Plasma Rich Growth Factor
Plasma Rich Growth Factor (PRGF) is exactly what the name suggests. The substance is a by-product of blood (plasma) that is rich in platelets. Until now, its use has been confined to the hospital setting. This was due mainly to the cost of separating the platelets from the blood (thousands) and the large amount of blood needed (one unit) to produce a suitable quantity of platelets. New technology permits the doctor to harvest and produce a sufficient quantity of platelets from only 20 cc of blood drawn from the patient while they are having outpatient surgery.
Why All The Excitement About PRGF?
PRGF permits the body to take advantage of the normal healing pathways at a greatly accelerated rate. During the healing process, the body rushes many cells and cell-types to the wound in order to initiate the healing process. One of those cell types is platelets. Platelets perform many functions, including formation of a blood clot and release of growth factors (GF) into the wound. These GF (platelet derived growth factors PDGF, transforming growth factor beta TGF, and insulin-like growth factor ILGF) function to assist the body in repairing itself by stimulating stem cells to regenerate new tissue. The more growth factors released sequestered into the wound, the more stem cells stimulated to produce new host tissue. Thus, one can easily see that PRGF permits the body to heal faster and more efficiently.
A subfamily of TGF, is bone morphogenic protein (BMP). BMP has been shown to induce the formation of new bone in research studies in animals and humans. This is of great significance to the surgeon who places dental implants. By adding PRGF, and thus BMP, to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.
PRGF Has Many Clinical Applications
Bone grafting for dental implants. This includes onlay and inlay grafts, sinus lift procedures, ridge augmentation procedures, and closure of cleft, lip, and palate defects. Repair of bone defects created by removal of teeth or small cysts. Repair of fistulas between the sinus cavity and mouth.
PRGF Also Has Many Advantages
- Safety: PRGF is a by-product of the patient’s own blood, therefore, disease transmission is not an issue.
- Convenience: PRGF can be generated in the doctor’s office while the patient is undergoing an in-office surgical procedure, such as placement of dental implants.
- Faster healing: The supersaturation of the wound with PRP, and thus growth factors, produces an increase of tissue synthesis and thus faster tissue regeneration.
- Cost effectiveness: Since PRGF harvesting is done with only 20 cc of blood in the doctor’s office, the patient need not incur the expense of the harvesting procedure in hospital or at the blood bank.
- Ease of use: PRGF is easy to handle and actually improves the ease of application of bone substitute materials and bone grafting products by making them more gel-like.
Frequently Asked Questions About PRGF
Is PRGF safe? Yes. During the in-office surgical procedure a small amount of your own blood is drawn out via the IV. This blood is then placed in the PRGF centrifuge machine and spun down. In less than 15 minutes, the PRGF is formed and ready to use.
Should PRGF be used in all bone-grafting cases? Not always. In some cases, there is no need for PRGF. However, in the majority of cases, application of PRGF the graft will increase the final amount of bone present in addition to making the wound heal faster and more efficiently.
Will my insurance cover the costs? It depends, in some instances insurance will cover the cost, but this is only in unique instances. The cost of the PRGF application (approximately $250) is paid by the patient if insurance does not cover the cost.
Can PRGF be used alone to stimulate bone formation? No. PRGF must be mixed with either the patient’s own bone, a bone substitute material such as demineralized freeze-dried bone, or a synthetic bone product, such as BondBone.
Are there any contraindications to PRGF? Very few. Obviously, patients with bleeding disorders or hematologic diseases do not qualify for this in-office procedure. Drs. Brunner and Lazerson will determine if PRGF is right for your specialized oral surgery procedure.