Platelet Rich Plasma
Platelet Rich Plasma (PRP) is exactly what its name suggests. The substance is a by-product of blood (plasma) that is rich in platelets. Until now, its use has been confined to use in the hospital setting. This was due mainly to the cost of separating the platelets from the blood and the large amount of blood needed to produce a suitable quantity of platelets. New technology permits the doctor to harvest and produce a sufficient quantity of platelets from a limited amount of blood drawn from the patient while they are having outpatient surgery.
Why all the excitement about PRP?
PRP 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 called a platelet. 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) assist the body in repairing itself by stimulating stem cells to regenerate new tissue. You can think of this as fertilizer for the bone. The more growth factors released into the wound, the more stem cells stimulated to produce new tissue. Thus, one can easily see that PRP 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 PRP to a graft, the implant surgeon can now grow bone more predictably and faster than ever before.
PRP has many clinical applications:
- Bone grafting of various types for dental implants.
- Bone and tissue reconstruction due to pathology
- Repair of bone defects created by the removal of teeth or small cysts
- Repair of fistulas between the sinus cavity and mouth
PRP also has many advantages
Safety: PRP is a by-product of the patient’s own blood, therefore, disease transmission is not an issue.
Convenience: PRP 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 saturation of the wound with PRP, and thus growth factors, increases tissue synthesis and thus faster tissue regeneration.
Cost effectiveness: Since PRP harvesting is done with limited amount of blood in the doctor’s office, the patient need not incur the expense of a harvesting procedure in hospital or at the blood bank.
Ease of use: PRP is easy to handle and actually improves the ease of application of bone substitute materials and bone grafting products by giving them more structure.
Frequently asked questions about PRP
1. Is PRP safe? Yes. During the surgical procedure a small amount of your own blood is drawn via the IV. This blood is then placed in the PRP centrifuge machine and spun down. In less than fifteen minutes, the PRP is formed and ready to use.
2. Should PRP be used in all bone-grafting cases? Not always. In some cases, there is no need for PRP. However, in the majority of cases, application of PRP to the graft will increase the final amount of bone present in addition to making the wound heal faster and more efficiently.
3. Will my insurance cover the costs? Unfortunately not. The patient usually pays the cost.
4. Can PRP be used alone to stimulate bone formation? No. PRP must be mixed with either the patient’s own bone, a bone substitute, or a synthetic bone product, to be effective.
5. Are there any contraindications to PRP? Very few. Obviously, patients with bleeding disorders or hematological diseases do not qualify for this in-office procedure. Check with your surgeon and/or primary care physician to determine if PRP is right for you.