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Platelet Rich Fibrin

 

Platelet Rich Fibrin

Platelet rich fibrin, commonly abbreviated PRF, is a fibrin matrix created from the centrifuged spinning of the patient's blood.  The fibrin matrix is packed with the patient's own platelet cytokines, growth factors, and stem cells used to promote wound healing through tissue and bone regeneration.  PRF is used effectively in biologic dentistry for procedures such as extractions, implant placement, and periodontal / cavitation surgery. 

PRF vs PRP

PRF – Platelet Rich Fibrin (gel).  Blood spun at 3,000 rpm’s for 12 minutes.

PRP – Platelet Rich Plasma (liquid).  Blood spun at 700 rpm’s for 3 minutes.

Dr. Matt at Meetinghouse Dental integrates PRF into extraction and ceramic implant procedures.

Both PRF and PRP are created from a drawn blood sample and have different clinical applications.  Clinical use for PRP is injection into compromised dental sites (cavitations).  While not as effective as full cavitation surgery, minor problems can be treated with x-tip injections of PRP or iPRF along with ozone injections into suspected sites.  Clinical use for PRF is placement into opened surgical sites like extractions or right before ceramic implant placements.  PRP and PRF are both used effectively in dentistry with extractions, implant placement, and periodontal / cavitation surgery.

  

Platelet Rich Fibrin

Platelet rich fibrin is formed from centrifuged blood to concentrate platelets, but unlike PRP, no thrombin and calcium chloride is added to activate platelets.  Without the addition of thrombin and clotting factors, the platelets, along with cytokines, become trapped in a fibrin clot (yellow slug) formed in the middle part of the tube between the red blood cells at the bottom and the liquid acellular plasma at the top.  The PRF contains less platelets than PRP, but it has more clotting factors, leukocytes, and cytokines.  PRF will stick around in the site for about 10 - 14 days and promotes wound healing, bone regeneration, graft stabilizations, skin sealing, and overall homeostasis.  Because the fibrin matrix in PRF is better organized than in PRP, PRF is able to direct stem cell migration and healing more efficiently. 

 

 

 

The two major differences between PRP & PRF are polymerization speeds & rate of growth factor release.  

Polymerization speed is responsible for different biologic properties. The addition of thrombin and calcium chloride in PRP causes rapid polymerization.  PRF polymerization is slower and more natural; thrombin activity is physiologic, resulting in better healing and homeostasis.  *PRP releases significantly higher proteins upon initial placement, which can aid immediate healing, but levels trail off same day.  PRF, on the other hand, generates a lower release level of growth factors on the day of placement, but release steadily continues over a 10-day period. PRF’s growth factors stimulate fibroblasts and aid in the formation of collagen and hyaluronic acid.  https://www.ncbi.nlm.nih.gov/pubmed/26809431  

PRF’s ability to spur angiogenesis (capillary formation) makes it especially suited for cavitation surgery. Circulation problems are inherent at sites of dead and decaying tissue; PRF’s ability to increase blood flow helps clear out toxins and brings in nutrients to aid in the regeneration of damaged bone and gums.

 

Growth Factors in Platelet Rich Fibrin (PRF)  

Platelet concentration of plasma rich fibrin is 3-5 times greater than human plasma. 

Platelet-Derived Growth Factor (PDGF)Regulates cell growth and division, especially in blood vessels.  In other words, this guy is the reason blood vessels in our body reproduce.

Transforming Growth Factor Beta (TGF-b)Promotes cell proliferation and differentiation for connective tissue and bone.

Fibroblast Growth Factor (FGF)Plays a vital role in wound healing and supports proliferation and differentiation of specialized cells and tissues.

Vascular Endothelial Growth Factor (VEGF)Responsible for vasculogenesis and angiogenesis.  It restores oxygen supply in cells when inadequate and helps create new blood vessels after injury.

Keratinocyte Growth Factor (KGF)Found in the epithelialization-phase of wound healing.  It promotes formation of epithelium immediately after a wound or injury occurs.

Connective Tissue Growth FactorAssists in cell adhesion, migration, proliferation, angiogenesis, skeletal development, and tissue wound repair.