Platelet Rich Plasma (PRP) is exactly what its name suggests. The substance is a by-product of blood (plasma) that is rich in platelets. Due to high cost, the use of PRP was once confined to the hospital setting. New technology permitted doctors to harvest a greater quantity of platelets from the patient, which lowered the cost and made it readily available.
Why use 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.
Platelets are one of those cell types. They 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. The more growth factors released into the wound, the more stem cells are stimulated to produce new host 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), which has been shown to induce the formation of new bone in research studies in animals and humans. This is significant to the surgeon who places dental implants. By adding PRP, and thus BMP, to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.
Can PRP be used in cosmetic procedures?
Platelet Rich Plasma (PRP) contains various growth factors that can be used to enhance healing and provide a matrix to stimulate collagen deposition for volume enhancement and potential improvement in skin quality and contour. PRP has a very high concentration of growth factors that help stimulate skin rejuvenation and restore volume due to atrophy and aging.
PRP has many clinical applications:
Bone grafting for dental implants. This includes onlay and inlay grafts, sinus lift procedures, ridge augmentation procedures, and closure of cleft lip and palate defects.
Repair of bone defects created by 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 super-saturation of the wound with PRP, and thus growth factors, produces an increase of tissue synthesis and faster tissue regeneration.
Cost effectiveness: Since PRP harvesting is done with only 55cc of blood in the doctor’s office, the patient need not incur the expense of the 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 making them more gel-like.
Frequently asked questions about PRP:
Is PRP safe?
Yes. During the outpatient surgical procedure, a small amount of your own blood is drawn out 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.
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, the cost of the PRP application is paid by the patient.
Can PRP be used alone to stimulate bone formation?
No. PRP must be mixed either with the patient’s own bone, with a bone substitute material such as demineralized freeze-dried bone, or with a synthetic bone product, such as BIO-OSS.
Are there any contraindications to PRP?
There are very few. Obviously, patients with bleeding disorders or hematologic diseases do not qualify for this in-office procedure.