Platelet Rich Fibrin and Its Role in Dental Surgery

When faced with the prospect of dental surgery, patients are understandably concerned about a number of factors, including recovery time and the risk of infection. Fortunately, advances in dentistry over the years have led to improved results and overall patient experience. One such advancement is the use of Platelet Rich Fibrin (PRF).

PRF is a living biomaterial derived from a patient’s blood that helps to promote the healing and regeneration of bone and soft tissue, both of which are critical to the success of any dental surgery procedure.

How is PRF created?

PRF is produced by taking a blood draw immediately prior to the surgical procedure and placing it into a centrifuge which separates it into three layers:

1) Clear liquid or plasma layer

2) Red layer rich in red blood cells

3) Yellow thick layer which is the PRF portion

The thick PRF layer is rich in fibrin, platelets, growth factors, and circulating stem cells. In addition, the fibrin network is composed of leukocytes and cytokines that play a significant role in inflammation and infection regulation.

When is PRF used?

PRF can be beneficial in a wide variety of oral surgery procedures ranging from wisdom tooth extractions to socket preservation and sinus lift procedures.

• Tooth extraction – Patients’ jawbones have very little blood supply compared to other tissues in the human body, which means this area has less ability to heal and less defense against infection. Placing RFP in the extraction site protects it from infection and delivers proteins that accelerate the healing process.
• Sinus Lift – This procedure is used when a patient needs an implant in the upper jaw but has a thin sinus wall unable to support implants on its own. A sinus lift grows bone in the floor of the maxillary sinus to enable the secure placement of dental implants. In this instance, PRF can be used to produce faster, stronger bone and soft tissue healing.
• Socket Preservation – The primary purpose of socket preservation is to preserve the health of the alveolar bone (i.e. the socket that holds the tooth in place). This bone is often damaged by disease and/or infection, which necessitates a tooth extraction that can create a jaw deformity if preventative measures aren’t taken. In a socket preservation procedure, PRF membrane, which contains bone growth enhancing elements, can be stitched over the wound or a graft material/scaffold that is placed in the socket of an extracted tooth before it is closed.
• Dental Implants – Insufficient jawbone is one of the leading causes of dental implant failure. In sites where implants are placed, PRF occupies the space between the extraction site and the dental implant, helping to expedite healing and creating jawbone structure.

Benefits of Using Platelet Rich Fibrin

Dentists and patients alike are benefiting from the increased use of PRF in surgical procedures. From decreasing pain to providing a cost-effective option, PRF offers a number of advantages.

• It’s 100% natural and easy to produce. Because PRF is derived from the patients’ own blood it is 100% natural and readily available. The use of PRF does not require anticoagulants, bovine thrombin, or any other jellying factor. This also means patients have virtually no risk of experiencing a rejection reaction (i.e., a foreign body response), which can happen when synthetic alternatives are used.
• Significant decrease in patient discomfort. The use of PRF has been shown to reduce the risk of complications and restrictions a patient may experience due to donor site morbidity. The result is a decrease in patient discomfort, post-surgical pain, and post-op bleeding.
• Faster healing. PRF has been shown to result in faster healing due to its slow polymerization (i.e., the rate at which molecules combine). This process generates a fibrin network that leads to more efficient cell migration and faster healing.
• High cost-benefit ratio. Due to the fact that PRF is readily available and inexpensive to produce, it is an affordable option for patients and providers. Additionally, by reducing the risk of donor site morbidity, the use of PRF can potentially spare the patient from undergoing a second surgery.

As noted, dental surgery has seen a number of advances in recent years and patients should always consult with their dental provider to discuss which procedures make the most sense based on their individual health history.