#11 Beyond the Recessions | PRP vs PRF

Welcome to the Holistic Dentistry podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body. Welcome to today's show. I wanted to discuss PRP versus prf. What is the difference? Well, prp, platelet rich plasma is a blood extract from your own blood that involves injecting this concentration of platelets into the skin or you know, into an area in the mouth or outside the mouth, could be a tendon or joint. And I remember when I was a resident at UCLA in 2001, we actually received the first PRP machine that was on the market. So that is already more than 20 years ago. And at the time this machine and this technology was pretty expensive and it's still relatively expensive compared to PRF technology. But PRP was the first generation autologous injectables, we call them autologous meaning blood related platelets are a type of blood cell that contains growth factors and it can help stimulate the production of collagen and elastin. So the whole idea of using PRP and really concentrating these growth factors is almost like miracle growth for plants. When you put miracle grow to a plant, it just exponentially grows, same like pr, you add it into a cellular area. The cells are getting the message that it's time to grow, multiply and heal. And hence it really accelerates healing. So PRP really started in medicine in the orthopedic department, using it for like tendons to help to regenerate, injecting in shoulders, knees, hips. And then in dentistry we wanted to look at, okay, how can we use PRP to really help with conditions. Mouth PRP are created really by isolating these platelets from a patient's own blood and concentrating them into a serum which is liquid so it's totally injectable that you can then inject in a treatment area that's let's say you have a non healing ulcer in the mouth. PRP is great for that. It can be applied topically or we can inject it, or maybe you had surgery that's not healing, it can be injected into that cell site and it really helps to promote tissue repair. PRP however has some disadvantages and for that reason I don't use it anymore. And a lot of dentists have gone to towards using PRF or platelet rich fibrin. The disadvantages of PRP is that the pre preparation protocol is pretty expensive. Like a kit in itself is a few hundred dollars. It's complicated and it's very operator dependent. In order to Separate that layer of cell which is liquid. Another reason why I don't like PRP is that it needs animal thrombin. Usually this is bovine anticoagulant, which you know, in some people, for example, those of you who are maybe don't want any animal product in, you just know that this bovine anticoagulant is used in the prp. Some of my patients actually have a sensitivity to bovine products, to bovine protein, especially those with autoimmune disease. So for that reason I stay away as much as possible from bovine products. Also, the short duration of the cytokine release and poor mechanical properties because it's liquid, it's not a solid, have resulted in search of new material. PRP is also used for the skin, not just for medical purposes, is used to improve texture and the tone of skin and reduce the appearance of fine lines and wrinkles. And I think for that application is great. But PRF can do the same thing. So the platelet rich fibrin really involves using the full clot. It involves the use of a different preparation process that actually result in a higher concentration of platelets and even a stronger, even two to three fold more release in growth factors as compared to prp. So PRF is the second generation that's much more user friendly and not as expensive and definitely more beneficial. It contains also the fibrin that's the F part of the prf. And the fibrin is a protein that helps to support, support tissue repair and regeneration. And for me as a dentist, I like to use the prf. That fibrin has substance. I actually can use the full clot. So by the time I spin or I prepare the sample, it actually literally looks like a little jello, like a jello shot almost. And this jello I can manipulate, it doesn't disintegrate compared to prp, which is completely liquid and it has no substance. So let me show you what a PRF machine looks like. So this is what I use to actually prepare the prf. And there's many, many different brands on the market. So what we do, we actually draw blood from you. We use test tubes like this. And let's say if I'm doing a tooth extraction, I need two vials, especially if it's a molar. If it's single rooted tooth, you can use one tube. But let's say if it's a molar with two or more roots is two tubes and oftentime maybe three or four tubes depending on the size of the tooth. What else I use PRF for is also gum grafting. Let's say you have some recession because we're using the whole fibrin. Fibrin in itself actually helps to stimulate collagen formation. PRP really doesn't do that because it doesn't have the fibrin component. So the initial PRF was actually introduced by Dr. Chokerin in back in 2001. So we've had it a long time. It's 100% natural. It does not contain any bovine additives, and basically it accelerates wound healing and tissue regeneration. It increases stimulation of osteogenesis, meaning bone regeneration and new blood vessel formation. It has 10 times more platelet concentration than normal blood. Again, we're concentrating those platelets to so you can heal faster. And it's got such amazing regenerative properties. After we draw the blood from you, let's say the tubes go directly into the centrifuge, which is what this really is. We close the lid and we actually go through a certain cycle here that allows us to separate the white blood cells, fibrin and platelets from the red blood cells. And the red blood cells get the cell discarded. And we only use maybe the top 10 or 20%. Typically. I say, you know, the PRF is a sign of good health. Some people have really a large concentration, maybe up to 50% of the whole test tube. I've seen it. So that means you're in great health. You have a large amount of platelets, a fibrin, and that's really, I say, a sign of longevity. PRP injections actually tend to have shorter duration of action compared to PRF injection. This means that the effect of the PRP injections may not last as long compared to prf. We know PRF cells can actually stay in the site for two weeks and sometimes even longer to allow all the healing cells to kind of march into the site to accelerate your healing. Stop that for a second, Wendy. Okay, let's see. After we spin the PRF products, and depending on the function that it's set on, I can use PRF as an injectable form or as I was telling you, as a liquid form. So PRF injectable is called iprf, I for injection. So I PRF I've used, for example, when I need to inject a site, what site do I want to inject? A lot of times I do some facial aesthetics. In the practice, I like to inject PRF as a natural biofiller to basically promote collagen formation in the face. So I'm talking about the nasal, labial folds, the marionette lines, any kind of dimples. We can inject lips, especially for the fine lines and wrinkles. We can also inject things in the mouth, as I mentioned to you, things that are not healing well. Or maybe let's say you've had IV bisphosphonate treatment and you have osteonecrosis of the jaw, meaning a bony area that's not healing. In that case, PRF works great because we're adding your own cells and growth factors to promote healing in that site. Most of the time, however, I use PRF as a full clot. The reason why I like the full clot is because this has substance. So essentially, it looks like jello. And then I can also flatten it out into thin sheets of almost. It looks like moldable. I want to say Saran Wrap, for lack of a better word, that actually really sticks onto a side. So let's say somebody has gum recession. I could easily take this sheet of PRF and basically adapt it underneath the tissue and then be able to even stitch onto it. One thing that I also like to look at, PRF when I look at the test tube is how clean your blood is. So for those of you that have, like, cloudiness in the blood, we know that probably it's due time for a detoxification. And I oftentimes will give you feedback when we do any kind of PRF procedure in our practice. Hey, it's time for detox. Your blood is little cloudy, but some of you have really nice clean blood is nicely oxygenated, and that's definitely a sign of good health. How do we get started with a prf? Really? We got started with a PRF because a lot of people are not healing well. Maybe they're not nutritionally fit. Maybe you're a smoker, Maybe you had radiation treatment. So then your cells are not as prone to healing. So instead of using a bone graft, for example, we use prf. PRP can be mixed with bone grafting, and a lot of the surgeons out there still use this technique. We take bone grafting, which is basically kind of like a dried powder. It looks like a white, dry powder. We mix the PRP in it, and that allows the PRP to wet the product. I prefer to use PRF in its liquid form, and it creates something called sticky bone. So I actually take. My preference is actually autogenous bone from the patient's own bone, but definitely can be like a donor bone, meaning in a bone graft. Vial. And if we take prf, mix it with the bone, it'll basically jellify in a few minutes, and that creates a bone patty. This bone patty can easily be manipulated in a site, such an extraction site, or any kind of bone grafting. And it allows the bone particles to really stay in the site. So. So PRF plays a huge role in my practice, and I wanted to explain what the difference is here. And PRF is more and more being used also in the natural beauty industry, you know, for facial rejuvenation. It can be used for, let's say, TM joint injections in order to promote healing. It's such a great product to use. It's your own, so you cannot have an adverse reaction to. So, quick tip of the day. How do you get your PRF to be in best possible shape? Definitely take multivitamin, be nutritionally fit, and therefore your cells will be rewarding you with the best growth factors. Please make sure you check out the show notes for any links mentioned in the show. Do you have a question you'd like me to answer? Message me on Instagram. Rsanda, this is Dr. Sandha. And remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.