PRP IN DENTISTRY

BLOOD DERIVATIVES

Platelet Rich Plasma (PRP)

Platelet Rich Fibrin (PRF)
Advanced Platelet Rich Fibrin(A-PRF)
Injectable Platelet Rich Fibrin(I-PRF)
INTRODUCTION

PLATELET RICH PLASMA

The regenerative growth factor found in platelets, which are the
reparative EQUIPMENTS: the procedure should involve the use
of all sterile instruments. 1.Disposable Syringe To Collect Patients
Blood
2.Sterile Gauze Piece Or Swab
3.Blood Collection Tubes
4. Centrifugal Machine
 Platelet Rich-Plasma is an advanced treatment which has played
a key role in wound healing and soft tissue regeneration, a well-
known technique in maxillofacial procedures, sports medicine and
cardiovascular surgery,
Platelet-rich Plasma (Commonly known as PRP) is a minimally
invasive procedure and now used with great success for aesthetic
purposes due to cells in our body.

USES:
1.PRF when used in conjunction with bone grafts can offer
several advantages including promoting wound healing, bone
growth and maturation, graft stabilization,wound sealing and
hemostasis and improving the handling properties of graft
material.
2. PRF can also be used as membrane.
3.PRF can also be used to treat gingival recession.

INJECTABLE-PRF (I-PRF)
 Platelet rich plasma (PRP) has found its uses in regenerative
dentistry as a supra-physiological concentrate of autologous
growth factors, which is capable of stimulating tissue
regeneration.
Despite this, many scientific papers have expressed concerns
regarding the use of anti-coagulants, agents which are known to
inhibit wound healing. In one study, a liquid formulation
of platelet rich fibrin (PRF) termed as injectable-PRF (I-PRF)
without the use of anti-coagulants was investigated.
This "super PRF" is produced with new type of tubes I-PRF
specifically indicated for this preparation. The use of I-PRF in
Dentistry is in its early stages, but already, the results in both oral
surgery and regenerative medicine are very promising. Injection
into the soft tissues usually increases vascularity and which will
perhaps improve the biotype, injection into the bone graft particles
(biomaterials) in order to coagulate and get a "solid" which will be
free of all movements granules. The graft clot interests lies in how
to carve a bone graft and give it a compact form.
The protocol for I-PRF is a real scientific and clinical innovation
and will allow many dental Surgeons to improve their results in
bone grafts.
Standard PRP and i-PRF (centrifuged at 700 rpm (60G) for 3min)
were compared for growth factor release up to 10days (8 donor
samples). Furthermore, fibroblast biocompatibility at 24h
(live/dead assay); migration at 24h; proliferation at 1, 3, and
5days, and expression of PDGF, TGF-S, and collagen1 at 3 and 7
days were investigated.

ADVANCED PLATELET RICH FIBRIN (A-PRF)

is a new advanced form of PRF that can help heal wounds
anywhere in the body, and also those sites involved in oral
surgery, using the patient’s own blood . Unlike in Platelet Rich
Plasma (PRP), A-PRF doesn’t contain additives. In addition to
that, A- PRF is very rich in platelets, leukocyte cells (growth factor
cells) and contains enriching Fibrin – the most key ingredient
responsible for initiating the healing of wound, with added
antibacterial properties.
A-PRF is more advanced than PRP due to having 20 times more
leukocytes cells. It can be used inside of extraction sockets and
around the dental implants to fast-track the process of bone and
gum formation. It allows the implant to heal at an accelerated rate.
When a wound is detected in the body, the healing process is
initiated by rushing different cells to the wound. One of the main
cell types is Platelets. Platelets circulating in our blood are the
cells which bind together when they recognize damaged blood
vessels.
When you get a cut or a wound, the platelets bind together at the
site causing a blood clot which stops us from bleeding. This
stimulates stem cells that help create new tissues. This overall
process allows the body to heal faster and more efficiently.
CLINICAL APPLICATIONS OF PRP / PRF

DENTAL

BONE REGENERATION

Sinus lift grafting

Ridge augmentation
Repair of bone defects created by removal of teeth or small cyst
Ridge preservation techniques
Periodontal defects
Closure of cleft lip and palate defects
Repair of oro-antral fistulas
Craniofacial reconstruction

SOFT TISSUE REGENERATION

Periosteal and connective tissue flaps

Free connective tissue and gingival grafts
Root coverage procedures
Controling soft tissue healing and tissue maturity

NON DENTAL
Acne Scars Removal
Hair Growth

PRP WITH IMPLANTS

Fontana et al. found a higher amount of peri-implant bone

volume after inserting PRP and laminar test implants into rat tibial
sites. Fuerst et al.
defined platelet rich in growth factors (PRGF), as the supernatant
from washed, thrombin-activated, allogenic, platelet- rich plasma
obtained after centrifugation, and used this solution with implants
with success to increase in BIC.
Few studies also advocated the benefits of topical application with
implants before insertion, and saw effects in early healing. On the
other hand, Weibrich et al. failed to see any benefit on BIC from
PRP in their trial in rabbits. In a recent study titanium non-coated
AIO grit-blasted and acid etched,and 18 magnetron-sputtered
calcium phosphate (CaP) coated titanium ( femoral condyles in
six goats. PRP was used as a test modality, as some implants
were dipped in PRP before insertion and other implants were
placed into sites where PRP-gel had been previously inserted.
Results and conclusions were that CaP coated implants rendered
higher values for BIC than the rough implants used as control. No
additive value for PRP was found except at an early healing
stage.

PERI-IMPLANT DEFECTS AND PRP

 A general extensive literature overview on marginal defects
around implants has been presented by Boticelli (2006), Yamada
et al. found similar results of tissue engineered bone and
autologous bone after GRAFTING and installation of implants in
two stages. BIC values for implants were comparable between
the sides in that study. Kim et al.used freeze-dried bone and
dentin-like material as filler material with and without PRP and
found better results with respect to BIC with the addition of PRP.
Sanchez et al. failed to see more than a low effect of PRP
combined with demineralized freeze-dried bone in 3-walls defects
in the mandible of dogs. In another study by Casati et al. a buccal
dehiscence implant defect model was used in dogs and the
defects were randomly filled with PRP or blood as control. No
effects on regeneration of that type of defect could be seen.

CONCLUSION

PRP therapy has evolved a long way from just use in Dermal /
Cosmetology procedures to innovative uses in Dentistry. While lot
of Studies, Research is underway uses & efficacy of PRP is
expected to increase manifolds in the field of Dentistry.

ADVANCED ARTICLE SERIES BY

CELEBRITY DENTISTRY INDIA & DENTAL REACH
AUTHOR – DR. HANISHA DABAS
MDS
CERTIFICATE IN COSMETOLOGY