PRF for socket preservation?

I have been considering placing just PRF  [Platelet Rich Fibrin] as the sole filling material into extraction for socket preservation and regeneration of bone, instead of bone graft material.  Have any of you been doing this?  Have you found that just placing PRF alone results in adequate bone regeneration?  If so, how long does the process take?

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24 thoughts on “PRF for socket preservation?

  1. Johannes Illge says:

    Buenas tardes, con mi equipo hemos estado utilizando LPRF para preservación de alveolos como material único, solo en casos en los que estén conservadas las paredes del alveolo, obteniendo muy buenos resultados en cuanto a la regeneración ósea.. En casos donde falta alguna de las paredes del alveolo (generalmente la vestibular), es recomendable utilizarlo en conjunto con algún injerto particulado.
    Espero le sirva lainformación
    Saludos cordiales

  2. Al says:

    I recently started to do that. It has been only 3 weeks since I got my unit and I performed 3 procedures so far. I will be opening flaps for all of them just to see if there is any difference. I saw few slides before and after at AAID CE(managing bone deficiencies) in St.Pete and the result was promising.

    • Wes Haddix says:

      My cases to this point have been using PRF as membranes over the socket opening and either autogenous or corticocancellous bone mixed with PRF as a graft. I’ve been lifting the socket edges to mobilize tissue; allows me to tuck in the edges of the PRF and also allows tissue mobilization for greater closure. Results have been great. Have seen two studies where PRF is used as the sole grafting material in subantral augmentations, all with excellent outcomes. I have been waiting for a socket preservation case to go “all PRF” and see no reason to believe that results will not be good. Still believe that good surgical procedures need to be followed for optimal outcome, bit when socket preservation is viewed as a necessary interim process that may or may not need to be revised, L-PRF would be annideal choice due to low cost and autogenous nature. The IntraSpin System has a mini press to make PRF plugs, and at this point with this procedure, I’d definitely use it.

      • Manosteel says:

        I use prp with mineralized corticocancellous human bone and place prf membrane over then collagen sponge wetted with prp to contain the graft. Sutured with vycryl 4-0 seems to produce good results for me😁

  3. Gianluigi Giammaria says:

    hi
    it’s necessary to use the “rocks” for socket preservation … and up the prf if you like
    sincerely
    Gianluigi Giammaria
    Pescara, Italy

  4. Dr. Shalash says:

    Prf has no significant effect on bone regeneration, despite all the claims by its inventor. Just read the current literature. I believe in a few years time when sufficient data is published we will see an end to this prf hype in the same way as its predecssor prp. Why are we interfering with a normal healing process?

    • Cliff Leachman says:

      It depends on what and who you read, I’ve been using PRF for ~5 years, now A-PRF+ and the sockets look beautiful upon reentry. Seemed to preserve tissue and bone width and height, contrary to the naysayers. They heal quicker, less pain and NO dry sockets even in the most viscous of smokers.
      Quite the opposite in the future I believe you will not do extractions without placing the “Biological Bandage” of PRF. in whatever form it has progressed too.
      I think we all can agree to disagree, but often I use Osteogen, if the sinus has a large enough perforation and squirt i-PRF+ onto the dressing and cover with membranes of A-PRF+. Or Raptos cortico-cancellous bone mixed with A-PRF+ fragments if I’m feeling insecure. If your using A-PRF+ I’ll bet you have had the same experiences and don’t want to practice again without it. I can remember the old days of leaving these gaping holes in wisdom tooth extractions and placing gelfoam and Clindamycin, hoping things would heal, now place A-PRF+ and sleep in on the weekends! Cheers

      • CRS says:

        Question Cliff do charge additional for the clot with third molars or is it part of your fee? Blood draw, materials fee or are you sedating and getting the blood when you start the IV? Sound like a good business model. Please advise. Thanks

    • Brad F. says:

      Dr. Shalash, I do not disagree with you that PRF has debatable direct effects on bone healing based on the literature. However, it is undeniable that PRF has a dramatic effect on soft tissue healing. This being the case, I use PRF routinely because I believe if I can achieve faster and better quality soft tissue healing over my graft, then the case will stand a better chance for success and less opportunity for complication. So far this has held true for me. In addition, patients also experience a shorter duration of pain and swelling. Just food for thought.

  5. David Morales schwarz says:

    If you want volume preservation you should place a non or slowly resorbable particulate graft.
    If you want the best quality and fast bone filling and you are not worried about loosing some tenth of millimeters width, you shouldn’t place anything or place platelet rich concentrate (don’t care how you name it).
    An optional approach would be to place an immediate implant with an immediate provisional restoration with tissue support for Alveolar soft
    “Would you tell me, please, which way I ought to go from here?”
    “That depends a good deal on where you want to get to.”
    “I don’t much care where –”
    “Then it doesn’t matter which way you go.
    Lewis carol

  6. Karim says:

    I have been using a-PRF for a year now . In the last 6 months or so I would place it in Every extraction socket . Doing an average of 5 per week .
    I’ve used it also as in aid in horizontal bone augmentation.
    Fantastic results so far. No dry sockets , decrease healing time , and definitely preserving the width and height of sockets.
    I can Highly recommend it .

  7. David says:

    I would like to venture into the PRF arena since I am doing IV sedation anyways. Does anyone have a recommended system to purchase?

    • Cliff Leachman says:

      Process for PRF Dr. Choukroun’s site.
      http://www.a-prf.com/en/
      Everything you need is there, very reasonable shipping to
      Canada. Videos, info everything you need to get started.
      The only difficult thing to learn is drawing blood and you
      Already have that mastered! You will wish you started sooner once you start!

  8. Brett Murphey says:

    I’ve been using PRF for over 5 years. We place it in 95% of sockets. It is remarkable in many ways much like the comments above. I would say that if you want to preserve the bone don’t reply on PRF alone. You will have to go back and do a ridge augmentation. Place a corticocancellous graft and cover it with PRF, don’t flap if you can, secure the PRF with a vicryl suture if needed.

    • Giol says:

      When you say you use it in 95% of sockets yet you use corticocancellous bone, what is the function of the PRF?
      Is it used just to seal the graft in the socket to stop it from escaping?, in which case you can use a collagen plug, etc
      Thank you for your opinion

  9. DRSSD says:

    You can place anything in a socket or even leave it empty. You will get bone but the question is the long term dimensional stability.
    I’m yet to see any literature on this regarding PRF in sockets.

  10. Brett Murphey says:

    The greatest advantage to PRF is the healing time. We place it for all wisdom teeth exts. Honestly, we’ve only had 2 or 3 cases of dry socket in the last 5 years.
    I don’t always place corticocancellous bone with the PRF. I only use the corticocancellous bone for “dimensional stability”, or when I know that I want the bone to be there when I come back.

  11. CRS says:

    I would like more info on PRF, I use PRGF and they have raised the prices on the kits. That’s why I stopped using PRP. Please advise.

    • Bill M says:

      check out intralocks system. Most research. Various things about the spin and angle are significant. Just need tube and catheter-that’s your disposables

  12. greg steiner says:

    If anyone wants a literature review on the various platelet rich preparations our scientific staff has put on together a current literature review on the subject. Give our office a call and we will be glad to email it to you. Greg Steiner Steiner Biotechnology

  13. Nick Fahey says:

    We have been using PRGF for many years now and routinely put it into extraction sites.

    However, I would challenge anyone to look at a healed extraction site or a healed implant surgery site and say “wow, they definitely did/ didn’t use PRGF/ PRF etc…”

    So why do we use it…

    I don’t know if it the placebo effect or the PRGF, but patients have noticeably fewer complications and post op discomfort when we use it.

    With extractions you have noticeably less bleeding (less post op phone calls etc…)

    Not sure about less swelling… we still get plenty of that and also we are using dex etc… when the pt is worried about swelling.

    It is amazing with autogenous and xenografts from a handling point of view especially in sinus grafts/ GBR/ socket preservation techniques.

    It is an adjunct to what we do at WHRDP, not a replacement, i.e. we whet the implant surface with PRGF before placement and put factor 1 (growth factors and fibrin) directly into the osteotomy. Where we would normally use a collagen membrane we still will, we just then cover this membrane with a fibrin rich membrane made from the PRGF, which really seems to help with the post op healing as previously discussed.

    I know the evidence is patchy and mostly from the inventors (like so often, it is….) but like one of the posters above I think biotechnology is the future. It just makes sense to me. Some of the biggest critics are people who soak their grafting materials in whole blood. This is just taking it one-step further and I think that I would rather have a concentration of growth factors and fibrin than whole blood even though I accept there may be less oxygen available for healing without RBCs.

    If we have problems when we have used PRGF (and you still do regardless of what the inventors say… they are just less frequent) – We can reassure the patient that we did everything we possibly could to get a satisfactory result. Which helps some of them, which in turn helps us.
    Paradoxically (and this is not a reason for using it) – When people decline to have PRGF and then go on to have problems, it is amazing how often they comment that they should have had it/ or wished that they had had it… rather than blaming me… so happy days.

  14. Bill M says:

    Nelson Pinto has been doing some great work with L-PRF. He spoke in a breakout group at the recent ADIS summit in Atlanta. Things have progressed much further with the socket preservation techniques. He had slides that resembled Marks with BMP on regeneration. It is technique sensitive. L-PRF will grow what it touches . In ext sites he removes the cribiform plate with a round brand then punctures the site. Places 6-8 membranes and fully condenses them to extraction site as much of the liquid as possible.
    .If buccal plate missing he will place a layer exterior to the plate over the buccal plate 5mm each side of the defect .
    The last 2 he places at opening tucking under the margins and expects to loose the top layer. If you dont remove the cribiform plate you get bone that is too dense. If you remove it then you get medullary bone

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