At Olney Center For Oral and Maxillofacial Surgery, we use Platelet-Rich Fibrin (PRF) to speed healing after surgical procedures. PRF is a blood-clot “fabric” of concentrated platelets and growth factors made from a patient’s own blood. When a PRF is put in oral surgery wounds, the wound site is protected, inflammation is reduced, and growth factors in the fibrin speed bone regeneration and soft tissue healing.

PRF is a by-product of blood (plasma) 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 while they are having outpatient surgery.

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 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 PRF, 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.

PRF has many clinical applications:
Dr. Tebyanian uses PRF in complex Bone grafting for dental implants:

• Onlay and inlay grafts
• Sinus lift procedures
• Ridge augmentation procedures
• Closure of cleft, lip and palate defects.
• Repair of bone defects creating by removal of teeth or small cysts.
• Repair of fistulas between the sinus cavity and mouth.

PRF also has many advantages:

• Safety: PRF is a by-product of the patient’s own blood, therefore, disease transmission is not an issue.
• Convenience: 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 PRF, and thus growth factors, produces an increase of tissue synthesis and thus faster tissue regeneration.
• Cost effectiveness: Since 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: 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.

How Does it work?

Creating PRF involves the following steps:

A small volume of a patient’s blood is drawn immediately prior to when it is needed. Through centrifugation, blood is separated into serum, fibrin, white blood cells/platelets and red blood cells. Platelets are fragments of white blood cells that aid in clotting and release growth factors. Fibrin is the first healing matrix the body forms after an injury to protect the wound and to create a bed in which blood vessels can form. The fibrin, white blood cells and platelets are then removed from the drawn blood sample and used as a potent regenerative material called PRF. The serum is used to hydrate the wound and the red blood cells are discarded.