Platelet rich plasma is a first generation platelet concentrate. Autologous (derived from your own blood) platelet rich plasma (PRP) injections were first developed in the 1970’s and first used in an open-heart surgery procedure performed in Italy in 1987. Today, PRP injections have been safely used in a variety of fields including in orthopaedics, sports medicine, urology, cosmetics and dental implant surgery. But what is platelet rich plasma and what are its benefits?
What is platelet rich plasma (PRP)?
Our blood contains plasma, platelets and blood cells (red and white); platelets are small cells with a lifespan of around seven to 10 days. Granules inside platelets contain both growth and clotting factors; these factors are liberated during the healing process. The granules are released when tissue is damaged; growth and clotting factors then incite the inflammation cascade (which is the body’s response to harmful stimuli), ultimately encouraging the healing process.
PRP contains up to four times the platelet concentration of normal blood. As such PRP is enriched with higher concentrations of tissue growth factors. The plasma extracted from your blood is pretty much unique to you, which is its main advantage.
PRP injections can help the body accelerate the normal tissue healing pathways, due to the concentration of growth factors found within the platelets. The release of high concentrations of growth factors in the wound stimulates cells (stem cells, fibroblasts and macrophages) that are involved in the healing process to produce new tissue.
In terms of PRP for dental implants, it’s is a new approach to tissue regeneration and a valuable tool for promoting healing in many procedures.
What is the history of PRP usage?
PRP first appeared in the 1980’s when it was used by cardiac surgeons to improve wound healing. PRP was then used by Veterinarians, who treated joint problems in animals (particularly race horses). An early Dental application was for prevention of ‘dry socket’ complications following tooth extractions.
In the early 2000’s, PRP was then adapted to Sports Medicine and Orthopaedics where it was applied to bone and joint injuries, including a large number of soccer and AFL players. A number of other elite athletes have also had success with PRP for the treatment of knee injuries.
More recently, platelet rich plasma has been widely used with dental, dermatology and cosmetic surgery fields, as to encourage wound healing, reduce signs of ageing and improve the appearance of scars.
What is Platelet Rich Fibrin (PRF) & what are its benefits?
Platelet rich fibrin (PRF) is a fibrin matrix in which platelet cytokines, growth factors, and cells are trapped and may be released after a certain time and that can serve as a resorbable membrane.
PRF is a new second generation of platelet concentrate. PRF is used to promote wound healing, bone regeneration, graft stabilization, wound sealing, and reduce bleeding. The fibrin matrix in PRF is more efficient than PRP in stimulating stem cell and encouraging tissue healing.
How is PRF used in dental procedures?
There are many clinical applications of PRF, including in dental implant procedures. Some patients have insufficient bone for implant placement; PRF can replace lost bone volume and promote successful implant treatment.
Improving the success of bone grafting (sinus lift and ridge augmentation) procedures as an adjunct to dental implant treatment. Repairing bone and tissue defects created by removal of teeth, cysts, tumours and fistulas between the mouth and the sinus cavities.
PRF isn’t needed bone grafting cases as sometimes there is no need. However, in the majority of cases, applying PRP to the graft increases the final amount of bone that’s present, in addition to helping the wound heal faster and more efficiently. PRP also can’t be used alone to stimulate bone formation. It must be mixed with a bone substitute (like demineralized freeze-dried bone), the patient’s own bone or a synthetic bone product like BIO-OSS.
It’s worth noting that bones are not lifeless matter attached to living tissues and they constantly change. Old bone cells are broken down and replaced with new ones in a three-part process called bone remodelling which involves resorption (the digestion of old bone cells), reversal (when new cells are birthed), and formation (where new cells turn into fully formed bones).
When PRP or as it’s sometimes called ‘super healing’ plasma is used in surgical procedures, it’s taken from the patient, placed in a PRP centrifuge machine and ‘spun down’. In less than 15 minutes, the PRP is formed and ready to use and is injected into the area requiring care. In most cases, there are no additives or foreign chemicals used. The advantage of this is that are generally no immune or allergic reactions and the risk of infection is very low.
What are the advantages of using PRP?
Platelet rich plasma, because it’s completely ‘whole and natural’, can more closely simulate a highly efficient in-vivo (or ‘in the living organism’) situation than other products that consist of artificial recombinant proteins.
In terms of the advantages of using PRP for dental implants, it helps the body to heal faster and more efficiently because it produces an increase of tissue synthesis that results in faster tissue regeneration. It’s convenient because it can be generated on-site at your dentist while you’re undergoing a surgical procedure like the placement of dental implants. It’s also easy to use and can actually improve the ease of application of various bone grafting products and bone substitute materials by making them more gel-like.
Most importantly? It’s relatively safe to use because PRP is a by-product of your own blood and therefore the transmission of disease is decreased. Because platelet rich plasma is prepared from your own blood, there is also no risk of developing a tumour or cancer.
Are there any side effects with using PRP?
Adverse effects are rare but as with any injection, there’s always a small risk of injury or infection in terms of blood vessels or nerves. Calcification and/or scar tissue formation is also a possibility at the injection site. You should also not consider using PRP if you have an active infection, a low platelet count, cancer, are allergic to local anaesthetic agents or are pregnant or breastfeeding.
Some pain can be felt following the injection, and most dental practitioners will recommend the use of paracetamol or paracetamol combined with codeine if your pain is debilitating.
Undergoing dental implant surgery and like to know more about the benefits of using PRP? Contact the experts at the Dental Implant & Specialist Centre today on (07) 5503 1744.