Dr Samintharaj Kumar
Platelet Rich Fibrin
PRF and A-PRF In Dentistry
PRP (Platelet Rich Plasma) – is plasma enriched with platelets, derived as a result of centrifugation of the blood collected from the patient. Adding thrombin and calcium ions makes a platelet rich preparation with consistency similar to the one of a gel, which includes a variety of growth factors affecting the bone regeneration process.
PRF (Platelet Rich Fibrin) and A-PRF (Advanced Platelet Rich Fibrin) – is fibrin enriched in platelets which is effective in stimulating bone growth due to a slow release of cell growth factors, thus producing excellent results when it comes to healing.
When planning prosthetic or implant procedures, insufficient bone or gum volume is typically a problem which needs to be circumvented. This substantial deficit of hard and soft tissue is often a result of bone damaged by periodontal inflammatory processes, periodontal diseases or tissue damaged during tooth extraction (tooth removal). However, there is a simple way to reduce this by using your own blood: a simple, safe and very natural method of accelerating the healing process. Platelet rich fibrin is put in the place of the defect. It has a high content of your own growth factors and healing proteins which stimulate the process of bone formation.
The method of obtaining PRP and PRF is not new – it was created in 1990s and has been employed in a variety of medical branches where there are bone regenerative processes.
What is PRF?
Platelet rich fibrin (PRF) is an autogenous matrix obtained from the patient’s platelet concentration. After drawing blood and spinning the blood in a centrifuge, we get a fibrin membrane which stimulates healing and growth of bones and soft tissue. It is rich in leukocytes and the vascular endothelial growth factor (VEGF).
PRF also initiates permanent release of the platelet derived growth factor (PDGF), a protein which plays a vital role in the angiogenesis process; beta–transforming growth factor (TGF), a protein which stimulates tissue growth; thrombospondin 1, an adjacent glycoprotein which participates in interactions between cells and in the angiogenesis process. The presence of these proteins significantly accelerates healing, especially in the critical phase during the first days after surgery.
The main advantage of this autogenous biomaterial is the slow release of growth factors from PRF which lasts more than 7 days. It may be done only from the RF membrane, but not from PRP or PRGF. The liquid drained from membranes is accumulated. It contains high numbers of proteins specialised in increasing the cell attachment to biomaterial, titanium and zirconia (ceramic implants). The biological and biomimetic quality of that membrane supports effective migration and cell proliferation and also eliminates the need to use biomechanical additions or anticoagulants.
What is the difference between PRP and PRF?
In comparison to the PRP technique (plasma enriched with platelets determining immediate release of growth factors which limits healing and regeneration effects) employed in dentistry and orthopaedics, I now use PRF (Platelet Rich Fibrin) which causes a slow, 7-day release of cell growth factors, accelerating vascularisation, healing and regeneration therapy. In the case of surgical, periodontal or implantology treatment, the A-PRF technique is used.
Using appropriate techniques of collection and spinning of the patient’s blood, and proper execution, A-PRF is a source of collagen, elastin, platelet growth factors (determining the process of multiplication and creation of blood vessels, as well as stimulating and differentiating other cells, e.g. endothelium, fibroblasts, bone cells) and also includes leukocytes releasing further growth factors, working with platelet factors. An increased effect of A-PRF stimulation is also related to trapping the whole volume of monocytes and ensuring their faster transformation into macrophages, thus increasing the effect of bone stimulation.
Why do I use this technique?
A-PRF factor in the shape of membranes, corks or powdered structure is used to accelerate wound healing and regeneration (growth and diversification) of tissue structures in areas of the oral cavity that are difficult to handle due to the patient’s anatomy. Moreover, it is used in combined techniques (with bones, MSC) to increase ossification (bone formation) and tissue regeneration (e.g. lost or damaged gingiva (gum) within the oral cavity).
Other clinical indications for PRF use:
Simultaneous Use with Bone Graft
Sinus lift Surgery
Soft tissue Surgery
Post-extraction alveolar ridges (bone regeneration for future implants and prosthetic reconstruction)
Enhancing wound healing (wound closure).
The following are observed after the use of PRF and A-PRF:
Effective creation of new vessels;
Accelerated wound closure;
Fast scar tissue remodeling.
The process of taking blood and preparing PRF adds an additional 15 minutes to the clinical time taken to do your procedure and will naturally incur a separate charge.
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