**8.5 PRF applications in other fields oral and maxillofacial surgery**

In oral surgery practice, oroantral fistulas may occur due to the morphology of the region or due to iatrogenic reasons in the attempts made in the posterior maxilla. Oroantral fistula formation can often occur due to tooth extractions from the region, after cyst excisions or in relation to implant surgery. In the process of

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**Figure 13.**

*PRF insertion over Ti-mesh membrane.*

**Figure 12.**

*Application of graft material.*

*Contemporary Overview of Blood Concentrates in Oral and Maxillacial Surgery*

closing these fistulas, generally shifted flap techniques are used. However, in recent years, PRF has been used to close these defects. After the region is removed from infected tissues as in other techniques, PRF is applied to the area as thin membranes. In this way, it is not necessary to use outsourced material or use techniques

Intraoral osteonecrosis scenarios appear due to various medical conditions, especially bisphosphonate group drugs. Generally, some studies in recent years have suggested the use of PRF in osteonecrosis cases, which is tried to be treated

that create serious donor site morbidity [49–51].

*DOI: http://dx.doi.org/10.5772/intechopen.93865*

*Contemporary Overview of Blood Concentrates in Oral and Maxillacial Surgery DOI: http://dx.doi.org/10.5772/intechopen.93865*

**Figure 12.** *Application of graft material.*

**Figure 13.** *PRF insertion over Ti-mesh membrane.*

closing these fistulas, generally shifted flap techniques are used. However, in recent years, PRF has been used to close these defects. After the region is removed from infected tissues as in other techniques, PRF is applied to the area as thin membranes. In this way, it is not necessary to use outsourced material or use techniques that create serious donor site morbidity [49–51].

Intraoral osteonecrosis scenarios appear due to various medical conditions, especially bisphosphonate group drugs. Generally, some studies in recent years have suggested the use of PRF in osteonecrosis cases, which is tried to be treated in various ways such as curettage, hyperbaric oxygen therapy, laser stimulations. It has been reported that PRF can act as a barrier membrane and accelerate soft tissue healing around the necrotic areas [52, 53].

PRFs can be used in the surgery of alveolar clefts apart from many other areas mentioned. In addition, it can be used to stimulate healing in patients who have or are likely to experience a healing problem due to medical problems [54].

#### **9. PRF for endodontics**

As a result of recent studies, regenerative endodontic therapies have begun to take their place among endodontics procedures. Regenerative procedures are mainly aimed at making the pulp functional by stimulating the pulp tissue that loses its function and cells with the potential for change in it [55, 56].

In the light of the studies, it was seen that PRFs can be used for regeneration in endodontics. For this purpose, in endodontics, PRF can be used for apex closure procedures and for revascularization procedures [55, 56].

In some of the studies conducted, PRF was used with MTA to manage the formation of apex. As a result, it was observed that beneficial results were obtained by using two materials together. The reason for the promising results obtained by using two materials together is that they work synergistically when they are together and thus stem cell and odontoblast stimulation is considered to be more successful [55–59].

Another area regarding the use of PRFs in endodontics is revascularization procedures. It is thought that PRFs can be used as scaffold material for regeneration of necrotic pulp and it is an ideal material as scaffold. The reason for this is, of course, the high amount of growth factors that PRF contains. Thus, it is a very successful skeleton for regeneration. In addition, the coronal pulp removed in regenerative pulpotomy procedures can be replaced with PRF to cover the underlying live pulp. Then it is covered with mineral trioxide aggregate (MTA). PRFs are also included in the apical surgery in the endodontic field. In this field, there are authors who say that the PRFs are successful, as well as the authors who say that the PRFs did not make a significant change. PRFs are thought to be mixed with MTA to create root end barrier. In order to fill the bone cavities formed after apical surgery, good results can be obtained by mixing the bone grafts and PRF [55–59].

#### **10. Using PRFs in periodontology**

In the field of periodontology, PRFs are used in the treatment of gingival recessions, intra-bone defects, furcation defects, wound healing of hard and soft tissues, and regeneration of all periodontium tissues. Growth factors used in the periodontium tissues achieve their therapeutic and regenerating properties of tissues by providing differentiation and proliferation inducing effects such as angiogenesis, cementogenesis, differentiation of osteoblasts, anabolic bone formation, etc. Compared with traditional periodontal treatments, it is seen that PRF systems provide very useful results thanks to these properties [60–62].

In addition to periodontal flap applications in teeth with intra-bone defects, successful results are obtained by providing regeneration in hard and soft tissues in the region related to PRF applications. With the use of PRF in intra-bone defects, a decrease in pocket depth scores, an increase in clinical attachment level, and an increase in bone filling of the region are observed, and significant advantages are observed as a result of use alone or in combination with other biomaterials [63, 64].

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surgery.

**Conflict of interest**

The authors declare no conflict of interest.

*Contemporary Overview of Blood Concentrates in Oral and Maxillacial Surgery*

observed in the teeth with aggressive periodontitis [65].

tant advantages of PRF applications in this area [66, 67].

As with intra-bone defects, PRF applications in furcation defects provide successful results with applications combined with traditional periodontal flap operations. Studies showed that the coronally advanced flap procedure gives more successful results when applied in combination with free connective tissue graft or PRF. Therefore; PRF applications are seen as an alternative to free tissue grafts in

The use of PRF has been shown to have successful results in patients with aggressive periodontitis. As a result of the combined applications of PRF systems with traditional periodontal surgery, an increase in the level of attachment, decrease in pocket depth and long-term follow-up bone regeneration can be

When it comes to gingival recessions, coronally advanced flap procedure with subepithelial connective tissue are among the first periodontal treatments that come to mind. With the widespread use of PRF, the use of PRF instead of subepithelial connective tissue graft is still an area in which studies are ongoing. Compared to the subepithelial connective tissue, it does not create a donor site wound, healing process and preventing patient discomfort during this process are the most impor-

Another use of PRF membranes in periodontology is that it can be used as a palatal wound bandage or protective membrane after placement of connective tissue grafts. Studies show that it is an effective method to protect the newly formed wound area in palatina and to increase patient comfort by accelerating wound heal-

PRF applications are among the most up-to-date and promising areas of periodontology due to their versatile nature. PRFs can be applied alone to the defect surfaces, as well as combined with graft materials or can serve as a thin membrane in regenerative treatments. In addition to these features, they have the feature of being an alternative to connective tissue grafts, thanks to their cellular content, when appropriate. In addition to the aforementioned areas of use, they can function as wound plugs and provide graft stabilization. Considering all these, with its low cost and biological features, PRF applications are effective in many areas in peri-

In many studies, successful results have been obtained from PRFs. It can be said that the most important reason for PRFs success is the growth factors in its own structure. The accelerator and strengthening effect of wound healing is quite obvious with their effect. Besides, it is seen that PRFs have positive effects in regeneration and augmentation procedures. Although more studies are needed on the use of PRFs in some specific areas, PRFs are used quite frequently. In the future, their use seems to increase in all fields of dentistry especially in oral and maxillofacial

*DOI: http://dx.doi.org/10.5772/intechopen.93865*

periodontal treatments [63, 64].

ing in the area [68, 69].

odontology [63, 64].

**11. Conclusion**

#### *Contemporary Overview of Blood Concentrates in Oral and Maxillacial Surgery DOI: http://dx.doi.org/10.5772/intechopen.93865*

As with intra-bone defects, PRF applications in furcation defects provide successful results with applications combined with traditional periodontal flap operations. Studies showed that the coronally advanced flap procedure gives more successful results when applied in combination with free connective tissue graft or PRF. Therefore; PRF applications are seen as an alternative to free tissue grafts in periodontal treatments [63, 64].

The use of PRF has been shown to have successful results in patients with aggressive periodontitis. As a result of the combined applications of PRF systems with traditional periodontal surgery, an increase in the level of attachment, decrease in pocket depth and long-term follow-up bone regeneration can be observed in the teeth with aggressive periodontitis [65].

When it comes to gingival recessions, coronally advanced flap procedure with subepithelial connective tissue are among the first periodontal treatments that come to mind. With the widespread use of PRF, the use of PRF instead of subepithelial connective tissue graft is still an area in which studies are ongoing. Compared to the subepithelial connective tissue, it does not create a donor site wound, healing process and preventing patient discomfort during this process are the most important advantages of PRF applications in this area [66, 67].

Another use of PRF membranes in periodontology is that it can be used as a palatal wound bandage or protective membrane after placement of connective tissue grafts. Studies show that it is an effective method to protect the newly formed wound area in palatina and to increase patient comfort by accelerating wound healing in the area [68, 69].

PRF applications are among the most up-to-date and promising areas of periodontology due to their versatile nature. PRFs can be applied alone to the defect surfaces, as well as combined with graft materials or can serve as a thin membrane in regenerative treatments. In addition to these features, they have the feature of being an alternative to connective tissue grafts, thanks to their cellular content, when appropriate. In addition to the aforementioned areas of use, they can function as wound plugs and provide graft stabilization. Considering all these, with its low cost and biological features, PRF applications are effective in many areas in periodontology [63, 64].
