What is PRF?
Platelet rich fibrin (PRF) or platelet enriched fibrin is an autologous preparation obtained from the patient's own blood. It is extremely rich in growth factors (TGF-beta, PDGF, VEGF, IGF, EGF) that participate in the healing processes, and as such has a wide range of indications in regenerative dentistry. Proved to accelerate the healing of soft and bone tissues and has a significant analgesic effect (reduces postoperative pain). In addition to growth factors, degranulation of activated platelets in PRF, and other cells present in plasma, fibrinogen, fibronectin, vitronectin and thrombospondin are also released, which are also responsible for regenerative effects. Leukocytes as a component of PRF have a role in controlling the infection. All of these PRF factors, together with a better organized fibrin mesh that attracts stem cells, contribute to better and better healing, which is the ultimate goal of the regenerative concept of healing in dentistry.
How to get PRF?
The PRF protocol is extremely simple:
Before starting the planned oral surgery or periodontal surgery, it is necessary to take the whole blood out of the patient. To this end, a specially contoured vacuum test tube without anticoagulant was patented by the inventor of the PRF protocol Prof Joseph Choukroun. A 6-8 tubes of 10 ml volume are to be weighed on average. After extracting the blood, the tubes are placed in a centrifuge (Duo Quatro Centrifuge) where they centrifugate at a certain number of revolutions for a certain period of time, which depends on the selected protocol (6 different protocols).
After centrifuging, in each tube a three-layer colloid consisting of an acellular plasma layer at the top, a fibrin clot in the central layer and a layer of red blood cells at the bottom of the tube formed. The fibrin clamp is removed from the tube with a tweezer and gently separated from the adhesive layer of the blood cells.
The resulting PRF is placed in a specially contoured "PRF box" where PRF membranes or cylinders can be obtained depending on the desire of the therapist guided by the indication.
Obtained membranes, which are actually biological tissue, can be used instead of artificial membranes, and can be mixed with artificial bones.
In addition to the PRF membrane, other PRF preparations such as APRF liquid (advanced PRF) and iPRF (injectable PRFs) can be obtained by selecting different protocols, which, thanks to an even smaller number of turns, are richer with growth factors and mesenchymal cells. These preparations are especially useful in mixing with artificial bones when the so-called. "Sticky bone" is made, which is irreplaceable in the augmentations of the alveolar ridge (increase in bone volume).
Does the use of PRF have any hazards?
The origin of the PRF is from the patient's blood so that there is no risk of blood-borne diseases and immunological-allergic reactions. PRF can even be used in patients who use drugs that have anticoagulant and antithrombotic activity.
In whom oral and periodontal intervention suggests the use of PRF?
1. After removing the teeth to preserve socket and prepare later for implant insertion.
2. Insertion of implants in a fresh extraction wound to enhance healing processes and osseointegration-receiving implants
3. Routine implantation because it increases the chances of osseointegration and increases primary stability in poor quality bone
4. Apicotomy / resection of the root of the root with cystectomy. Using oscoinductive materials such as PRF, regeneration of lost tissues and faster healing results in the reduction or elimination of postoperative complications
5. Sinus lift or elevation of the maxillary sinus. In addition to being used in raising the sinus membrane, PRF is also used to repair the damaged sinus membrane.
6. Augmentation of the alveolar ridge and implant installation. Atrophy of the fork bones often prevents the implantation of the implant because the implant requires the appropriate height and width of the bone. Long-term edema in the patient leads to loss of bone and height and width. In order to overcome this condition and create the conditions for implanting, the bone must be enlarged. For this purpose, PRF materials are used in combination with artificial bone alone or with the intervention of the spread of the alveolar ridge "ridge split"
7. Treatment of muco-gingival recesses - loose teeth, infrared pockets and furations
8. Treatment of jaundice osteonecrosis caused by the treatment of bisphosphonates or radiation in patients with head and neck tumors
9. Treatment of wrinkles and rejuvenation