Platelet rich plasma (PRP) is a natural part of the blood (plasma) that is rich in platelets, which contain many of the body’s growth factors. 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 and the large amount of blood needed to produce a suitable quantity of platelets. New technology permits doctors to harvest and produce a sufficient quantity of platelets from only a small amount of blood, withdrawn at the time of the procedure.
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 begin the healing process. One of those cell types is the platelet. Platelets perform many functions, including the formation of a blood clot and release of growth factors (GF) into the wound. These growth factors: platelet derived growth factor (PDGF), 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 and deposited into the wound, the more stem cells are stimulated to produce new tissue. Thus, PRP permits the body to heal faster and more efficiently.
A sub-family of TGF, is bone morphogenetic protein (BMP). BMP has been shown to induce the formation of new bone in extensive human research studies. This is of great significance to the surgeon who places dental implants. By adding PRP and BMP to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.
PRP can be used to aid bone grafting for dental implants. This includes onlay and inlay grafts (growing bone either on or in another bone), sinus lift and ridge augmentation procedures, and closure of cleft lip and palate defects. It can also assist in repair of bone defects created by removal of teeth or small cysts and the repair of openings between the sinus cavity and mouth.
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 the placement of dental implants.
Faster healing: The supersaturation of the wound with PRP, and thus growth factors, produces faster tissue repair and new tissue formation.
Cost effectiveness: Since PRP 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 a 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 making them more gel-like.
Is PRP safe? Yes. During the outpatient surgical procedure a small amount of your own blood is drawn out via the intravenous line. This blood is then placed in the PRP centrifuge machine and spun down. In less than 15 minutes, the PRP is formed and ready to use.
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.
Will my insurance cover the costs? Unfortunately not. The cost of the PRP application (approximately $400) is paid by the patient.
Can PRP be used alone to stimulate bone formation? No. PRP must be mixed with either the patient’s own bone, a bone substitute material (like demineralized freeze-dried bone), or a synthetic bone product (cow bone material like BioOss).
Are there any contraindications to PRP? Very few. Obviously, patients with bleeding disorders or hematologic 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.