, while greater increases in root length and female sex are identified as independent risk factors for canal calcification. These findings help clinicians select appropriate scaffolds and implement targeted long-term monitoring strategies to balance regenerative outcomes and calcification risks.