Tooth Extraction

Tooth Extraction

When a tooth is extracted, there is a hole in the bone where the root of the tooth used to be. This fills in with blood that, over time, clots into a fibrous mass that fills the void in the bone. One of the first parts of the blood that helps that clot to start is the platelets. After the clot has formed, the epithelium starts to grow over the top of the clot. This closes the wound a few weeks after your tooth extraction. Over time the bone fills in where this clot was, and you have solid bone after a few months of healing.

Some discomfort is expected during that initial healing time, which mostly occurs on the first day. The body relies on the ingredients in blood to tell it to draw in the necessary chemicals and cells to fight infection and start the tissues’ change into normal body parts. Many of those ingredients that trigger this reaction are in the platelet portion of blood. If we could concentrate the chemicals that start things to heal and fill in the tooth socket with that concentration instead of red blood cells and plasma, the healing would go much faster and with much less inflammation. And in the case of teeth, far, far less dry socket risk (which is when the clot separates from the bone). To accomplish this, we use platelet rich fibrin (PRF) therapy.

Platelet Rich Fibrin Therapy

What is platelet rich fibrin therapy?

There are some surgical procedures that dentists do. When the procedure is finished, such as an extraction of a tooth, there is a healing process. One of the steps to healing is to get an area of trauma to clot and stop bleeding. Blood has a lot of different things in it. Mostly we think blood’s purpose is to carry oxygen in the red blood cells. These red cells do very little to help wounds heal. Platelets on the other hand do much to help things heal. However, platelets are a very minor percentage of your blood.

Some blood is taken from a patient’s arm as if they are getting blood drawn for a blood test. That is put in a centrifuge and spun around real fast for several minutes. Red blood cells are heavy and settle to the bottom of the tube. Plasma is light and comes to the top of the tube. The platelets tend to congregate in the middle of the tube between those layers.
Platelet Rich Fibrin

After several minutes of spinning, the fibrin in the plasma globs together and forms a clot. This results in the platelets sticking mostly to one end of this clotted fibrin. By this time the tooth has been extracted. We then take the platelet rich fibrin clot from the tube and place it in the socket where the root of the tooth was. So right away the clot is well on its way to getting established. The platelets are there in greater numbers to tell the body to start sending in the things needed to heal the extraction site.

Research

An oral surgeon that I refer frequently for wisdom teeth has been using this treatment for years. He taught me how, along with several other general dentists, in a class at their office a few years back. His office was the first office in Arizona to use this new, and in my opinion, revolutionary procedure. It sounded great. But I have been to other lectures that make a product sound great in the lecture which wasn’t really all that great. Because of this, I didn’t consider doing it in my general dentistry practice. Over time, this procedure has proven to be effective, almost eliminating the occurrence of dry sockets. If you have ever had a dry socket or know someone who has had a dry socket, you would avoid it if you could.

Other research and oral surgery offices have validated the value of PRF since then. Patients that I have sent to them have healed very nicely and without nearly the amount of pain I would have expected them to have after having wisdom teeth extractions. I have become a believer of PRF therapy. This year, I began looking into what it would take to start offering this treatment on all our extractions. We have purchased the necessary equipment and have become trained so that now Valley of the Sun Dentistry can offer this in our office. To learn more about this procedure from my mentors – and the pioneers who first used it after dental extractions in Arizona, follow this link: https://azctr4implants.com/procedures/platelet-rich-plasma/