Platelet rich plasma (PRP), sometimes called platelet rich fibrin (PRF) is exactly what the name suggests. The substance is a by-product of blood (plasma or fibrin) that is rich in platelets. Until now, its use has been confined to the hospital setting. This was due mainly to the cost of separating the platelets from the blood (thousands) and the large amount of blood needed (one unit) to produce a suitable quantity of platelets. New technology permits the doctor to harvest and produce a sufficient quantity of platelets from only 55 cc of blood drawn from the patient during out-patient surgery.
PRP/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 GF (platelet derived growth factors PGDF, 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 sequestered into the wound, the more stem cells stimulated to produce new host tissue. Thus, one can easily see that PRP/PRF permits 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 animals and humans. This is of great significance to the surgeon who places dental implants. By adding PRP, and thus BMP, to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.
Safety: PRP/PRF is a by-product of the patient’s own blood, therefore, disease transmission is not an issue.
Convenience: PRP/PRF can be generated in the doctor’s office while the patient is undergoing an outpatient surgical procedure, such as placement of dental implants.
Faster Healing: The supersaturation of the wound with PRP/PRF, and thus growth factors, produces an increase of tissue synthesis and thus faster tissue regeneration.
Cost Effectiveness: Since PRP/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 hospital or at the blood bank.
Ease of Use: PRP/PRF is easy to handle and actually improves the ease of application of bone substitute materials and bone grafting products by making them more gel-like.
Is PRP/PRF Safe?
Yes. During the out-patient 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/PRF Be Used In All Bone Grafting Cases?
Not always. In some cases, there is no need for PRP/PRF. However, in the majority of cases, application of PRP/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 Cost?
Unfortunately not. The cost of the PRP/PRF application (approximately $400) 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 Contradictions To PRP/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/PRF is right for you.