Do I Need PRP/PRF/PDGF/BMP For Dental Implants and Bone grafts?

In this video, I described what is PRP and PRF and how to concentrate growth factors, stem cells and molecular enhancers made from your own blood to be used in dental implant and bone grafting procedures. PRP, PRF, PDGF, BMP, and others, are all abbreviations for wonderful enhancers of dental implant bone grafts.

I make it from simply drawing a few test tubes of your own blood from your arm and concentrating your natural growth factors made from your own immune system. I have been using this technique since about 2003 and it always helps to reduce pain and make your bone and gums heal faster and stronger with less complications.

PRP/PRF is also helpful in reducing infections and helping blood to clot in a bone graft and makes the bone graft material handling hold together. It is extremely beneficial and safe because it is made from your own blood. It has been very well studied and documented for many years . Most of my patients that have very large sinus bone grafts usually only need Advil or Tylenol afterwards if they have had PRP/PRF/PDGF/BMP. There are other medical specialties that use this technology including vetrinarians.

it works very well and treating peri-implantitis also.

Watch this video to learn a lot more and feel free to ask questions of course.

Abbreviations
PRP = platelet rich plasma
PRF =platelet rich fibrin
PDGF =platelet derived growth factor
BMP =bone morphogenic protein

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

38 thoughts on “Do I Need PRP/PRF/PDGF/BMP For Dental Implants and Bone grafts?”

  1. Dear Dr. Amin,
    thank you very much for your informative blog.
    I have a front tooth implant that was placed far too high. There is a lot of bone loss around the top area of the implant and also the adjacent teeth. When removing it, there will be a very large bone defect. The surgeon who plans to remove it does not use PRP/PRF but plans to just use some kind of cadaver bone. What do you think about only cadaver bone? Can it work well for large bone defects without plasma?
    Most likely I will need braces afterward and an adjacent tooth might be moved slightly into that area.
    Thank you.

    Reply
    • Hello Yoko,
      Large bone grafts always do better with live cells. What I mean by this is these types of grafts typically do better if combined with some of your own bone. Often times a block bone graft is used. Sometimes cadaver can be used but I personally like to use a piece of your own bone taken from your jaw. This has the best chance of reconstructing a large area along with PRP/PRF. This is especially important when it comes to reconstructing something in the upper front area where bone volume reconstruction is very critical.

      I hope this helps you

      Ramsey Amin DDS

      Reply
  2. Do all posterior extractions require a bonegraft? Is it possible to achieve quality bone formation using only PRF and no allograft ? Are there any studies showing that PRF infused bone grafts provide better quality bone regrowth as compared to allograft mixed with saline?

    Reply
  3. Hello Dr. Ramsey,
    Thank you for this wonderful blog, I am very happy to find such a rich source that helps patients understand and find answers for their concerns. My case started six weeks ago, when I had my upper wisdom tooth (#1) extracted, the roots were very deep and close to the sinus. When I came back after one week to remove the stitches, we found that I have an oroantral fistula. My dentist put plugs and stitched it but after 2 weeks the fistula was not closed so he did the procedure as you described it (bone grafting using my own blood – PRP, rom PRF,…) putting a collagen membrane then the bones created from my plasma mixed with some graft material covered with another collagen membrane then additional resolvable membrane was stitched on the top for extra protection then I was following up for three weeks.
    Two days ago, I went for my last check-up. I tried closing my nose pushing some air and all seemed to be fine. The panorama X-ray showed the bone is in place. Now I feel air passing through a narrow hole in the same area and I can hear it and feel it but I don’t feel it in my nose because I said it seems to be very small. Is this something I should be concerned about. Is this an indication that there will be a small fistula that might remain permanent or will it close by time? Any further action needs to be taken now or later?
    Thank You,
    Amy

    Reply
    • wait on it for awhile….dont push on it for 3 months then re-asses. If it is still open it can be closed surgically.

      Reply
      • Do all posterior extractions require a bonegraft? Is it possible to achieve quality bone formation using only PRF and no allograft ? Are there any studies showing that PRF infused bone grafts provide better quality bone regrowth as compared to allograft mixed with saline?

        Reply
        • “ALL” is a strong word so I would say no. PRF is a cell attractant and aids in the healing process but does not just build bone on its own. there are thousands of studies on PRF at this point. I’m sure you can do a search on pub med about it to help learn more since it seems that you are very detailed. Remember that for every study that says something is good there are studies that say it is useless. Clinically I find it to be very beneficial for a number of different uses besides just building bone.

          Reply
  4. Hi Dr. Amin,

    I should have visited this blog before I had the implant procedure, which is very powerful in knowledge and expertise to the current implant technologies. Fortunately it is not too late yet for the post-implant knowledge.

    18 days ago I had a tooth #5 right upper, extraction, bone graft and implant same time. So far today the surrounding gum including the site is still swollen and looks infected because I started taking antibiotic medicine after 3 days of the procedure.Because the doctor forgot to proscribe it. I can feel it with tongue, especially the next tooth to the implanted not just swollen, it is sore, hurting, and moving. I took some shots today. I take almost 30 tablets Amoxicillin, and will continue taking it, I have total 42 tablets.

    Dr. Amin, you think the situation above is normal in the process of healing as my dentist told me, it is side effect of implant, and will get better with time goes, like my dentist told me?

    Thank you very much for your valuable time.

    Reply
    • Thank you for your very kind words. You are still early in the healing process so this is definitely within range although 18 days out is a long time to still have pain. typically in my practice a single tooth implant does not yield too much pain at all but every patient and every dentist is different.

      Hopefully within a few short days you will improve. If not an x-ray should be taken to evaluate. If the implant is failing should be removed right away and not left to fester. Antibiotics are good but they will not cure a bad surgical intervention. Hopefully this all works out. You may want to consider adding on a second antibiotic called metronidazole in conjunction with amoxicillin.

      Reply
  5. Hi i hope this thread is still active.
    Wondered if you could give me some advice. I lost my front upper tooth a few years ago and have tried twice to have a bone graft so i cam have an implant put in but both times my graft failed. I am going to have one final attempt but i was wondering what i could look for in the things you’ve suggested above as in using my blood. Previously only cow bone was used with pig collagen. Thanks

    Reply
    • I would seek care with another dentist rather than try a third time with the same. We all have a different skill set, level of experience, judgment and training.

      Reply
  6. Hi Dr. Amin,

    I’m a healthy 36yr old male from Massachusetts that still have all 4 wisdom teeth. The bottom 2 are impacted, top 2 have come out and neither are bothering me, but my dentists keep insisting I get them removed every annual checkup after looking at the xrays. I will go to an oral surgeon for evaluation and most likely end up getting them removed. After doing research on how to heal faster after extraction I am extremely confused.

    Which is better for wisdom teeth recovery time PRP or PRF?

    Thank you.

    Reply
  7. Hi Dr Amin

    Hope you are well. I have a cyst that’s been growing silently above one of my front teeth that was apicected many years ago and filled with amalgam. I saw an oral surgeon at the hospital today and he said he would remove the cyst by creating a gum flap and going in through my buccal bone high up and also will extract the apicected tooth …..but will use my own blood to grow new bone. Is that prp you mention here or does he mean just the blood that’s there already in the socket? He said he wouldn’t use block bone grafting nor use cow bone. He said when he comes to place the implant in 4 or so months time he can bulk the area out if it needs it with cow bone but other than that he prefers to just use blood. Does this sound normal?

    Many thanks :@)

    Reply
    • sounds like they’re going to draw blood from your arm which is exactly what I mention in this post. Typically these growth factors such as PRP/PRF/PDGF/BMP and a host of other varieties of platelet concentrates are used in addition to some sort of particulated bone graft and not as a stand alone graft. I would asked for clarification.

      Reply
      • Thanks for your response. The oral/max surgeon did clarify he would use whole blood not prp from my arm and cow bone from bottle. Then some bone regen at a later date. He also said he would do a gum flap and go in through the buccal bone above the root to remove the large cyst in the first instance. He said this won’t matter as it will re grow. I got a second opinion on this and they said you shouldn’t go in this way as my buccal there is about half a mm thick and it needs to be left alone and go in through the extraction socket. Otherwise if I do need a bone graft there will be nothing to attach it to (if it hasn’t already resorbed totally).

        I’m really at a loss of what to do :@( I have emailed you pics incase this helps though! Thanks again.

        Reply
        • I can’t comment on your actual situation because I cannot see your x-rays and have not clinically evaluated you. Generally, we try to avoid going through the thin outer wall of bone especially in the upper front teeth as it is extremely delicate.

          But if a cyst or a lesion is there it is the best approach to be sure to have remove the entire defect. You will likely need to stages of bone grafting rather than just a single.

          Reply
  8. Hello Dr. Ramsey
    I hear that A-PRF and i-PRF are the best ways to go when you have dental implant put in.
    The process is 100% natural, 50% higher growth factors, has BMP 2 & 7, monocytes and leuycocytes. There are no anticoagulants or calcium citrate A-PRF is a more advanced form of L-PRF. I also hear that there are stem cells in i-PRF which is an injectable liquid form.

    Reply
    • there are many different versions and methods to prepare platelet concentrates. The problem with I-PRF is that it needs to be drawn within three minutes of actually using it. Many times it is not realistic to be able to do that and there is not a lot of information to supportthat it works better than other techniques. Thank you for your comments

      Reply
  9. Hi I just had a quick question on whether using PRP/PRF/PDGF/BMP differed depending on the type of implant or person and also whether these growth factors MUST be used in combination with bone from the patient, cadaver or cow or if they can be used on their own for new bone to grow for an implant?
    Thank you

    Reply
    • Laura,

      You ask excellent question. In general, you must use some type of additional bone material in addition to the growth factors.

      This is exceedingly more important that the larger the bone graft is and when you are missing the entire outer wall of bone. The growth factors alone have not been found to be as good as when used with some sort of bone substitute. It would be great if we can just use a growth factor alone. Maybe this will occur in my lifespan but as of 2015 is not here today.

      Bone grafts are extremely technique sensitive. This means that the technique and surgical skill of the dentist outweighs materials and growth factors.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  10. On average how much (%) do the use of PRP, BMP, PDGF, etc. reduce healing time and infections when doing an implant bone graph?Thanks.

    Regards,
    Jim

    Reply
    • Great question Jim.

      It would be difficult to answer in a percentage. The point is to prevent an infection. It is a rare to get an infection in the first place so by adding L PRF/PRP/PDGF or BMP your only further reducing that chance but more importantly enhancing the ability to heal. It is like turbo charging your own healing ability… Like natures Band-Aid

      I have been using blood concentrates made from my own patients for about 13 years now as of 2015. They work wonderfully well and I rarely do a procedure without them.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  11. I have both top and bottom dentures. The top ones are great. No problem. But my lower denture is driving me crazy. I can put fixodent in the denture but within a couple of hours it comes up off my gums even if I don’t eat anything. I can’t eat with them in because they come up even after a few bites. In the meantime food is getting under them and it hurts. I can’t eat without em because I can’t chew up anything. My gums stay cut up from food and really sore. I’ve had the denture relined a couple times and I couldn’t tell any difference. Could you please tell me the best way to go to keep my denture in,. I don’t know much about implants but if implants will make my denture stay in, then I’m all for it. I just don’t know what to do. I would certainly appreciate it if you could let me know what i can do and what would be best. Thank you, Sandy Carver

    Reply
    • Hello Sandy,

      I totally understand your frustration. Without dental implants, your teeth will just floating around in your mouth.

      If you are not opposed to having removable teeth, you can do a dental implant over denture. This means you would place implants underneath your denture and it would snap in to place. Do not mistake this with a fixed dental implant bridge which never comes out.

      Over dentures can help support existing dentures. I would stay far away from mini dental implants

      These articles should help you
      Snap In Dentures on Dental Implants – Burbank Dental Implant Specialist

      overdenture video

      basics of over dentures

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  12. Dear Dr. Amin,

    I came across your site and I am interested in the
    PRP technique you mention. I was told I have completely resorbed maxilla and I am edentulous. I was told I would require donor bone for grafting from my hip or I can do zygomatic implants. I would prefer to not have to undergo a second surgical site and am afraid the hip donor option would present long term risks to my hip.

    The ultimate goal for me would be to have a non-removable denture secured by implants that is horse shoe shaped and no upper palate. I am an otherwise healthy 56 year old female. I quit smoking in 2002 and have never touch a cigarette since.

    I was looking into BMP as another option for bone growth and see that you recommend PRP. I was wondering if you could recommend someone in the NYC area that can do PRP and evaluate my case.

    Cost is also an issue and was wondering if any of the dental schools in NYC would take my case. I appreciate the referral.

    Reply
    • As of the year 2015, it is very rare to have to go to the hip together enough bone to do even the most severe cases of bone loss in the mouth. In the late 1990s, my training included iliac crest bone grafting from the hip. This is mostly been replace with the use of cadaver bone which does not require a donor site.

      It is not the PRP, L PRF or BMP that does everything. Is a combination of excellent surgical technique, some type of bone structure whether it be your own, cadaver or cow.

      Most zygomatic implants can be avoided by doing lateral window sinus bone grafts on each side and placing somewhere between 6-10 implants for the upper jaw. You need to be seen by very skilled expert level provider whether that be in a dental school or in private practice. This is one of the most costly dental restorations because of the magnitude of bone reconstruction and teeth reconstruction a needs to happen.

      A full mouth replacement with the Prettau dental implant bridge and bone grafting may be all that you need.

      These links should help you:
      Prettau full mouth dental implant bridge

      Sinus Lift Bone Graft

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  13. HI DOCTOR JUST I WANT YOU TO SEND FOR ME THE MANUAL PROCEDURE FOR BMP AND PDGF PREPARATION FROM BLOOD AND WHAT IS THE CLINICAL USE FOR BOTH.

    THANK YOU

    Reply
    • Hi AMIN WILLIAM

      I guess you are dentist! Education is great to be shared with other colleagues.

      This blog platform is intended for patients not dentists. I cannot teach you all of this from this article. I do teach other dentists these procedures through one-on-one mentoring and continuing education courses that I teach. Let me know if you’re interested in doing that. There is no manual for doing this, just clinical guidelines.

      In a nut shell, using growth factors made from your patients own blood sets up a chain reaction cascade of events that activates proteins, cytokines, and other chemicals. This chain reaction turns on other growth factors such as BMP which naturally occurs during the healing process of bone. Using only one growth factor does not initiate chain reaction events that occur naturally.

      Blood supply provides the necessary cells, growth factors, and inhibitors to initiate the osteogenic biomineralization cascade. Injury to blood vessels during oral surgical procedures causes blood extravasation, subsequent platelet aggregation, and fibrin clot formation.

      The major role of fibrin in wound repair is hemostasis, but fibrin also provides a matrix for the migration of fibroblasts and endothelial cells that are involved in angiogenesis and is responsible for remodeling of new tissue. Platelet activation in response to tissue damage and vascular exposure results in the formation of a platelet plug and blood clot as well as the secretion of biologically active proteins.

      Platelet alpha granules form an intracellular storage pool of growth factors (GF) including platelet-derived growth factor (PDGF), transforming growth factor Beta (TGF beta, including Beta -1 and Beta -2-isomers), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF). Insulin-like growth factor-1(IGF-1), which is present in plasma, can exert chemotactic effects towards human osteoblasts. After platelet activation alpha granules fuse with the platelet cell membrane transforming some of the secretory proteins to a bioactive state.

      Active proteins are secreted and bind to transmembrane receptors of target cells to activate intracellular signaling proteins. This results in the expression of a gene sequence that directs cellular proliferation, collagen synthesis, and osteoid production.
      Anyway… Sorry for all the science for those of you for prospective patient’s that are reading this. There is a whole lot that goes on in the healing process. I strongly believe using leukocyte rich PRF is an excellent way to turbo charge healing.

      I hope this helps you to start your journey learning more about blood concentrates.

      Platelet Rich Plasma (PRP)

      Respectfully,

      Ramsey Amin DDS

      Reply
      • thank you doctor for this information and i looking to lean the preparation of BMP . i know how to prepare prp and prf if you can tell me the website or books to learn BMP preparation and what is the difference between prp and bmp .

        thank you.

        Reply
        • Dear Amin William,

          PRF sets the chain reaction that allows the body to produce BMP and hundreds of other naturally occurring growth factors.

          Respecfully,

          Ramsey Amin DDS

          Reply
  14. Wow…. I am also a dentist who follows your blog routinely. You really know your stuff!! thank you for your dedication to excellence in implant dentistry and bone reconstruction. I took one of your courses about 3 years ago and it changed my life.
    I will email you privately to see if you have additional courses to offer.

    Reply
    • Thank you for your kind words. I really do enjoy sharing knowledge and education from personal experience and from scientific literature.

      Ramsey Amin DDS

      Reply

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