USE OF PRF AND PRGF FOR THIRD MOLAR EXTRACTION SOCKETS

We have been using the PRF, L-PRF, and PRGF technologies now for many years. This technology uses concentrated platelets processed at the time of surgery, as a graft material either alone or in combination with bone graft material (autologous, allograph, and/or xenograft). A recent study looked at outcomes when this is used as a socket treatment at the time of wisdom tooth extractions. (J Oral Maxillofac Surg 75:2497-2506, 2017). The idea is to try to enhance the healing process. In the study they found that it provided a significant reduction in pain, swelling, and incidence of alveolar osteitis (dry socket). They go on to suggest its use for “more complicated” third molar extraction cases.

We in our practice have a lot of experience with this and that we have used this material extensively for grafting procedures, but we have also used it regularly to help with the healing process for bone defects. The results have been great. We have seen greatly enhanced healing, especially noticeable in cases where there is a larger surgical site such as defects left by lesions (such as odontogenic cysts), with large extraction defects, or with bone reconstruction procedures such as osteotomies, to name a few. If we had to look for a downside it would be additional cost of treatment and some added treatment time with processing the platelets.

We will generally offer this and recommend it for larger procedures, but not for routine procedures. This is a little arbitrary, but we do not feel that the improvement of outcomes is significant enough for the smaller procedures to warrant the expense which is typically not covered by third party carriers.

Most procedures we perform, both hard and soft tissue, could benefit from the use of platelet concentrates in their various forms to enhance healing.