Platelet Rich Fibrin in Dental Extractions
One aspect that has drawn me into the dental field and kept me excited about pursuing my dream is the fact that this field is constantly changing and evolving. In dentistry there are constant new, better ways to provide care in a quick, efficient, and empathetic manner. Today’s blog post is exactly the same- quick, efficient, and empathetic as I discuss a new technique I have recently learned called Platelet Rich Fibrin or PRF. This is a simple but anxious-inducing process that drastically decreases the healing time necessary for dental implants and extractions.
However, if you walked into the dental clinic and were asked to pull up your shirt sleeve so the dentist or dental assistant could draw blood, chances are you would have many questions. This is entirely fair and I completely understand patients' concerns involving both extractions and the healing process. This post is designed to mitigate those fears as I describe the “typical” extraction process vs this modified PRF process and the benefits and shortcomings of both.
Traditional Extraction:
In a “typical” or more traditional extraction, once the tooth is removed, saline is used to flush the site, and is also mixed with bone collagen that is placed inside the extraction site. Sutures are put in, and the patient is sent home with gauze, pain relievers, and instructions on how to promote healing. However, the healing process can take months because we rely on the body to recognize the missing tooth and excess bleeding, and then signal white blood cells to go to the extraction site, create clots, and slowly begin the healing process. This takes a much longer time to heal than PRF.
PRF Extraction:
PRF includes the withdrawal of blood, the spinning of this blood in a centrifuge which separates the red blood cells from the platelet rich fibrin and plasma layers (shown in the picture below). The platelet rich fibrin helps promote growth of the tissues while plasma is full of healing factors. By removing the red blood cells, we are able to utilize the healing factors and stem cells directly from our patient. We now have both a plasma membrane that will be placed directly in the extraction site. Recall the layer of platelet rich fibrin that is a liquid full of white blood cells that can be mixed with bone collagen similar to the above process. This is also shown in the photo with the metal tray and dishes. By replacing saline with these white blood cells, we are able to bring all the necessary healing factors directly to the site versus waiting for the body's natural processes to send the necessary signals. This drastically reduces the healing time that you would need to wait if you wanted to follow through with implants- a lengthy process in itself.
Benefits and Shortcomings:
In the traditional extraction process, the healing time is much longer, but the appointment time is shorter and less invasive since you don’t need to have blood drawn. This could also be problematic if the patient is afraid of needles. As well, by using saline instead of Platelet rich fibrin, the bone collagen is harder to manipulate and can be more uncomfortable than the patient's own platelets. On the other hand, PRF is a much more effective way of healing, but is more invasive and takes longer. It’s also dependent on what the patient wants for future treatment. For a patient who wants to get an implant, PRF is definitely a method to consider. If the patient does not plan on implants and has healthy oral habits (ie: no smoking, brushing and flossing daily, etc), then perhaps a traditional route is more beneficial.
This picture shows the process of placing PRF into the extraction site and placing a temporary tooth over the wound. In my experience, we typically do not place a temporary crown atop.
If you are curious about this, and want more information, I recommend checking out these links and websites.
As always, thank you for reading through my blog and sharing my passions. :)
XX
-Beka
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