Use of PRGF to Help Heal Extraction Sockets

As soon as we started using PRGF for bone-grafting procedures in our practice, I recognized the great benefit that this technology had for healing in bone defects.  (J Oral Maxillofac Surg 79:305-312, 2021)  I read with interest this article where PRGF was used to help with the healing of tooth extraction sites for patients undergoing liver transplantation.  These patients are ill and often show difficult or slower healing.  The authors found a significant acceleration of healing in patients where PRGF was used.  It is of note that an atraumatic flapless procedure was used for both the treatment and control sites.

Aside from bone-grafting procedures — where we use PRGF for almost all of our treatments along with allograft or xenograft — I have used PRGF alone to enhance healing for larger bone defects such as jaw lesions, or for otherwise medically compromised individuals where I felt it was worth the added treatment time and expense to the patient.  I generally do not recommend it or even offer it to patients (guardians or decision-makers) for routine-care cases such as otherwise expected routine third molar (wisdom tooth) extraction cases.  This decision is made by my “feeling” (based on experience) that it does not appear to make a “significant enough difference” in healing for otherwise healthy patients.  There is some evidence out there which suggests that it does make a significant difference.

The plain truth is that, in my practice, patients undergo routine care for impacted third-molar teeth typically do very well.  If a patient or caregiver shows an interest in adjunctive care such as PRGF, I will discuss it and offer it as an adjunctive treatment.  When I have treated my family members, who are otherwise healthy, I have not used it.