Applications for in office obtained PRF clot and/or PRP?

prfA few weeks ago I posted a question asking people here what their experience was with regards to centrifuging to obtain a PRF clot. Thank you to those who provided very good information regarding angle as well as time and rpm settings. I would like to open up the discussion and move the focus to what people have been using the obtained PRF clot and/or PRP for in practice? Last fall I attended a course at the AAID in Orlando which made it sound as if just this PRF clot placed on it’s own would provide bone growth. It’s what got me interested in doing this in my office. I have since come to the conclusion that it is not THAT easy but it certainly seems promising. In particular, I am looking for applications involving implants and/or grafting vs. periodontal uses. Thank you, all.

52 Comments on Applications for in office obtained PRF clot and/or PRP?

New comments are currently closed for this post.
CRS
2/20/2015
The growth factors with PRF and PRGF will help but a scaffold with particulate bone maintains the space. The same is true for BMP.
greg steiner
2/21/2015
PRF and PRP have only soft tissue growth factors and no bone growth factors. The overwhelming evidence based on controlled clinical trials is that PRF and PRP do not stimulate bone formation and actually inhibit bone formation. Greg Steiner Steiner Biotechnology
CRS
2/22/2015
I think when the bovine thrombin is added the bone regenerating factors are inactivated. I use PRGF which has no bovine factors. Nothing wrong with a combination of materials one to promote soft tissue growth and bone growth so I use both. The clot helps hold the particulate bone together vs using a filler material in the paste products which give a "spotty " fill in of bone. I'm just a clinician not a researcher. It is interesting that when Marx jumped on the BMP bandwagon, the early trials without using a particulate spacer did not generate bone. I think what works best in one hands coupled with literature reading and these valuable posts are the way to go.
btcdentist
2/21/2015
I think PRF is a decent spacer/buffer material when doing sinus lifts with residual bone heights of atleast 5mm. But when you have a potato-chip-thin ridge, I don't feel PRF alone lasts long enough to maintain the space needed for bone formation. I can post a case I did using just PRF, and I did get 3mm of additional bone height but it was more dependent on the implants tenting up the membrane rather than PRF. Thus PRF is not very effective as a scaffold, but a great space filler. I believe most problems that occur with sinus lifts such as infections is due to traditional bone graft material escaping into the sinus space through a tear. Thus I'd like to see more effort initiated to eliminate the usage of bone particulates in the sinus space and find safer alternatives like PRF. I know there already is a school of thought that just tenting up the membrane and creating space is enough to increase bone height. I feel this is the correct trend. I only user PRP/PRF for two things in my office: 1: Wisdom tooth extraction site improved healing (seems to have real benefits) 2: Sinus lifts for cases with a residual bone height >5mm (Much safer than using bone particulates,since even if you have a tear, the implant will integrate and you eliminate the possibility of having graft material escaping into the space)
CRS
2/22/2015
Actually I find that bone augmentation with particulate in the sinus is very predictable and just knowing how to manage a tear and the technique works well. I am curiousdo you charge an additional fee for the fibrin clot with the thirds? Sounds like a beneficial technique, I would like to hear more. And I agree that a well tented sinus membrane will form some great bone. It is interesting the early sinus lifts proceeded to elevate and pack all the way to the mesial wall which can get you into trouble. I like to just pack some particulate where the implants are going to be. Very good post.
Dr.Dr.Hossam Barghash
2/22/2015
if we really know the biology and molecular biology of healing then we know exactly what ,why when to use material to booster bone healing. PRF is not only for soft tissue but it is essential for any healing process,why, because it is important for the most essential and important stage which is angiogenesis. without blood supply no healing. second it's fibrin mesh help to trap the growth factors whether inside the PRF(platelet growth factors) or locally induced from tissue area( depending on the site)
CRS
2/22/2015
Agree it is not an all or nothing issue with the growth factors.
Richard Hughes, DDS
2/22/2015
Greg not so. If one includes the Buffy coat.
greg steiner
2/22/2015
This week I presented a lecture on osteointegration at an implant conference. In my lecture I presented a review of the literature on PRF. I reviewed only the controlled clinical trials. The conclusion of all of the studies is that PRF does not stimulate bone formation and a very well done study showed that because PRF only contains soft tissue growth factors that PRF inhibits bone formation. Dr. Choukroun followed me on the podium. He said he does not pay any attention to clinical studies and that whenever you use his products and the surgery fails it is because the dentist is a lousy surgeon. My presentation was primarily histology and when he was questioned why he did not present any histology he said histology did not mean anything either. If the clinical research showed that PRF works for bone regeneration Dr. Choukroun would be touting the results rather than presenting grainy panoramic films of his surgery. Greg Steiner Steiner Labnoratories
CRS
2/22/2015
Sounds like he doesn't want to be educated!
KPM
2/22/2015
So we have some guys saying PRF will not contribute to growth and, in fact, retards and/or prevents it and we have others saying the exact opposite. It would seem that this kind of thing would be a bit more concrete at this point, no? Unless its use in dental bone grafting is really that novel an idea? I do know it is certainly a "hot topic" but that doesn't necessarily mean it is a new topic. Just look at the continued Mercury in amalgam discussion or 3rd molars contributing to anterior crowding. Richard, would you please expand on your menton of the "Buffy coat"?
CRS
2/23/2015
I have been using PRP since it came out for dental but I switched because of cost of the refill kits to PRGF. This PRF looks similar. When I am doing a more extensive graft I use it with particulate human bone and it works well. I would not trust fibrin only for space maintenance except in a small sinus lift where that is not an issue. I think that part of the controversy could be market driven to get the products used by the inventor. I personally don't know all the research particulars being a clinician but I am comfortable with the results I'm getting. I have had some issue with particulate size consistency and am experimenting with a different vendor. No harm in using a soft tissue enhancer with the grafts. I have been doing bone grafts since OMS residency and am humbled and amazed with all the technical advancements.
KPM
2/22/2015
Looking for articles concerning PRF I came across this interesting piece. I must say that I do not know the researchers or anything about their reputation nor that of whatever system they may be affiliated with but I believe it is worth noting... http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557480/pdf/blt-11-102.pdf
FKM
3/4/2015
This paper addresses PRP. That is way different than PRF. More, all of those products are far from being identical, even if they have the same name.... Look up this recent issue of POSEIDO. http://www.poseido.info/publication/volume-2-2014/issue-2.html
Oliver Scheiter
3/4/2015
Please keep in mind that M. Dohan Ehrenfest who is the head researcher of the study is the editing director of POSEIDO and also speaker for intra-lock L-PRF. They are all banging their heads in over market shares...
FKM
3/4/2015
And what about all the other authors? Prof Quirynen from Leuven University? Prof Hom Lay Wang from Michigan university, etc..... Those are hard data and not mere couple of clinical cases that want to make science..... Those measures can be duplicated in any lab tomorrow and will confirm findings. Let's stop to be suspicious, and let's just look at facts....
Dr.Dr.Hossam Barghash
2/23/2015
Greg would you please give the reference that said that PRF inhibit bone formation.
Greg Steiner
2/24/2015
Dr. Barghash Here is the study that found that growth factors in PRP and PRF inhibited bone growth. Tissue Eng Part A. 2014 Feb;20(3-4):874-82. doi: 10.1089/ten.TEA.2013.0058. Epub 2013 Nov 27. Effects of platelet-poor plasma, platelet-rich plasma, and platelet-rich fibrin on healing of extraction sockets with buccal dehiscence in dogs. Greg Steiner Steiner Biotechnology
Russell Fitton
2/24/2015
Anyone who reads this article and has experience with Platelet Rich Concentrates would probably not agree with this study from a clinical point of view. I would like to see more studies along the same lines.Not just one. The big problems with some of these studies is you don't know how well the socket was cleaned out to start with. If you don't have good clean bone with bleeding you don't get a good fill no matter what you put in there. From everything I have seen so far PRP and PRGF don't stay around long enough to matter much long term. The denser fibrinogen in PRF and now CGF and I suppose A-PRF trap more of the GF's and Leukocytes and factors are released over a longer period of time. I wonder what the beagles were eating and chewing on post surgery. I just read the abstract so I don't know if it was discussed. I have a hard enough time with human beings taking care of my work post op. I didn't read in the abstract whether they went over post -op instructions with the dogs!
Dr.Dr.Hossam Barghash
2/26/2015
thanks for posting the reference Greg. I read the whole article and it is about comparing PPP PRP and PRF. it state that PRF and PRP promote bone maturation in presence of abundant osteogenic cells. first this means that no bone resorption. seconed what is abundant in scientific term. how was the follow up in opened extraction socket as Russel stated. Forth in the contrary to this article there is ohtrer articleS stated the effect. of PRF .any how we still in the area understanding molecular biology but at the same time we need to red carefully what is published on judge on scientific bases not on believes .
Dr.Dr.Hossam Barghash
2/26/2015
just to correct my previous statement, no bone inhibition,instead of bone resorption.
Greg Steiner
2/26/2015
Any way you read the article the authors conclude that PRP and PRF growth factors inhibits bone formation. I read all the published articles on PRF and bone regeneration. All of the articles were published by dentists. There were no articles on bone and PRF published by orthopedics. Most of the articles were well done and published by researchers in Turkey and India. The articles were designed as most all call clinical research articles to find positive results but they did not. So the orthopedic community and the dental academics in the US and Europe have no interest in this technology. This is just a word of caution to my dental colleagues. Greg Steiner Steiner Biotechnology
Dr.Dr.Hossam Barghash
2/27/2015
Greg,I read the article conclusion and it was that PPP is sufficient for bone preservation in socket with buccal dehiscence. he also stated that PRF and PRP play a significant rule in bone maturation.and he also stated that both would be stimulatory for bone formation. the intensive work on bone regeneration and growth factors include BMP was done by dentist, so I wounder that your advise is to follow what orthopedic do, any how I would like to know your scientific explanation how PRF and PRP inhibit bone formation
greg steiner
2/28/2015
Dr. Barghash When bone is forming it is woven bone. After the bone stops growing it is remodeled into lamellar bone (mature bone). When a bone graft produces more bone it will grow for a longer period of time and therefore remodeling is delayed. The PRP and PRF group had more mature bone because they stopped growing earlier and produced less bone. The following study confirms that PRP and PRF inhibit osteoblasts and as a result less bone is produced. A three-dimensional cell-loading system using autologous plasma loaded into a porous β-tricalcium-phosphate block promotes bone formation at extraskeletal sites in rats. Greg Steiner Steiner Biotechnology
Cliff Leachman
3/3/2015
Interesting discussion, I use A-PRF almost everyday, for socket preservation, bone grafting and tissue augmentation. i-PRF is even more exciting, bone grafts are enhanced and seemed to heal quicker, less pain and better results. Maybe I'm getting better as a clinician? A-PRF+ is my go to material for grafting, mix Raptos cortico-cancellous with chopped up fragments of A-PRF+, cover with A-PRF+ membranes and Bob's your uncle. NO COW BONE! Never,ever resorbs... FOund myself picking it out of the surface when I opened up sites, like picking the fly shit put of pepper! Also no more comments from patients asking if they will be mooing tonight! Never mind cost saving and using the patients own materials! Dr. Choukroun has some papers with excellent histology and he is a real doctor not a tooth jockey like myself. SYFAC in Paris last July showed some grouind breaking research being done using A-PRF, like being done at Harvard, regenerating lungs in mice, never mind bone. Some still think the moons made of cheese soo....
Raul Mena
3/3/2015
My experience is that the any of the PPPPPP's are beneficial on soft tissue not for bone grafting. Dr. Mohamed Sharaway has done some studies and he alsobelieves that is the case. For bone grafting I favor NHP over the PPPP's Raul
Joseph Choukroun
3/4/2015
Dear Friends, I would like to put few comments. 1. About the angle of the rotor. Changing the angle (going from 33 to 45°) increases only the G Force. The G force is calculated from the radius at the bottom of the tube. I wanted to reduce the G force, just for increasing the white cells amount. And also increasing the circulating stem cells (MSCs) . It's the concept of the new Advanced and injectable PRF..and will be published soon. 2. About the controversy of the bone formation. I agree with Dr Bargash: we need to see which surgical protocol was applied. In the article, they found less growth factors than in PRP: of course ! PRF releases slowly and constantly the factors.How many membranes do they use ? only one: it's not enough.. etc... I told to Dr Steiner in Miami that the most important when we do a surgery is the surgical protocol. Nowadays, we have several scientific and fundamerntal publications about the benefit of the PRF on the vascularization. Because the most important is first to get new vessels. However, if your clinical protocol is wrong, impossible to get sufficient bone: in time and in volume PRF is only the best physiological scaffold that we can use. Saying that some growth factors are only for soft tissue is a stupidity...
Oliver Scheiter
3/4/2015
Dear Colleagues, I have been following this discussion for a while and must say it takes on the same form and tone the companies and 'researchers' have been conversing in over the last few years. In Europe clinical application really started with PRGF after PRP did not prove to be easily integrated into daily practice. Ever since we have had the same discussion: It does nothing, only soft-tissue, it harms the graft... I am with Cliff and I have 15 years of surgical experience backing me up. PRGF, PRF and now my own clinical protocol with post-extraction CBCTs showing a higher bone density in the former alveoli than in the surrounding bone, strong soft tissues around the implants and happy, pain free patients. About the biology from a humble clinicians point of view: We are inside an extraction socket, surrounded by bone and we reduce the inflammatory process and boost angiogenesis. What else can happen but bone growth? I would not say we should discard the studies completely but it can't be a coincidence that these studies are promoted either by the different plasma product companies trying to discredit each other or by the biomaterial multinationals trying desperately to get rid of the annoying competition.
greg steiner
3/6/2015
Most of you may not believe it but I have supported the use of PRF mixed with our beta tricalcium phosphate granules. When asked by our customers if this was appropriate my opinion was that because PRF is biocompatible the two should work well together. Because of these questions I have read all of the research relating to PRF and bone so I would know the facts. There are four sinus augmentation studies that looked at mixing PRF with xenografts and allografts and found that PRF did not improve bone regeneration. However, PRF was doomed to fail before the start because they used non-biocompatible particulate grafts that produce bone through an inflammatory process resulting in sclerotic bone. Because PRF is biocompatible it produces bone without inflammation and the result is normal bone. Whenever you mix non-biocompatible bone graft material with biocompatible bone grafts the inflammatory process blocks normal bone formation so the PRF in these studies never had a chance to improve bone formation. There are four studies that looked at PRF in sockets and three of the four studies found no benefit using PRF over no graft. This was surprising to me because I would think that covering bone with a biocompatible material would be better than leaving bone exposed to the oral environment. For those interested in researching PRF I suggest you study PRF in combination with a second generation beta TCP such as Cerasorb or our 3rd generation OsseoConduct. If you mix it with a non-biocompatible bone graft you will just be producing more studies where PRF fails to improve regeneration. My customers say PRF works very well with our beta TCP and I continue to support the use of PRF with our products. Greg Steiner Steiner Biotechnology
Raul Mena
3/6/2015
Greg, What do you mean by using a graft that is not biocompatible?
greg steiner
3/9/2015
Raul Bone grafts are considered non biocompatible if they produce significant inflammation in the host. Most bone grafts are non biocompatible because they contain foreign proteins. The foreign proteins from either another human or animal, stimulate the hosts immune system to eradicate the antigenic material. However, because the bone graft contains foreign proteins osteoclasts cannot resorb the bone graft and the only option for the host is to surround the bone graft in minerals to isolate it from the host. Once the bone graft is encased in minerals the inflammation reduces but the bone that is produced is sclerotic. Sclerotic bone cannot be remodeled and therefore once it is formed it cannot adapt to changes which is why you see implants placed in sclerotic bone have a higher failure rate than implants placed in normal bone. The density of the sclerotic bone is related to the antigenicity of the foreign proteins & that is why animal bone grafts produce a higher level of sclerosis than allografts. Clinicians who favor allografts and xenografts don't accept these statements but they have never seen human histology of how these materials heal in humans and they do not have long term studies on implants placed in these materials. The inflammatory response to non biocompatible bone grafts overwhelms any other material that is attempting to produce normal bone. Greg Steiner Steiner Biotechnology
Raul Mena
3/9/2015
Greg, I fully understand what is a biocompatible material, but I never heard of using a non-compatible material for grafting. As far as I know In order to do grafting the material needs to be biocompatible. Thanks for your posting. Raul
greg steiner
3/10/2015
Raul If you want normal bone the bone grafts must be biocompatible. The non biocompatible bone grafts such as allografts and low temp xenografts produce mineralized scar tissue called sclerotic bone. The histology of freeze dried bone allografts and some xenografts during healing in the 6 to 8 week period are filled with an inflammatory infiltrate of cytotoxic T cells. Cytotoxic T cells are responsible for organ rejection. Most all of us have sclerotic bone in our bodies. Hardening of the arteries is actually sclerotic bone and is called atherosclerosis. If you have a joint with osteoarthritis you will have a joint with sclerotic bone formation. Atherosclerosis and osteoarthritis are induced via inflammation just like the sclerotic bone produced by allografts and xenografts. None of the clinicians using these materials know how they heal and what type of bone they are producing but when we come to the realization that the type of bone we put our implants in will determine how long they last this subject will gain increasing interest. We have a free CD on this material if you have further interest in this subject. Greg Steiner Steiner Biotechnology
Cliff Leachman
3/10/2015
I'm interested , but when you say, "supported the use of PRF mixed with our beta tricalcium phosphate granules". This makes me question your honesty and the validity. OUR beta tricalcium? What about mine? We know, from numerous studies, the beta-Tricalcium does induce giant cells and inflammatory infiltrate. The jury is not out on whether A-PRF+ produces bone, they delivered the verdict! Guilty as charged...
Raul Mena
3/10/2015
Greg, Interesting argument and that may be the case with some materials that you have tested. That has not been my experience. I have several allograft cases, both block graft and also cases with cancellous particles. We have obtained excellent results without any sclerotic bone formation. A variety of this cases demonstrate from 54% of new healty bone formation to 95 % of new healthy bone formation after 4 month of grafting and no sclerotic bone. Histology done by Dr. Mohamed Sharaway at the Medical College of Georgia School of Dentistry. I remain open minded to learn from your experience. Raul
greg steiner
3/10/2015
Cliff I am interested to read the studies on bTCP and inflammatory infiltrate. Could you please provide the references. Thank you Greg Steiner Steiner Biotechnology
greg steiner
3/11/2015
Raul Let's share histology. You can contact me at my office. I also would be happy to have our histologic discussion on this web site if the webmaster would agree so our colleagues can be part of the discussion. If you want an impartial opinion you can also ask any general pathologist to look at your histology. Greg Steiner Steiner Biotechnology
Cliff Leachmsn
3/17/2015
Many more just plug into google! Biomedical Materials Volume 7 Number 1 Shahram Ghanaati et al 2012 Biomed. Mater. 7 015005 doi:10.1088/1748-6041/7/1/015005 The chemical composition of synthetic bone substitutes influences tissue reactions in vivo: histological and histomorphometrical analysis of the cellular inflammatory response to hydroxyapatite, beta-tricalcium phosphate and biphasic calcium phosphate ceramics Shahram Ghanaati1,2,6, Mike Barbeck1, Rainer Detsch3, Ul
Dr.Dr.Hossam Barghash
3/15/2015
I think the key for the discussion is understanding biology, broad terms like inflammation is not acceptable to use without understanding the molecular biology of the term. we can not claim we do understand every thing but many things started to be different. for example we use to generalized macro phage cells because they all look the same but at the molecular level they are different as we have M1 macrophage which are catabolic and M2 macrophage the anabolic one. but still inflammation is the first step in healing. and of course I can not talk about the whole molecular biology of the process, but it is the preparatory for the most important step in healing (what ever the tissue kind) , it is angiogensis the key of survival for all tissue and especially when the tissue we are talking about(bone) is defined as highly vascularized tissue. now we can tell if PRF is useful or not for bone even we just look from one angle of angiogensis. by the way all the last cases of sinus lift I have done in the last few years I only use PRF with no other graft materials
Greg Steiner
3/19/2015
Cliff Thanks for the reference. The article was well done and multinucleated giant cells were found on the surfaces of the graft particles but there was no inflammatory infiltrate. Any foreign object will be lined with cells that identify the material as foreign. They are necessary for the removal of the foreign material. The important thing is that the histology showed no inflammatory infiltrate which would have indicated an immune response. Greg Steiner Steiner Biotechnology
Cliff Leachman
3/19/2015
Just plug into Goggle, there is a ton of them, especially the Journal of Oral Implantology. This is why I stopped using beta-tricalcium phosphate, CaSO4 instead. Cheers
Robert J. Miller
5/9/2015
Dr. Leachman made the statement that A-PRF unequivocally grows bone. Guess he has not read the current papers just published by the Dohan group from France. Dr. Dohan is the undisputed expert on PRF and has published more papers on this subject than any other researcher. In the papers comparing the quality of fibrin using different protocols and 4 different centrifuges, the A-PRF system performs the most poorly. In measuring production of TGFb1, PDGF-ab, or VEGF, the standard L-PRF system produces 100% more growth factors at all stages of testing than A-PRF. When measuring the release of BMP, contrary to what Dr. Choukroun has claimed, there is close to ZERO production of bone morphogenic protein from A-PRF. Worst of all, A-PRF membranes are completely resorbed at 3 days (70 hours), and therefore can no longer release ANY growth factors. If bone growth begins at 7-14 days, would Dr. Leachman like to explain how the "jury" has come back to suggest that A-PRF produces bone? Read the papers on the POSEIDO website and leave the emotion behind. Sorry for the doctors who bought into the A-PRF hype before there were any peer-reviewed papers to prove clinical efficacy (or lack thereof). Dohan Ehrenfest DM, et al. The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a Leucocyte- and Platelet-Rich Fibrin (L-PRF) clot and membrane. Parts I, II, and III. POSEIDO 2014 (poseido.net) RJM
Oliver Scheiter, D.D.S.
5/10/2015
Careful! You are speaking about peer-reviewed papers? Interesting choice of research you quote. If anything it shows how money changes allegiances. Dohan Ehrenfest used to speak for Choukroun. After being scored by Intralock he now engages Choukroun wherever he can. POSEIDO, by the way is his paper. It publishes only what Dohan wants. If you want to read tainted research you can also go to DentalDialog Spain. That's Eduardo Anitua's Paper and it shows the unparalleled effects of PRGF Endoret....blablaba. One thing should be very clear: All of these systems produce plasma concentrates. No matter who spins it which way, the one big variable in the equation is the patients blood and it's contents. There are big inter-individual differences between a healthy 20-year old and an osteoporotic lady in her 70s. This becomes very clear when you look at clinical performance. I've tried PRGF, L- and A-prf and CGF over the years. They all work clinically. But with varying levels of success in different patient groups. And one more thing: I don't know how they made the A-prf membranes disappear after 3 days in their research. In my patients mouths it lasts as long as the L-PRF membranes...
Cliff Leachman
5/10/2015
Dr. Miller just keep guessing, read the papersand had a great laugh at the POSEIDO site (Should be Poseidon), but thought it was purely propaganda and found his recent webinar a poor attempt to write Dr. Choukroun out of the history books. Found it revealing you didn't compare CGF, which is spun at similar g-force as A-PRF+. You live in a fantasy world where you think you actually contributed something to the discourse when in fact you reveal your intent to separate dentists from their cash for old technology you stole from Dr. Choukroun. I took the course you offered years ago on L-PRF because of the affiliation you used to brag about that you had with Dr. Choukroun, but when i couldn't purchase the PRF box from Intralock, without buying the centrifuge as well I approached Dr. Choukroun myself and bought the box your purport as your own, NOT! Seems he had enough of your greed as well, dentists be aware L-PRF is OLD technology. Its NOT patentable, its a g-force and should be open technology as Dr. Choukroun has prescribed, simple greed is driving Dr. Miller and sees the ground crumbling beneath him as he resorts to intellectual dishonesty. Vibrations, vibrations..... Keep talking you only reveal yourself for what you obviously are. You only concern is $$$$$$$$$. Good luck with that.
Robert J. Miller
5/10/2015
It's obvious that you have not read any of the three papers. I would suggest that before anyone denigrates scientific research projects, they at least read the contents and then debate them on their merits, not on the basis of some accusation of "bias". Are you aware of who the additional authors are, or their academic positions? Several authors, including Hom Lay Wang of University of Michigan Department of Periodontics, have NEVER been paid lecturers for Intra-Lock International. Do you think that they would put their academic honesty on the line by falsifying scientific results for the sake of publishing? These papers are as well written as anything I have seen in the PRF world and represent the collated research from respected institutions from around the world. You make the statement that A-PRF membranes last as long as L-PRF membranes in your patients. How did you determine this? Did you open up these sites and do the histology on the membranes to prove your statement? Further, did you do the histology on the quality of fibrin and the vitality of cells in the A-PRF sample? Are you aware that damaged cells will not release growth factors? Look at the histology in these papers and then respond. That is exactly what this outstanding group of researchers did and simply published their findings. I know that the defenders of A-PRF may feel slighted or even offended by the results of the research, but sometimes the truth hurts. The research suggests that those who use the A-PRF system are not getting the clinical efficacy they have been promised. At the same time, the authors have shown that the L-PRF protocol still remains the standard by which all other iterations should be judged. RJM
Cliff Leachman
5/10/2015
Put your shovel away! You are obviously pissed they threw your lawsuit against the inventor out of court! Another loss of your integrity!
Oliver Scheiter, D.D.S.
5/11/2015
@RJM Well, isn't it interesting what kind of reaction a little clinical experience and a critical observation can provoke! Must have put my finger on something there. You ask how I can determine how long membrane last in my patients? I don't know what you do with them but our extensive clinical protocol for the use of enriched plasma includes its use as a fully exposed membrane. I do not take histologies but my very successful treatment protocol has evolved over 15 years and in my hands all of the existing plasma protocols work. Different indications for each one of them but like I said before: It's a plasma concentrate. The only ingredient is the patients blood. So in our concept we focus on the question how to help the patients metabolism for us to be able to harvest not only GFs but also a lot of CD34+ cells. But that, one can't sell... Why the hell does nobody talk about the advantages of enriched plasma in comparison to conventional surgical protocols instead of banging each other's heads in. Most of the world still doubts that any of the plasma products work. Big loss for the patients... regards from Mallorca
Robert J. Miller
5/10/2015
Sorry, Cliff, if you believe that bona fide scientific research is laughable if you find it contrary to your personal opinions. First, I get NO income from the sale of PRF systems, and never have in the past. Second, I did have an affiliation with Dr. Choukroun many years ago, but when he was dishonest about having both European CE and FDA clearances for Process for PRF, I decided to end that association. It was Dr. Dohan, and the original PRF researchers, that put Dr. Choukroun on the map, NOT the other way around. So why wouldn't I decide to work with the researchers who actually created this protocol? If you find the results of this research so objectionable, why don't you author an open letter to these doctors accusing them of intellectual dishonesty? I actually find your response to be highly objectionable and offensive. Let the clinicians reading this post log onto the POSEIDO website,and peruse ALL of the papers being published, not just on PRF. I believe they will find them to be highly enlightening, well written, erudite, and great contributions to the body of knowledge in our profession. And, while the L-PRF protocol preceded A-PRF, it is obvious that the "older" protocol clearly outperforms the poorly conceived and inadequately researched new one. RJM
Cliff Lechman
5/10/2015
You should follow the rules of holes, when you in one, stop digging....
Robert J. Miller
5/11/2015
Dr Scheiter; You are correct when you make the statement that the use of growth factors gives superior results over cold surgical steel alone. But you made the statement previously that "I’ve tried PRGF, L- and A-prf and CGF over the years. They all work clinically. But with varying levels of success in different patient groups." Isn't that the point; that all formulations do not have the same efficacy? When an individual claims to have developed a superior, or in this case an "Advanced" formula for a biologic, do we not have the right to challenge that assertion? And those challenges, unlike the rollout of this product that was devoid of literature and research, should be based on science, not emotion. Here we have, arguably, the finest researchers in PRF in the world publishing a bona fide challenge to the marketing hype for A-PRF and what do we get in return? Derision, claims of academic dishonesty, and excoriation because of a claimed alliance with a corporate entity. I challenge the users of A-PRF to demonstrate that the papers from POSEIDO are inaccurate, that the authors were tainted by fiduciary gain, or that they have a vendetta against an indivdual who is bringing a new product to market. Clinical observation is wholly subjective and, in a court of law, would have no credence. Only cold, hard science in the light of day will be the true arbiter of clinical efficacy. Go to the POSEIDO website, read the papers, and make your decision based on histology and biochemistry. Then we can debate PRF on it's merits, not on emotion. RJM
Joseph CHOUKROUN
5/11/2015
Just to tell you how they try to put the customers in trouble. (Poseido, Intra-Lock and all the band) They want to show about CD34.. This is bla-bla-bla.. The last consensus about Mesenchymal stem cells from the ISCT: International Society for Cell Therapy : MSC require to be positive to CD105, CD73, CD90. But they have to be negative to CD34 & CD45. In addition, these cells need to have several other characteristics, as adherence to plastic and multilineage differenciation capacity. If they want to go in the science, they are welcome. The problem is they can go only on marketing. sorry for them.
Robert J Miller
5/11/2015
Typical slight of hand. What does this have to do with A-PRF Joseph? Please respond directly to the research as published by POSEIDO. RJM

Featured Products

OsteoGen Bone Grafting Plug
Combines bone graft with a collagen plug to yield the easiest and most affordable way to clinically deliver bone graft for socket preservation.
CevOss Bovine Bone Graft
Make the switch to a better xenograft! High volume of interconnected pores promotes new bone. Substantially equivalent to BioOss and NuOss.