Payton King

*Platelet-Rich Fibrin

By coincidence!I was running out of time to choose a topic to research for knowledge transfer, and did not have a specific clinical scenario to form a PICO question on. I was researching various methods for periodontal therapy and came across platelet-rich fibrin.

*How I Came Upon This Topic

PICO Question:

Does platelet-rich fibrin, when used as an adjunct to open flap debridement, increase the rate of bone regeneration and clinical attachment levels in patients with three wall infra-bony defects compared to open flap debridement

alone?

Databases:• EBSCOhost• Google Scholar

Key Phrases:• “platelet-rich fibrin AND perio* AND healing”• “platelet-rich fibrin AND perio*”• “platelet-rich fibrin AND dental hygiene therapy”• “platelet rich fibrin”• “platelet-rich fibrin periodontal therapy”• “platelet rich fibrin periodontal therapy AND scaling AND root

planning”

*Research Method

*Can anyone tell me what the goal for

periodontal treatment is?

To improve and maintain the periodontium into a state of

comfortable function!1

• “A simple and inexpensive procedure”2

• A sample of the patients’ blood is drawn at the time of the surgical procedure, and is placed in a centrifuge.2

• Once centrifuged, the platelet-rich fibrin clot forms between the plasma and red blood cell layers respectively.2

• This clot is quickly pulled out of the sample and is further compressed, which makes the clot elastic-like.2

*What is PRF?

*Here’s a video to show you the process of

prepping PRF.http://www.youtube.com/watch?v=EjhR90E707A

• The clot is then placed into a three-wall infra-bony defect after completing open-flap debridement on the patient2

• “Contains concentrated leukocytes, platelets, and growth factors that are trapped within a fibrin matrix”.2

*What is PRF?

http://www.regenexx.com/tag/platelets/

• Results are collected nine months after the surgical procedure.1,3

• Clinically proven that probe depths, clinical attachment level, sulcus bleeding index, periodontal attachment level, and plaque indexes were significantly reduced in systemically healthy people that received platelet-rich fibrin along with open flap debridement.1,3

*Does PRF Work?

• Clinical attachment levels were gained in systemically healthy people that received platelet-rich fibrin therapy in adjunct with open flap debridement.1,3

• Infra-bony defects, when filled with PRF after receiving open flap debridement, where approximately 46.92% filled with new bone.1,3

• Infra-bony defects that received open flap debridement alone only filled approximately 28.66%.1,3

*Does PRF Work?

*SUCCESS!

http://www.jidonline.com/viewimage.asp?img=JInterdiscipDentistry_2011_1_2_115_85033_f1.jpg

http://www.jidonline.com/viewimage.asp?img=JInterdiscipDentistry_2011_1_2_115_85033_f4.jpg

http://www.jidonline.com/viewimage.asp?img=JInterdiscipDentistry_2011_1_2_115_85033_f5.jpg

• Studies have shown that using platelet-rich fibrin as an adjunct to open flap debridement provides:

• clinically significant regenerative healing in infra-bony defects1,2,3

• gained clinical attachment levels1,2,3

*Conclusion

* This is NOT to say that open flap debridement itself does not work; however, platelet-rich fibrin does

increase the rate of healing.

• No, I cannot answer my question because more thorough research is needed, as platelet-rich fibrin is becoming a new concept to periodontal therapy.1,2,3

*Can I Answer my PICO Question?

Any Questions??

*The End!!

1.Thorat MK, Pradeep AR, Pallavi B. Clinical effect of autologous platelet-rich fibrin in the treatment of intra-bony defects: a controlled clinical trial. J Clin Periodontol. 2011 Oct; 38(10): 925-932.

2.Rock L. Potential of platelet rich fibrin in regenerative periodontal therapy: literature review. Can J Dent Hygiene. 2013;47(1):33-37.

3.Sharma A, Pradeep AR. Treatment of 3-wall intrabony defects in patients with chronic periodontitis with autologous platelet-rich fibrin: a randomized controlled clinical trial. J Periodontol. 2011 December;82(12):1705-1712.

*References