The use of platelet rich plasma following tooth removal appears to speed healing and bone formation, according to a recent article in the Journal of Oral Implantology.
When a tooth is removed, poor healing can lead to excessive bone loss in the jaw that can delay tooth replacement, require costly reconstructive surgery, or even be impossible to fix, according to the authors.
"Patients and clinicians could benefit if a cost-effective, simple technique were available that decreased bone-healing time and increased the predictability of favorable results,” the authors wrote.
For the study, radiography techniques were used with patients to detect bone changes after surgery to remove molars, specifically the bilateral mandibular third molar. For each patient, one extraction site was treated with PRP and the site on the other side of the mouth was not, serving as the control. Three patients received PRP on the right side and three on the left.
The patients returned after the operation for evaluations and digital radiographs at three days plus weeks 1, 2, 3, 4, 6, 8, 12, 16, 20, and 24. Observers checked them visually to evaluate the extraction site’s tissue opening, bleeding, inflammation, facial edema, and pain. The early radiographs found a significant increase in bone density in the PRP-treated sites.
"The PRP treatment had a positive effect on bone density immediately following tooth extraction,” the authors wrote, while the control site had a decrease in bone density during the first week after surgery. After the initial two weeks, both sites had relatively parallel increases in bone density.
“It took approximately six weeks for the control sites to reach the same bone density that the PRP-treated site had reached by week 1,” according to the article. “The immediate start of bone formation seen with PRP treatment is of clinical relevance because it is the initial two weeks following bone-manipulation oral surgery that are important.”
Patients did not report significant differences in their perception of pain, bleeding, numbness, facial edema, or temperature between the different sites, according to the study.
Faster bone formation could benefit patients who need immediate prostheses or dental implants, according to the article’s authors, because the current four- to six-month wait for these could be reduced to two to four months if PRP is used.
Some studies report that PRP does not affect bone formation yet others, such as this study, do report faster bone formation. Rutkowski et al., hypothesize that it is how the PRP is prepared and what time points are used for measurement that influence bone formation results.
Overall, the authors conclude that PRP increases the rate of bone formation and decreases the healing time during the initial two weeks after surgery, helping patients return to “full function” sooner.
To read the entire article, “Platelet Rich Plasma to Facilitate Wound Healing Following Tooth Extraction,” visit www2.allenpress.com/pdf/ORIM36.1FNL.pdf.
To read more about platelet-rich plasma, go to www.dentistryiq.com/index/display/article-display/371521/articles/dental-economics/industry-news-2/2009/12/platelet-rich-plasma-enhances-bone-and-tissue-growth-for-dental-implants.html.
To comment on this subject, go to community.pennwelldentalgroup.com/.
