BACKGROUND: This study evaluated the efficacy of concentrated growth factor (CGF) sticky bone combined with guided tissue regeneration (GTR) in treating shallow infrabony defects and explored factors influencing clinical outcomes. METHODS: Thirteen patients with 31 shallow defects (≤3 mm) were treated using CGF sticky bone (CGF + deproteinized bovine bone mineral), covered with a collagen membrane and CGF membrane. Probing depth (PD), clinical attachment level (CAL), and gingival recession (REC) were examined at baseline and 1 year post surgery. The distance between the base of the defect and the cementoenamel junction (BD-CEJ) were measured on periapical radiographs. Gingival volume and thickness were assessed with digital intraoral scans. Linear regression identified factors influencing CAL gain, PD reduction, and bone gain (ΔBD-CEJ). RESULTS: One year post surgery, CAL increased by 2.48 ± 1.72 mm (p <
0.002), PD reduced by 2.90 ± 1.40 mm (p <
0.002), and bone gain was 2.46 ± 1.71 mm (p <
0.002). REC remained stable (p = 0.254), and the volume and thickness of gingival contour showed no significant changes (p = 0.751 and p = 0.915, respectively). Greater baseline attachment loss was associated with higher CAL gain (coefficient 0.436, p = 0.002). Deeper preoperative PD predicted greater PD reduction (coefficient 0.573, p = 0.029). Greater bone gain was correlated with lower baseline bone height (coefficient 0.305, p = 0.018). CONCLUSIONS: CGF sticky bone combined with GTR demonstrates benefits in CAL gain, PD reduction, and bone gain while preventing REC and gingival contour collapse in the treatment of shallow infrabony defects with residual pockets after initial therapy. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2300069617). PLAIN LANGUAGE SUMMARY: This study explored a novel approach to treating shallow bone defects around teeth using a combination of concentrated growth factor (CGF) sticky bone and guided tissue regeneration (GTR). The treatment involved using a specially prepared bone graft material (CGF sticky bone) along with a collagen membrane and a CGF membrane. The researchers tracked the changes in gum and bone health in 13 patients with 31 shallow defects over 1 year. The results showed significant improvements: Gum attachment levels increased by an average of 2.48 mm, gum pockets reduced by 2.90 mm, and bone growth averaged 2.46 mm. Notably, gum recession and gingival contour remained stable, meaning the treatment did not compromise the appearance of the gums. The study also found that patients with worse gum or bone loss at the start of the treatment tended to experience the greatest improvements. These findings suggest that CGF sticky bone combined with GTR is a promising option for restoring shallow bone defects, particularly in cases where traditional therapy has left residual gum pockets.