Platelet Rich Fibrin In

Periodontology
Prepared By :
Dr. Tanvir Ahammed Tushar
BDS (CIDC)
Oral & Dental Surgeon
 CONTENTS
Introduction
Definition of platelet concentrates
M/A of platelet concentrates
Definition of PRF
Clinical application of PRF in periodontology
Technique for PRF preparation
Different ways of using PRF
Benefits and limitations
Conclusion
References
 INTRODUCTION

Platelet rich fibrin(PRF) was first developed by Choukroun

et al. in 2001. Unlike PRP, it does not require the addition
of an anticoagulant. It is a natural bioactive membrane,
which can enhance soft/hard tissue healing, at the same
time, can also protect surgical sites, grafted materials
from external aggressions.
 PLATELET CONCENTRATES

It is a recent innovation in dentistry which are prepared by

the centrifugation from individual units of whole blood.
It includes :
1. Platelet Rich Plasma (PRP)
2. Platelet Rich Fibrin (PRF)
 MECHANISM OF ACTION OF PLATELET
CONCENTRATES
Released growth factors

Bind to cell membrane surface of cells in the graft, flap, wound

Activation of endogenous internal signal protein

Induces gene expression for cell proliferation, collagen

synthesis, matrix and osteoid formation
 PLATELET RICH FIBRIN (PRF)
 It’s a second generation of platelet concentrate.
 An autologous leucocyte platelet rich fibrin
matrix containing cytokines, platelets and
numerous growth factors.
 It is a biodegradable scaffold that promotes
-Wound healing
-Guides epithelial cell migration
-Used as an adjunct for bone and soft tissue regeneration
 CLINICAL APPLICATION OF PRF
IN PERIODONTOLOGY

 For treatment of intrabony and furcation defects

 Treatment of gingival recession
 Guided tissue regeneration
 In periapical lesions
 TECHNIQUE FOR PRF PREPARATION
Withdrawal of 10ml of blood into a
collection tube

Then subjected to centrifugation at

3000 rpm for 10 minutes without
addition of an anti-coagulant
 CONTINUE….
After centrifugation, the blood in the blood collection tube is seen to
be divided into three layers. They are:
1. Top layer -Platelet poor plasma
2. Middle layer-Platelet rich fibrin
3. Bottom layer -Red blood cell

The autologous fibrin membrane can

be obtained by squeezing out the serum
from the clot.
DIFFERENT WAYS OF USING PRF

Clot Membrane Injectable liquid

Plug Cut in fragments

 CASE-1

Fig 1: Pre-operative radiograph and pre-

operative view
Fig 2: Intraoperative view Fig 3: PRF with alloplast Fig 4: Adaptation of Guided
condensed in place tissue regeneration barrier
membrane
Fig 5: Flap approximated and sutures Fig 6: Post-operative radiograph after 6
placement months
 CASE-2
Fig 2:
Fig 1: Pre-treatment
Marginal marginal tissue
tissue recession of
recession 5mm

Fig 3: Fig 4:
PRF Post-operative
membrane (The amount of
secured over coverage
recession achieved was
defect of 4mm)
 BENEFITS

No addition of Bovine thrombin or anticoagulant to blood

Contains large quantity of platelet and leukocyte cytokines
Ease of preparation and application
More efficient cell migration, proliferation and hemostasis
PRF can be obtained in a definite firm structure
Simple and cost effective procedure
 LIMITATIONS

Autologous – Only a limited volume of PRF can be used

-Cant be used for general surgery
No anticoagulant used – Quick handling is required (success
depends on this)
Unfeasible for tissue banks – As contains cytokines and growth
factors
- Highly antigenic
 NO CONTRAINDICATION

PRF has no contraindications, they can be used in all kinds of

patients with
Systemic conditions where healing is compromised ( i.e.
Diabetics, Smokers )
Surgically compromised situation ( i.e. Damaged flap )
 CONCLUSION

PRF is the new generation of platelet concentrates. It can be

used alone or in combination with grafts or other biomaterials.
PRF shows to have beneficial outcomes and satisfactory clinical
results giving new perspectives of treatment in dentistry field.
 REFERENCES
Essential of Clinical Periodontology by Shantipriya Reddy
(5th Edition)
Panacea for periodontology by Dr. Priyam Mishra
 Prakash P. Management of marginal tissue recession using platelet-rich fibrin:
A case report. Indian J Dent Res [serial online] 2021 [cited 2023 Aug
26];32:264-7. Available from:
https://www.ijdr.in/text.asp?2021/32/2/264/330858