Originally posted December 1, 2021; updated
Your body has a natural ability to heal. You see it, for instance, any time you get a cut, scratch, or scrape. You bleed, and the blood clots to close the wound. Inflammation kicks in to clean and heal the site. New tissue is created.
There are things we can do to help the body along in its healing process, as well. If a cut is especially large, say, it can be sutured. In the case of oral surgery, we can incorporate tools such as ozone and platelet rich fibrin, or PRF for short.
Previously, we took a quick look at a recent scientific review on the use of ozone in wisdom tooth extractions. Now we turn to the latest review on PRF in such surgeries, published earlier this fall (2021) in the journal Oral Surgery.
Unlike earlier reviews, this one has the benefit of considering only double-blinded randomized controlled trials (RCTs). These are considered the gold standard in medical research. More, only studies determined to be of moderate or good quality were included, though this drastically reduced the number of RCTs. Just 6 out of 221 made the cut.
All together, those 6 studies “indicated an advantageous effect of PRF in reducing the frequency of alveolar osteitis” – a/k/a dry socket, or inflammation of the bone after a blood clot fails to form or falls out. Dry socket can be extremely painful, both in the socket and along nerves radiating to the side of the face.
Notably, one of the things PRF does is support revascularization, increasing blood flow and supplying the surgical site with platelets that are especially rich in growth factors. Those growth factors have been shown to accelerate and enhance the healing process for hard and soft tissues alike.
We also see better wound healing, and our patients consistently report less post-op pain and shorter periods of discomfort following procedures. Yet the authors of the new Oral Surgery review said that they found “an unclear effect of PRF on post-operative pain levels, oedema [edema], and wound healing” after wisdom tooth removal.
Of course, this isn’t necessarily a ding against PRF. It just means that the evidence for its other benefits wasn’t as clear among the particular studies they analyzed. Other reviews and reports have suggested otherwise.
Also, the current review looked only at the record regarding third molar/wisdom tooth extractions. Broader, more comprehensive reviews suggest that it can be effective across a wide range of procedures. And because of the ways in which PRF supports healing, it has proven an excellent help in preventing cavitations – hidden infections, often at old surgical sites, that can have whole body effects.
Frankly, we can’t imagine doing surgery without it.