PRF Applications in Endodontics. Mahmoud Torabinejad
teeth as a result of iatrogenic procedures, for root-end resection procedures, and for the management of surgical cysts.
This textbook is for both the beginner as well as the advanced endodontist and practicing dentist working in the field of endodontics wishing to further improve their practice by adopting some of the latest regenerative protocols. It is certainly a first of its kind and a must-read in the field of endodontics, highlighting the benefits of autologous blood concentrates specifically dedicated to endodontic procedures.
Colleagues will certainly enjoy this read, and it will undoubtedly open many avenues of future research on the topic!
Richard J. Miron, DDS, MSc, PhD
Group Leader, The Miron Research Lab
Lead Educator, Advanced PRF Education
Venice, Florida
As endodontists and periodontists, we are all familiar with the potential applications of platelet-rich plasma (PRP) in medicine and dentistry. But in the past few years, platelet-rich fibrin (PRF) has emerged as an alternative material in its own right. One of our first opportunities to observe the effects of PRF was in discussion with colleagues using it in oral surgery procedures. Their patients experienced remarkable hard and soft tissue healing with minimal postoperative discomfort. Intrigued, we dug further and discovered the widespread applications of PRF in dentistry and medicine.
The appeal of PRF stems from the fact that it is made from a patient’s own blood. It is easy to prepare and can be used for many kinds of procedures, making it cost-effective. PRF has many potential applications in endodontics. It can be used in surgical endodontics and adjunctive surgical procedures such as root amputation and hemisection. In addition, it can be used for root perforation repair, vital pulp therapy, and regenerative endodontics. Furthermore, it can be used as a bone graft binder during socket preservation to create “sticky bone” for the closure of surgical sites.
When the three of us first met, the idea of sharing these various applications of PRF was an immediate common ground. We were working with residents at the time and knew how much they could benefit from learning about PRF. After using PRF and observing successful outcomes in several cases, we decided to take things to the next level. We brought together some of the most forward-thinking endodontists, periodontists, oral surgeons, and general practitioners to share our thoughts regarding potential use of this material in endodontics and other fields of dentistry.
This book, representing a collaboration of like-minded clinicians, is the first to introduce the idea of PRF and cord blood stem cells in endodontics. It contains an overview of PRF itself with up-to-date information on tissue regeneration, as well as step-by-step instructions on how to use PRF in a variety of endodontic and oral surgery procedures. We have been using this knowledge for years to improve tissue healing for our patients, and we hope this book will help you on your quest to improve healing for your patients.
Kayvon Javid, DDS
Private Practice
San Pedro, California
Yvonne Kapila, DDS, PhD
Professor
Department of Oral and Maxillofacial Surgery
School of Dentistry
University of California San Francisco
San Francisco, California
Gregori M. Kurtzman, DDS
Private Practice
Silver Spring, Maryland
Edward S. Lee, DDS
Clinical Instructor
Department of Preventive and Restorative Dental Sciences
School of Dentistry
University of California San Francisco
San Francisco, California
Carlos Fernando Mourão, DDS, MSc, PhD
Private Practice
San Pedro, California
Yogalakshmi Rajendran, BDS, MS
Assistant Clinical Professor, Health Sciences
Director, Predoctoral Periodontics
Department of Orofacial Sciences
School of Dentistry
University of California San Francisco
San Francisco, California
Mohammad (Mike) Sabeti, DDS, MA
Professor and Endodontic Program Director
Department of Preventive and Restorative Dental Sciences
School of Dentistry
University of California San Francisco
San Francisco, California
C. Cameron Taylor, PhD
Research and Development Supervisor
Invitrx Therapeutics
Irvine, California
Mahmoud Torabinejad, DMD, MSD, PhD
Adjunct Professor
Department of Preventive and Restorative Dental Sciences
School of Dentistry
University of California San Francisco
San Francisco, California
Habib Torfi, MSE
CEO and President
Invitrx Therapeutics
Irvine, California
Eric Wong, DDS
Division Chair, Endodontics
Department of Preventive and Restorative Dental Sciences
School of Dentistry
University of California San Francisco
San Francisco, California
Recent studies using novel biomaterial scaffolds that contain host endogenous growth factors represent a departure from traditional clinical approaches and may result in better and more predictable regenerative solutions in medicine and dentistry. As early as 1966, Rule and Winter published a case report regarding continued root formation and apical closure in an immature human premolar tooth using pulp bleeding as a scaffold. Nygaard-Ostby et al, Nevins et al, Iwaya et al, Banchs and Trope, as well as others reported pulp revascularization in teeth with necrotic pulps and immature apices that showed continuous root maturation, dentinal wall thickening and, in some cases, a positive response to vitality tests. In 2011, we reported a case of pulp revascularization using platelet-rich plasma (PRP) in a second maxillary premolar with immature root that had been accidently extracted and then replanted. After removing the necrotic pulp, irrigating it with 5.25% sodium hypochlorite, and medicating it with a triple antibiotic paste for 3 weeks, we prepared PRP from the patient’s blood and injected it into the canal space. Mineral trioxide aggregate (MTA) was placed over the clotted PRP and double-sealed with Cavit (3M) and amalgam. Radiographic examination of this tooth 5.5 months later showed resolution of the periapical lesion, further root development, and continued apical closure. Vitality tests elicited positive responses like those found in the first premolar tooth. The shortcomings of PRP include the need to draw blood from the patient and the complexity of centrifugtion and purification in a