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Platelet-Rich Plasma in Dental Surgery

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Platelet-Rich Plasma (PRP) has been used in many surgical settings since the mid-1990s, but more recently it has become popular in the dental industry. It is a safe, convenient, and cost-effective way to reduce post-operative pain, promote tissue and bone growth, and reduce healing time in a wide variety of oral and maxillofacial surgical settings. You can get a PRP injection right in your provider’s office in as little as thirty minutes.

What is platelet-rich plasma?

Plasma is the liquid part of blood that is made up of mostly water and protein. It allows red and white blood cells to move throughout your bloodstream. Platelets are a type of blood cell that make your blood clot, and play an important role in healing. They contain hundreds of proteins called growth factors. Platelet-rich plasma (PRP) is taken from a patient’s own blood and injected into injured or diseased tissue to promote faster healing by stimulating and increasing the growth of reparative cells that your own body produces. Whereas platelet counts in normal blood range from 150,000/1L to 350,000/1L, platelet-rich plasma has a concentration of at least 1,000,000/1L. This high concentration of platelets is useful in producing cells that are critical to rebuilding tissue and bone. It also provides significantly increased vascularity in healing tissue.  

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How is PRP beneficial to the dental community and what are its applications?

PRP injections have been used for over twenty years in a variety of surgical scenarios. Recently, they have shown to be effective in speeding up healing after oral and maxillofacial procedures. There is also evidence of platelet-rich plasma therapy aiding in periodontal regenerative therapy. The injections can be used in a wide range of procedures, including onlay and inlay grafts, sinus lift procedures, ridge augmentation procedures, and in cleft, lip, and palate surgeries. PRP can also be used after tooth extractions or cysts removal to repair bone defects. In bone grafting procedures, PRP therapy has improved patient outcomes, as bone morphogenic protein (BMP) is increased by its use. BMP helps grow new bone at a faster rate than traditional methods of bone regeneration.

Additionally, there are studies being conducted that are looking into using PRP for bisphosphonate-related osteonecrosis of the jaw (BRONJ) with the goal of enhancing wound healing and bone maturation. Dental patients who have received PRP injections report less pain immediately after surgery.

There are many other benefits to using platelet-rich plasma in dentistry, including:

  • Convenience – the amount of blood used is minimal, and is drawn directly prior to surgery. The PRP is produced in office while the patient is undergoing their procedure
  • Cost – PRP injections are more affordable than ever, because they do not have to be produced at a blood bank or in a hospital.
  • Faster healing – application or injection of PRP speeds up recovery after dental surgery by stimulating the body’s natural healing process.
  • Ease of use – platelet-rich plasma is easy to handle and improves the ease of application of bone substitute materials by making them more gel-like.  
  • Safety – because a patient’s own blood is used to create PRP, disease transmission is not a concern. PRP has also been seen to reduce instances of infection, thus minimizing the need for antibiotics and painkillers. 

Who is a candidate for PRP?

Most patients who undergo a dental procedure are good candidates for PRP therapy. It has been used in a wide variety of oral and maxillofacial procedures, from simple tooth extractions to more complicated bone grafts. Because the PRP is produced from the patient’s own blood, there are few risks or side effects of PRP use, however it is possible to experience pain, irritation, or bleeding at the injection site. Most people can resume normal activities immediately after having a PRP injection. You are not a good candidate for PRP if you have a bleeding disorder such as hemophilia. Your healthcare provider can help you determine if you are a good candidate for PRP therapy. 

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What is the process for PRP use?

The process for using PRP is simple, and begins in your dental provider’s office right before your procedure. A qualified medical professional will draw a small amount of your blood, about 55cc. Then your blood will be placed in a centrifuge machine to separate the platelet-rich plasma from the rest of your blood. Typically your blood will be spun two to three times to achieve the best results. Once the PRP is isolated from the rest of the blood, your dental provider will collect it and apply it to the appropriate areas, either via a thick application directly to a wound, or via injection into tissue or bone. If you are awake for the procedure, your dental provider will likely numb the area prior to injection. In some surgical settings, your doctor will use an ultrasound machine to ensure they’re injecting the right area. A PRP procedure typically takes about 30 minutes. Most patients experience little to no downtime after their PRP procedure.

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