Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration

Abstract

Platelet-rich plasma (PRP) is a new approach to tissue regeneration and it is becoming a valuable adjunct to promote healing in many procedures in dental and oral surgery, especially in aging patients. PRP derives from the centrifugation of the patient's own blood and it contains growth factors that influence wound healing, thereby playing an important role in tissue repairing mechanisms. The use of PRP in surgical practice could have beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration. Studies conducted on humans have yielded promising results regarding the application of PRP to many dental and oral surgical procedures (i.e. tooth extractions, periodontal surgery, implant surgery). The use of PRP has also been proposed in the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with the aim of enhancing wound healing and bone maturation. The aims of this narrative review are: i) to describe the different uses of PRP in dental surgery (tooth extractions and periodontal surgery) and oral surgery (soft tissues and bone tissue surgery, implant surgery and BRONJ surgery); and ii) to discuss its efficacy, efficiency and risk/benefit ratio. This review suggests that the use of PRP in the alveolar socket after tooth extractions is certainly capable of improving soft tissue healing and positively influencing bone regeneration but the latter effect seems to decrease a few days after the extraction. PRP has produced better results in periodontal therapy in association with other materials than when it is used alone. Promising results have also been obtained in implant surgery, when PRP was used in isolation as a coating material. The combination of necrotic bone curettage and PRP application seem to be encouraging for the treatment of refractory BRONJ, as it has proven successful outcomes with minimal invasivity. Since PRP is free from potential risks for patients, not difficult to obtain and use, it can be employed as a valid adjunct in many procedures in oral and dental surgery. However, further RCTs are required to support this evidence.

Effects of washed platelets vs platelet-rich plasma on the proliferation and mineralization of rat dental pulp cells

“…The primary advantages of the clinical use of autologous PRP include the following: blood platelets contain a high amount of various growth factors that promote the repair and regeneration of organisms and tissues, and PRP is autologous and therefore exhibits reliable biological safety (Albanese et al, 2013;Hata et al, 2013). However, various growth factors present in blood platelets might only be released by activation using an appropriate approach.…”

Bilateral platelet rich plasma injections with assisted techniques for temporomandibular joint disorders

“…Platelet-rich plasma injection for strengthening the TMJ connective tissue is a rarely performed therapy but has positive results in bone, cartilage, ligament, and muscle tissue [5][6][7][8][9][10]. The popularity of this novel treatment method triggered an increase in studies.…”

Reduction of relative centrifugal forces increases growth factor release within solid platelet-rich-fibrin (PRF)-based matrices: a proof of concept of LSCC (low speed centrifugation concept)

“…One of these systems is platelet-rich plasma (PRP), a technique that has been developed for clinical practice and tissue regeneration therapies [1,2]. PRP is prepared by multiple centrifugation steps using patient blood to which anticoagulants have been added to achieve a platelet-rich concentrate that can be used for different indications [3].…”