The burgeoning research in medical science has led to several finds that are both interesting and advantageous. One such research is the Platelet Rich Fibrin or PRF. Dr. Joseph Choukron, a French surgeon, is credited with the invention of the PRF techniques (L-PRF, A-PRF, and i-PRF). While performing facial surgeries, Dr. Choukron found that PRF accelerates the healing process. Since then, PRF techniques have been used in maxillofacial surgeries and various disciplines of dentistry.
What is Platelet Rich Fibrin (PRF)?
PRF is a biomaterial obtained from the patient’s blood to promote soft tissue, bone healing, and regeneration. Its ease of derivation makes it popular amongst surgeons/specialists. It is also financially realistic and goes light on the patient’s pocket. PRF can be prepared instantly and poses practically no risk of rejection reaction as it is not a foreign body.
The fibrin matric offers a 3D architecture to the PRF membrane, and its characteristics of being flexible, good density, strong and flexible make it wonderful for suturing, handling, and manipulation.
Successful treatment using the PRF technique depends on various factors such as:
- Quick collection of blood from the patient and immediate transfer to the centrifuge – Dr. Choukroun states the right time as 2 minutes)
- Maturation of the collected clot before it can be used – Dr. Choukroun mentions the perfect time to be as 4 – 8 minutes
- Preparation of the membrane – using the standard technique as stated
- Proper conservation of membrane before it can be used
Platelet Rich Fibrin can be used in various forms –
- Injectable or liquid form – which is referred to as i-PRF
- Membrane form – which is referred to as A-PRF or L-PRF
The membrane can be cut into smaller fragments and used for additive therapies where it is mixed or added to bone substitutes or stand-alone therapies used as protective barrier/plug/filler. It can be utilized in a combination therapy where the PRF is combined with other biomaterials such as GBR procedures. It can be used as a protective barrier.
Evolution of Platelet Concentrates
Using blood-derived biomaterials to boost the healing process is a method that started 40 years ago. Earlier platelet concentrates were solely used to prevent hemorrhages in severe thrombopenia. The fibrin matrix in platelet concentrates has sticky characteristics that aid in the regeneration of soft and hard tissues. Initially, for stimulation of tissue repair, platelet concentrates were developed with fibrin glue or sealant. The adhesives were either prepared from the plasma collected from the patient (autologously), using commercial products, or donor plasma. The cost of production, risk of disease transmission, and difference in the concentration levels of fibrin in the plasma were some drawbacks of this process.
Hence, two decades earlier, in 1998, Platelet Rich Plasma or PRP was introduced, which used autologous blood products with high platelet concentrations. The growth factors present in the platelets combined with the properties of fibrin glue helps in the regeneration and healing process. Currently, there are more than 40 different processes available for PRP production using autologous blood. Between 20 – 80 mL of venous blood is collected from the patient stored in a tube and an anticoagulant. Two centrifugations are involved in the process and are completed within an hour, and the PRP obtained from the process is then mixed with activators during the time of application. Although PRP has been in use widely and is still used, it does lack uniformity.
After activation, PRP should be administered within the first 10 minutes. But in the past few years, there have been several cases where PRP drawbacks have been reported. For instance, preparing PRP requires using an anticoagulant. It has been noticed that the inclusion of anticoagulation interfered with the healing process. It prevented fibrin clot formation and coagulation. Other cases reported that the release of growth factors was limited to a concise duration.
Since replantation of blood-derived products is illegal, Platelet Rich Fibrin or PRF found its way into medical history in 2001. Preparing PRF doesn’t require any anticoagulants. The healing process is not affected by anticoagulants. Clot formation happens naturally. PRF can be defined as an autologous platelet fibrin biomaterial rich in leukocytes that releases cytokines in the fibrin clot, accumulates platelets, and promotes immunity. Activators such as calcium chloride or bovine thrombin, commonly used in PRP or other traditional methods, are not required in PRF.
Application of PRF in Dentistry
Some common applications of PRF in dentistry include:
- Platelet Rich Fibrin is routinely used in maxillofacial and oral surgeries to promote healing. At Healthy Smiles, our practitioner takes an autologous blood sample from the patient, centrifuges it, and then places it on the surgical site in the form of a clot. L-PRF is the most common way of PRF preparation in these types of surgeries. The leukocyte content, architecture of fibrin that traps growth factors and cytokines are significantly decisive in its ability to heal.
- The platelet concentrates, and autologous fibrin clots replicate the effects of bleeding from a surgical site. Basically, it allows the area to trigger neoangiogenesis, form a fibrin clot, and offer a foundation for the leukocytes to clean debris and protect the surgical area from being infected.
- PRF is also used as a barrier between tissues during periodontal surgery and has helped prevent healing by long junctional epithelium (common in patients who have periodontal disease, where their connective tissue is destroyed).
- Dental Surgeons and PRF practitioners at Healthy Smiles also use PRF to prevent any gingival tissue damage that is likely to happen during bone grafting surgery. PRF also boosts the healing process of soft tissue.
- Platelet Rich Fibrine (L-PRF) is also used as membrane and filling material in Guided Tissue Regeneration. The L-PRF membrane doesn’t interfere with the natural healing process and is compatible with the host tissue. L-PRF is considered stronger than a natural clot. Our surgeons have successfully used it as a filling to regenerate hard tissue in intrabony
- PRF is also commonly used in palatal (palette) wound healing and in root coverage procedures. It boosts the root coverage and heals the soft tissue.
- It is also commonly used in sinus augmentation treatments to repair a perforated Schneiderian membrane or cover the graft material as a membrane or in bone grafts.
Benefits of Platelet Rich Fibrin in Dentistry
There are several advantages of using PRF. The advantages have been listed as below:
- Platelet Rich Fibrin attracts bone-forming cells known as osteoblasts and helps restore the peri-implant bone to the area of usage.
- The alveolar ridge, which can often be resorbed after dental treatments such as tooth extraction, is preserved.
- PRF can heal periodontal defects and boost new bone generation, aiding in the improvement of the health of your teeth.
- For those who have undergone surgery for cancer, PRF can be beneficial as it can reconstruct bone defects.
- It is also helpful in the enhancement of gum volume as it promotes gum regeneration.
- Some organs in our body, like the mouth, have a moist inner lining known as mucosal. It protects against some invading pathogens. Sometimes, post-dental treatments, even the sutures, fail to repair the mucosal margins. But, using PRF helps in joining them back.
- Platelet Rich Fibrin treats and prevents infections, as they possess antibacterial properties.
- PRF also helps in speeding up the healing process of the wounds.
- Several studies reveal that PRF is the only material that can enhance the maxillary sinus floors. The maxillary sinuses help improve our nose’s respiratory function, and the roots of the molar, premolars, and sometimes canine teeth are closely connected to the maxillary sinus.
- PRF can reduce bone inflammation by 90%.
Why is Blood Drawn in PRF?
If you have scheduled surgery at Healthy Smiles, one of our specialists may have to draw your blood on the day of the surgery.
As discussed above, PRF is autologous, which means it is the blood of the patient centrifuged and placed in the area of surgery for various benefits that it provides (also discussed above). The amount of blood drawn is equivalent to the amount of blood drawn for a blood test. You must not fear being tired or losing blood. PRF is a safe procedure and has been performed by our specialists for years with success.
A very small concentrate or fibrin clot is drawn just before your surgery and centrifuged. The PRF is then used in your surgery area.
PRF derived from your blood is extremely useful and helps the area heal quickly, keeps infection at bay, protects your wounds, promotes bone regeneration, and lowers postoperative pain.
Patients often fear contraindications. However, you must not fear any medical conditions or symptoms to interfere with this process. In fact, patients with health issues must go ahead with this process because it accelerates the healing process.
Blood runs in your body and keeps you healthy. It is efficient and doesn’t have any drawbacks. It provides you with the necessary factors and environment that are essential for your healing process. Unlike synthetic or other biomaterials, you don’t have to worry about rejection. It is your blood, and it will seamlessly blend in to offer you several benefits.
PRF at Healthy Smiles
To treat your dental issues with the advantageous PRF technique and heal your wounds quickly and in a better way, get in touch with us today. We will help you understand more about the technique before going ahead with the treatment process. Our contact details are mentioned below:
You can book a dental appointment online with us or reach out to us on the below contact details.
Healthy Smiles Dental Group
Address: 152 Canterbury Road, Blackburn South, VIC 3130
Phone Number: 03 9877 2035