Using PRF in the treatment of dry socket?

Last Updated: Aug 03, 2017

I’ve only found articles on using PRF to prevent dry socket. I’d like to know if there are dentists out there who have tried placing PRF to actually treat a dry socket? Does one place the plugs into the socket then cover it with the flattened PRF membrane or is the latter step not necessary. Is relief quite instant?

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29 Comments on Using PRF in the treatment of dry socket?

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Cliff Leachman

08/03/2017

Me tinks its too late? Use it as much a spossible for exo's, or OSTEOGEN, IF I CANT GET A VEIN, cant remember the last time I smelt clove/ eugenol!

Bill M

08/03/2017

Just saw Dr Pintos at ADIS Summit in atlanta this morning. The benefits of L-PRF are exploding. He suggest the first step in any infection or tissue breakdown is L-PRF.

Michel Jazzar

08/03/2017

Yes you can do it but be careful to bring as much blood as you can from the edges of the socket than fill with plugs and sutures.

Merlin Ohmer

08/03/2017

That sounds like a lot of overkill for a dry socket.

Merlin Ohmer

08/03/2017

It's just a dry socket. No one ever died from one. It's not worth drawing blood and the expense of prf.

Bill m

08/04/2017

little expense w/PRF and best to do with Ext. There is a different protocol for ridge preservation if you want bone

Delia

08/03/2017

I use it with very good and fast results for dry sockets. No multiple visits and pain goes away .

Alex Galo

08/03/2017

Thank you for your reply. I guess it's best to anesthetize, scrape the socket with a curette to get some bleeding, place the PRF plugs then suture it up. Sound about right?

Gene Messenger

08/03/2017

PRP cost about 3 buck. its worth it

Michel Jazzar

08/04/2017

ðŸ‘

Drshalash

08/18/2017

Scrapping the socket is an old practice that is no longer recommended as it tends to disturb any healing process that is taking place and can actually prolong the suffering of the patient

Merlin Ohmer, DDS, MAGD

08/03/2017

It is invasive to the patient. Why get stuck to treat something as innocuous as a dry socket? It's like using a grenade to kill a mosquito. Just because we have it, doesn't mean it makes sense to use it.

Cliff Leachman

08/03/2017

I can't imagine a dry socket on a lower wisdom, trying to do a block and the trying to suture a site you assaulted a few days earlier, does seem rather dramatic...

Merlin Ohmer DDS MAGD

08/04/2017

I can imagine drawing someone's blood to spin down to put in an old extraction site. Just because you have a fancy tool does not mean it is a panacea.

Cliff Leachman

08/03/2017

It would make more sense to use it at the initial appointment?

Tarek Assi

08/03/2017

I use L-PRF with every extraction! Never had dry socket. But if I do get one, will definitely place PRF along with dry socket protocol. I believe in L-PRF, made healing experience for my patients amazing. Again I use for every surgery I Do. It is a must or I do not do survey! As far expense it is insignificant for patients, and on many occasions I do it complimentary!!!! Great question! Thank you.

Alex Galo

08/03/2017

Thanks, I just got my centrifuge machine and took a PRF course so I look forward to seeing the benefits you all are talking about.

Merlin Ohmer

08/04/2017

When all you have is a big, bright fancy hammer everything is a nail. Simple irrigation with saline and placement of some gauze with eugenol. Works great. Saline irrigation and keeping the are clean works too. All I'm saying is this if overkill. Put a piece of GelFoam or Collagen in it for that matter. There is morbidity from IV draws too.

Andy Malovatzky

08/04/2017

Why to use only PRF ?? Why not to use IPRF ??!!!! When using the IPRF we have enough blood and you can preserve the socket. Then cover with PRF.

CRS

08/04/2017

Okay as an oral surgeon who rarely gets dry sockets my preferred treatment is Toradol IM then post injection PO. It works in 15 min. All these other techniques involve re- injuring an inflamed localized osteitis not an infection. Understanding what a dry socket is key. Prevention is from knowledgeable handling of the tissues and diagnosis not gadgets or cook book techniques I see listed here, do what you like but listen to an expert who is trained and experienced. Your welcome.

Cliff Leachman

08/04/2017

What about using A-PRF at the extraction appointment for socket preservation? Do you think that is a gadget too? I'm interested in your expert opinion....

CRS

08/05/2017

You are giving a different scenario, for my extraction cases I place a bone graft and make the clot with my laser for disinfection or a PRGF clot depending on the clinical situation. I am differentiating what a dry socket is a local osteitis caused by many things especially trauma. Retraumatising the area and placing Eugenol actually worsens the situation. Old old techniques. The PGRF is technically more difficult but I really like the fact that both a clot and fibrin membrane are produced separately. Often you can avoid a secondary CT graft. I used to use PRP. I have a different understanding of bone physiology and healing and try to explain it simply to my dental colleagues. There seems to be much misinformation out there evidenced in this blog. I daily hear from patients about their experiences with dry sockets if their dentists only knewðŸ˜·

David A. Hall

08/04/2017

There is a simpler way to prevent dry socket, based on an excellent study published about 25 years ago, and corroborated by my experience. First, be gentle in the amount of force you apply in extracting impacted mandibular third molars. Remove more bone or section more rather than apply more force. Second, place a square of Gelfoam impregnated with a suspension of clindamycin in normal saline into the socket post-operatively, before suturing. You can read about my experience with this on my blog: https://www.mynewsmile.com/blog/preventing-dry-socket/. I had zero dry sockets over a ten-year period applying this technique.

Phil

08/04/2017

I concur. But, Gelfoam is expensive. Another option is Benacel, which is made from biocompatible oxidized cellulose. Here is good study using Benacel: A retrospective study on the use of a dental dressing to reduce dry socket incidence in smokers

Cliff Leachman

08/04/2017

GelFoam/ Clindamycin used to be my protocol, but A-PRF+ really wipes the floor with it...

CRS

08/04/2017

Yes old technique many moons ago.

Ramesh bulbule

08/05/2017

I have been using PRF for a decade. Switched to A-PRF/I-PRF 2 years ago. I have treated 3 cases of dry socket where the patients had the extractions at other offices and were then referred to me. This was prior to switching to A-PRF/I-PRF. What I did in all the three cases was: Good curettage of the site to eliminate dead bone. Irrigation with saline. socket was filled with PRF plug without compression. This would allow the serum fluid from PRF to percolate into the bony trabeculae of the socket. Fill the socket with PRF plugs. Pack as many PRF plugs as possible into the site and suture. One of the three patients was prescribed amoxicillin 500mg every 8 hours for 5 days as the patient was medically compromised(long standing poorly controlled type 2 diabetic). Othe two patients were prescribed NSAID as needed. Both of them had to have NSAID for 24 hours. This resulted in complete resolution and good healing of the sockets. In case of one of the two patients , an implant was placed ten weeks later. And he has had absolutely no further complications.

CRS

08/05/2017

The NSAID is what did the trick in controlling the inflammation. You actually caused more trauma, I like to get it right the first timeðŸ˜·

CRS

08/05/2017

Also re-entering a recent wound and resuturing is not appropriate surgical protocol that intervention probably was it necessary. Tordadol IMðŸ˜·

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