Using PRF in the treatment of dry socket?
I’ve only found articles on using PRF to prevent dry socket. I’d like to know if there are dentists out there who have tried placing PRF to actually treat a dry socket? Does one place the plugs into the socket then cover it with the flattened PRF membrane or is the latter step not necessary. Is relief quite instant?
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29 Comments on Using PRF in the treatment of dry socket?
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Cliff Leachman
8/3/2017
Me tinks its too late?
Use it as much a spossible for exo's, or OSTEOGEN, IF I CANT GET A VEIN, cant remember the last time I smelt clove/ eugenol!
Bill M
8/3/2017
Just saw Dr Pintos at ADIS Summit in atlanta this morning. The benefits of L-PRF are exploding. He suggest the first step in any infection or tissue breakdown is L-PRF.
Michel Jazzar
8/3/2017
Yes you can do it but be careful to bring as much blood as you can from the edges of the socket than fill with plugs and sutures.
Merlin Ohmer
8/3/2017
That sounds like a lot of overkill for a dry socket.
Merlin Ohmer
8/3/2017
It's just a dry socket. No one ever died from one. It's not worth drawing blood and the expense of prf.
Bill m
8/4/2017
little expense w/PRF and best to do with Ext. There is a different protocol for ridge preservation if you want bone
Delia
8/3/2017
I use it with very good and fast results for dry sockets. No multiple visits and pain goes away .
Alex Galo
8/3/2017
Thank you for your reply. I guess it's best to anesthetize, scrape the socket with a curette to get some bleeding, place the PRF plugs then suture it up. Sound about right?
Gene Messenger
8/3/2017
PRP cost about 3 buck. its worth it
Michel Jazzar
8/4/2017
ðŸ‘
Drshalash
8/18/2017
Scrapping the socket is an old practice that is no longer recommended as it tends to disturb any healing process that is taking place and can actually prolong the suffering of the patient
Merlin Ohmer, DDS, MAGD
8/3/2017
It is invasive to the patient. Why get stuck to treat something as innocuous as a dry socket? It's like using a grenade to kill a mosquito. Just because we have it, doesn't mean it makes sense to use it.
Cliff Leachman
8/3/2017
I can't imagine a dry socket on a lower wisdom, trying to do a block
and the trying to suture a site you assaulted a few days earlier, does seem rather dramatic...
Merlin Ohmer DDS MAGD
8/4/2017
I can imagine drawing someone's blood to spin down to put in an old extraction site. Just because you have a fancy tool does not mean it is a panacea.
Cliff Leachman
8/3/2017
It would make more sense to use it at the initial appointment?
Tarek Assi
8/3/2017
I use L-PRF with every extraction! Never had dry socket. But if I do get one, will definitely place PRF along with dry socket protocol. I believe in L-PRF, made healing experience for my patients amazing. Again I use for every surgery I Do. It is a must or I do not do survey! As far expense it is insignificant for patients, and on many occasions I do it complimentary!!!!
Great question!
Thank you.
Alex Galo
8/3/2017
Thanks, I just got my centrifuge machine and took a PRF course so I look forward to seeing the benefits you all are talking about.
Merlin Ohmer
8/4/2017
When all you have is a big, bright fancy hammer everything is a nail. Simple irrigation with saline and placement of some gauze with eugenol. Works great. Saline irrigation and keeping the are clean works too. All I'm saying is this if overkill. Put a piece of GelFoam or Collagen in it for that matter. There is morbidity from IV draws too.
Andy Malovatzky
8/4/2017
Why to use only PRF ??
Why not to use IPRF ??!!!!
When using the IPRF we have enough blood and you can preserve the socket.
Then cover with PRF.
CRS
8/4/2017
Okay as an oral surgeon who rarely gets dry sockets my preferred treatment is Toradol IM then post injection PO. It works in 15 min. All these other techniques involve re- injuring an inflamed localized osteitis not an infection. Understanding what a dry socket is key. Prevention is from knowledgeable handling of the tissues and diagnosis not gadgets or cook book techniques I see listed here, do what you like but listen to an expert who is trained and experienced. Your welcome.
Cliff Leachman
8/4/2017
What about using A-PRF at the extraction appointment for socket preservation?
Do you think that is a gadget too? I'm interested in your expert opinion....
CRS
8/5/2017
You are giving a different scenario, for my extraction cases I place a bone graft and make the clot with my laser for disinfection or a PRGF clot depending on the clinical situation. I am differentiating what a dry socket is a local osteitis caused by many things especially trauma. Retraumatising the area and placing Eugenol actually worsens the situation. Old old techniques. The PGRF is technically more difficult but I really like the fact that both a clot and fibrin membrane are produced separately. Often you can avoid a secondary CT graft. I used to use PRP. I have a different understanding of bone physiology and healing and try to explain it simply to my dental colleagues. There seems to be much misinformation out there evidenced in this blog. I daily hear from patients about their experiences with dry sockets if their dentists only knew😷
David A. Hall
8/4/2017
There is a simpler way to prevent dry socket, based on an excellent study published about 25 years ago, and corroborated by my experience.
First, be gentle in the amount of force you apply in extracting impacted mandibular third molars. Remove more bone or section more rather than apply more force.
Second, place a square of Gelfoam impregnated with a suspension of clindamycin in normal saline into the socket post-operatively, before suturing.
You can read about my experience with this on my blog: https://www.mynewsmile.com/blog/preventing-dry-socket/. I had zero dry sockets over a ten-year period applying this technique.
Phil
8/4/2017
I concur. But, Gelfoam is expensive. Another option is Benacel, which is made from biocompatible oxidized cellulose. Here is good study using Benacel: A retrospective study on the use of a dental dressing to reduce dry socket incidence in smokers
Cliff Leachman
8/4/2017
GelFoam/ Clindamycin used to be my protocol, but A-PRF+ really wipes the floor with it...
CRS
8/4/2017
Yes old technique many moons ago.
Ramesh bulbule
8/5/2017
I have been using PRF for a decade. Switched to A-PRF/I-PRF 2 years ago.
I have treated 3 cases of dry socket where the patients had the extractions at other offices and were then referred to me. This was prior to switching to A-PRF/I-PRF.
What I did in all the three cases was:
Good curettage of the site to eliminate dead bone.
Irrigation with saline.
socket was filled with PRF plug without compression. This would allow the serum fluid from PRF to percolate into the bony trabeculae of the socket.
Fill the socket with PRF plugs. Pack as many PRF plugs as possible into the site and suture.
One of the three patients was prescribed amoxicillin 500mg every 8 hours for 5 days as the patient was medically compromised(long standing poorly controlled type 2 diabetic).
Othe two patients were prescribed NSAID as needed. Both of them had to have NSAID for 24 hours.
This resulted in complete resolution and good healing of the sockets.
In case of one of the two patients , an implant was placed ten weeks later. And he has had absolutely no further complications.
CRS
8/5/2017
The NSAID is what did the trick in controlling the inflammation. You actually caused more trauma, I like to get it right the first time😷
CRS
8/5/2017
Also re-entering a recent wound and resuturing is not appropriate surgical protocol that intervention probably was it necessary. Tordadol IM😷
