Platelet Rich Plasma and Fibrin
Platelet Rich Plasma (PRP) and Platelet Rich Fibrin (PRF) are by-products of blood (plasma) that are rich in platelets. Until now, their use has been confined to the hospital setting. This was due mainly to the cost of separating the platelets from the blood and the large amount of blood needed to produce a suitable quantity of platelets. New technology permits doctors to harvest and produce a sufficient quantity of platelets from only 55 cc of blood, which is drawn from the patient while they are having outpatient surgery.
Why All The Excitement About PRP and PRF?
PRP abd PRF permit the body to take advantage of the normal healing pathways at a greatly accelerated rate. During the healing process, the body rushes many cells and cell-types to the wound in order to initiate the healing process. One of those cell types is platelets. Platelets perform many functions, including formation of a blood clot and release of growth factors (GF) into the wound. These growth factors; platelet derived growth factors (PDGF), transforming growth factor beta (TGF), and insulin-like growth factor (ILGF), function to assist the body in repairing itself by stimulating stem cells to regenerate new tissue. The more growth factors released and sequestered into the wound, the more stem cells are stimulated to produce new tissue. Thus, PRP and PRF permit the body to heal faster and more efficiently.
A subfamily of TGF is bone morphogenic protein (BMP). BMP has been shown to induce the formation of new bone in research studies in both animals and humans. This is of great significance to the surgeon who places dental implants. By adding PRP, and BMP, to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.
PRP and PRF Have Many Clinical Applications
PRP and PRF can be used to aid bone grafting for dental implants. This includes onlay and inlay grafts, sinus lift procedures, ridge augmentation procedures, closure of cleft and/or lip, and palate defects. They also assist in the repair of bone defects created by removal of teeth or small cysts, and repair of fistulas between the sinus cavity and mouth.
PRP and PRF Have Many Advantages
Safety: PRP and PRF are a by-product of the patient’s own blood, therefore, disease transmission is not an issue.
Convenience: PRP and PRF can be generated in the doctor’s office while the patient is undergoing an outpatient surgical procedure such as the placement of dental implants.
Faster healing: The supersaturation of the wound with PRP and/or PRF, and thus growth factors, produces an increase of tissue synthesis and faster tissue regeneration.
Cost effectiveness: Since PRP and PRF harvesting is done with only 55 cc of blood in the doctor’s office, the patient need not incur the expense of the harvesting procedure in a hospital or at a blood bank.
Ease of use: PRP and PRF are easy to handle and actually improve the ease of application of bone substitute materials and bone grafting products by making them more gel-like.
Frequently Asked Questions About PRP and PRF
Are they safe? Yes. During the outpatient surgical procedure, a small amount of your own blood is drawn out via the IV. This blood is then placed in the PRP/PRF centrifuge machine and spun down. In less than 15 minutes, the PRP/PRF is formed and ready to use.
Should PRP and/or PRF be used in all bone-grafting cases? Not always. In some cases, there is no need for either. However, in the majority of cases, application of PRP and/or PRF to the graft will increase the final amount of bone present, in addition to making the wound heal faster and more efficiently.
Will my insurance cover the costs? Unfortunately not. The cost of the PRP/PRF application is paid by the patient.
Can PRP/PRF be used alone to stimulate bone formation? No. PRP/PRF must be mixed with either the patient’s own bone, a bone substitute material such as demineralized freeze-dried bone, or a synthetic bone product, such as BIO-OSS.
Are there any contraindications to PRP and PRF? Very few. Obviously, patients with bleeding disorders or hematologic diseases do not qualify for this in-office procedure. Check with your surgeon and/or primary care physician to determine if PRP and/or PRF are right for you.