Download (PRP) and platelet-rich fibrin (PRF)

A natural road to faster healing...
What is L-PRF?
L-PRF is Leukocyte and Platelet Rich Fibrin, which is a matrix of platelets, leukocytes and fibrin
bound up to produce a natural membrane full of numerous cytokines and growth factors including
PDGF-AB (platelet derived growth-factors), which advances and enhances the healing of bone and
soft tissue. VEGF (vascular endothelial growth factor), TGFß-1 (transforming endothelial growth
factor ß-1), IGF-1 (Insulin-like Growth Factor), bFGF (basic Fibroblast Growth Factor), PAF-4
(platelet activating factor-4) and EGF (Epidermal Growth Factor)
The L-PRF method was originated in France by Dr. Joseph Choukroun, a cardiac surgeon and
anesthesiologist. L-PRF is created by drawing a small sample of your blood from a vein in your arm
and then spinning it rapidly in a medical centrifuge, this creates a fibrin clot that is rich in platelets
and leukocytes. This clot can be molded and compressed to use as a bandaid over the extraction sites.
This physically protects the open wound and the platelet growth factors stimulate and direct stem
cell migration to speed up wound healing.
No More Dry Sockets. . .
Dr. Gary Lines and Donald Hoaglin conducted a study using L-PRF in lower jaw wisdom tooth
sites and compared 100 consecutive patients whose treatment included PRF compared to a control
group of 100 patients whose treatment did not include L-PRF. 1 In the cases with L-PRF, no “Dry
Sockets occurred”, healing time and post operative pain was significantly reduced. The patients who
did not receive L-PRF had over 8% incidence of “Dry Sockets” and required more medications to
manage discomfort.
L-PRF is the solution to “Dry Sockets” and improves healing in all types of medical and oral
surgery procedures (extractions, dental implants and grafting sites). Drs. Hoaglin and Lines had a
early 100%! success rate in eliminating “dry sockets” with PRF. We are the first dental office on
Vancouver Island to offer this cutting edge technology to our patients, utilizing scientifically proven
techniques to provide patient care with comfortable, predictable, long-term results.
1
D. Hoaglin and G. Lines, “Prevention of Localized Osteitis in Mandibular Third-Molar Sites Using Platelet-Rich Fibrin,”
International Journal of Dentistry, article id 87530, vol. 2013.
Patients on Anticoagulant Regime
Cardiac patients that take anticoagulant medications and need a tooth extraction face an
increased risk of bleeding that must be addressed by the treating clinician. Therefore, a protocol for
heart patients is needed that will avoid significant bleeding after dental extractions without
suspending anticoagulant therapy.
A study reported in the current issue of the Journal of Oral Implantology evaluated the use of
leukocyte- and platelet-rich fibrin biomaterial. This material is commonly used in dentistry to
improve healing and tissue regeneration. It was tested as a safe filling and hemostatic material after
dental extractions in 50 heart patients undergoing oral anticoagulant therapy..
One method of controlling bleeding without suspending the anticoagulant is the use of platelet-rich
plasma gel placed in postextraction tooth sockets. Platelet-rich fibrin offers an alternative
biomaterial that is simple and inexpensive to prepare. Platelet-rich fibrin has proved useful in daily
dental practice as filling material for regeneration in order to place implants.
In this study, 50 heart patients following an anticoagulant therapy were treated with leukocyte- and
platelet-rich fibrin clots placed into postextraction sockets. Complications of bleeding were reported
in only two of these patients, and 10 had mild bleeding. All complications were resolved within a few
hours after the oral surgery.
Additionally, the study reported no painful events, quick healing of soft tissue, and complete wound
closure within one week after oral surgery. Leukocyte- and platelet-rich fibrin offers an excellent
option for use in heart patients on an anticoagulant regimen.
Source: Journal of Oral Implantology
Coming soon …
ADVANCED PRF
In May 2013, at the Osteology conference in Monte Carlo, Dr. Choukroun revealed his
latest improvement to L-PRF with A-PRF, or Advanced Platelet Rich Fibrin.
Why Choukroun's A-PRF™?
Many recent studies have shown the interest and potential of white cells in the inflammatory
phenomena, as a corollary, a prominent action in the early days of stimulation osteoprogenitor cells.
(Omar & Thomsen, Biomaterials, 2012, Kawazoe T. Cell Transplant. 2012)
It was therefore natural to try to capture more monocytes in the PRF, to make it more active in
stimulating bone grafts, but also to turn to a more rapid transformation of monocytes into
macrophages to increase the effect bone stimulation
The first results of our research, conducted at the Laboratory of Clarion Research Group,
Pennsylvany university (USA) and Repair-Lab, Institute of Pathology, Johannes Gutenberg
University, Mainz (Germany) show a release of BMP-2 (Bone Morphogenetic Protein) , BMP-4 and
BMP-7. These studies also show a greater release of VEGF.
Many scientific studies are underway: The results will be published shortly. But the presence of
BMP in sufficient quantity, already provides the A-PRF ™ a future, putting a very powerful product
for bone reconstruction.This is done with the A-PRF
Reference Articles
Clinical and Histological Evaluation of Postextraction Platelet-rich Fibrin Socket Filling:
A Prospective Randomized Controlled Study
Dipalma, Luciano Pacifici, Francesco Inchingolo
HAUSER, FABIEN MD, DMD*; GAYDAROV, NIKOLAY DDS†; BADOUD, ISABELLE‡; VAZQUEZ, LYDIA MD, DMD§; BERNARD,
JEAN-PIERRE MD‖; AMMANN, PATRICK MD¶
Platelet Rich Fibrin (P.R.F.) in Reconstructive Surgery of Atrophied Maxillary Bones:
Clinical and Histological Evaluations
Marco Tatullo , Massimo Marrelli, Michele Cassetta4, Andrea Pacifici, Luigi Vito Stefanelli,
Salvatore Scacco, Gianna
The use of platelet rich plasma (PRP) and platelet rich fibrin (PRP) extracts in dental
implantology and oral surgery
Refuat Hapeh Vehashinayim. 2007 Jan;24(1):51-5, 84. Hebrew.
Schwartz-Arad D, Levin L, Aba M.
Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to
leucocyte- and platelet-rich fibrin
David M. Dohan Ehrenfest, Lars Rasmusson and Tomas Albrektsson
Platelet-rich fibrin increases cell attachment, proliferation and collagen-related protein
expression of human osteoblasts
C-L Wu1,2,3, S-S Lee4, C-H Tsai1, K-H Lu1,2,3, J-H Zhao5, Y-C Chang6
Platelet Rich Fibrin (P.R.F.) in Reconstructive Surgery of Atrophied Maxillary Bones:
Clinical and Histological Evaluations
Marco Tatullo,1,2,3*
Massimo Marrelli,2,3* Michele Cassetta,4 Andrea Pacifici,4 Luigi Vito
4
Stefanelli, Salvatore Scacco,1 Gianna Dipalma,2 Luciano Pacifici,4* and Francesco Inchingolo2,5*
In Vitro Effects of Choukroun's Platelet-Rich Fibrin Conditioned Medium on 3 Different
Cell Lines Implicated in Dental Implantology
Clipet, Fabrice DDS, MSc*; Tricot, Sylvie MSc†; Alno, Nora DDS, MSc‡; Massot, Murielle DDS§;
Solhi, Hélène MSc†; Cathelineau, Guy DDS, PhD‖; Perez, Fabienne DDS, PhD‖; De Mello, Gilbert
DDS, PhD¶; Pellen-Mussi, Pascal Master in Engineering
Sinus floor augmentation with simultaneous implant placement using Choukroun's
platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6
months.
Ziv Mazor, Robert A Horowitz, Marco Del Corso, Hari S Prasad, Michael D Rohrer, David M Dohan
Ehrenfes
The use of leukocyte- and platelet-rich fibrin during immediate postextractive
implantation and loading for the esthetic replacement of a fractured maxillary central
incisor.
Marco Del Corso, Ziv Mazor, James L Rutkowski, David M Dohan Ehrenfest
Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and
platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: Periodontal and
dentoalveolar surgery.
Marco Del Corso, Alain Vervelle, Alain Simonpieri, Ryo Jimbo, Francesco Inchingolo, Gilberto
Sammartino, David M Dohan Ehrenfest
Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and
platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: Bone graft, implant and
reconstructive surgery.
Alain Simonpieri, Marco Del Corso, Alain Vervelle, Ryo Jimbo, Francesco Inchingolo, Gilberto
Sammartino, David M Dohan Ehrenfest
L-PRP/L-PRF in esthetic plastic surgery, regenerative medicine of the skin and chronic
wounds.
Agata Cieslik-Bielecka, Joseph Choukroun, Guillaume Odin, David M Dohan Ehrenfest
The role of leukocytes from L-PRP/L-PRF in wound healing and immune defense: new
perspectives.
Tomasz Bielecki, David M Dohan Ehrenfest, Peter A Everts, Andrzej Wiczkowski
Simultaneous sinus-lift and implantation using microthreaded implants and leukocyteand platelet-rich fibrin as sole grafting material: a six-year experience.
Alain Simonpieri, Joseph Choukroun, Marco Del Corso, Gilberto Sammartino, David M Dohan
Ehrenfest
Sinus floor augmentation with simultaneous implant placement using Choukroun's
platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6
months.
Ziv Mazor, Robert A Horowitz, Marco Del Corso, Hari S Prasad, Michael D Rohrer, David M
Dohan Ehrenfest
Three-dimensional architecture and cell composition of a Choukroun's platelet-rich fibrin
clot and membrane.
David M Dohan Ehrenfest, Marco Del Corso, Antoine Diss, Jaafar Mouhyi, Jean-Baptiste Charrier
A proposed protocol for the standardized preparation of PRF membranes for
clinical use
Mito Kobayashi a,b, Tomoyuki Kawase a,*, Makoto Horimizu a,b, Kazuhiro Okuda b, Larry F.
Wolff c,
Hiromasa Yoshie