Platelet Rich Fibrin and Tissue Growth Factors
Platelet rich fibrin (PRF) is a by-product of blood (plasma) that is rich in platelets and tissue growth factors . New technology permits doctors to harvest and produce a sufficient quantity of platelets from only 10 cc to 20cc of blood, which is drawn from the patient while they are in the office for their outpatient surgery.
Why All The Excitement About PRF?
PRF permits 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 include: platelet derived growth factors (PDGF), transforming growth factor beta (TGF), and insulin-like growth factor (ILGF), which assist the body in repairing itself by stimulating stem cells to regenerate new tissue. The more growth factors released into the wound, the more stem cells are stimulated to produce new tissue. Thus, PRF permits the body to heal faster and more efficiently.
As a ‘bonus’, 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 are doing bone grafts for dental implants. By adding PRF (and BMP) with bone graft materials, the surgeon can now grow bone more predictably.
PRF Has Many Clinical Applications
PRF can be used to aid in onlay grafts, inlay grafts, and sinus lift procedures commonly required to support dental implant surgery. PRF can also be applicable to ridge augmentation (reconstruction) procedures and closure of clefts of the alveolar ridge and palate. It can also assist in repair of surgical defects created by removal of teeth, jaw cysts and even for repair of fistulas between the sinus cavity and mouth.
PRP Also Has Many Advantages
Safety: PRF is a by-product of the patient’s own blood, therefore, disease transmission is not an issue.
Convenience: PRF can be generated in the doctor’s office while the patient is undergoing an outpatient surgical procedure such as bone grafting, placement of dental implants or extractions with socket preservation techniques.
Faster healing: The supersaturation of the wound with PRF, and the associated growth factors, produces an increase of tissue synthesis and faster tissue regeneration.
Cost effectiveness: Since PRF harvesting is done with only 10 cc to 20 cc of blood in the doctor’s office, there is reduced expense of the harvesting procedures that have previously been done primarily in the hospital setting or at a blood bank.
Ease of use: PRF is easy to handle and actually improves the ease of application of bone graft materials making them more gel-like.
Frequently Asked Questions About PRF
Is PRF safe? Yes. During the outpatient surgical procedure a small amount of your own blood is drawn out via a venipuncture. Sometimes the IV site for the anesthesia administration can be used. This blood is then placed in the PRF centrifuge machine and spun down. In about 15 minutes, the PRF is formed and ready to use.
What about FDA regulations? Anchor Bay Oral Surgery, PC has adopted the INTRA-LOCK ™ system for preparation of the PRF in the office. The INTRA-LOCK ™ system in the only PRF system that has received FDA clearance.
Should PRF be used in all bone-grafting cases? Not always. In some cases, there is no need for PRF. However, in the majority of cases, application of 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 PRF generation is paid by the patient.
Can PRF be used alone to stimulate bone formation? No. PRF must be mixed with either the patient’s own bone or a bone graft material such as demineralized freeze-dried bone (human cadaver bone).
Are there any contraindications to PRF? Very few. Obviously, patients with bleeding disorders or hematologic diseases may not qualify for this in-office procedure. Check with your surgeon and/or primary care physician to determine if PRF is right for your treatment needs.