CGF versus A-PRF?

cgfI have been using Platelet Rich Fibrin (PRF) for a few years. Better platelet preparations are now available to use and so I have decided to use either Concentrated Growth Factor (CGF) from Silfradent or A-PRF from Choukroun. One advantage is that these make the bone graft sticky and provide better handling properties and easier adaptability to the surgical site, to better maintain the desired position of the graft. However, these advantages appear to be offered by both systems, so I’m not sure which one to buy. Which of these products do you recommend and why? Points of comparison are ease-of-use, better handling, running costs, use of any additive to make graft sticky etc.

15 Comments on CGF versus A-PRF?

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greg steiner
9/28/2015
The growth factors in these preparations are soft tissue growth factors and have been shown to interfere with bone formation. These preparations have been shown to not provide any better results in extraction sockets than no graft when evaluating bone formation and ridge width maintenance. In animal studies it has been shown that if you remove the growth factors from PRF and just use fibrin you get a better result that you do with PRF. Greg Steiner Steiner Biotechnology
Cliff Leachman
9/29/2015
Greg I agree it interferes with bone formation, it causes it bone and soft tissue to form! I guess if you put it in with your elbow and let crap get in there it will be equal to nothing, but you have to be near incompetent to get those kind of results? I've used, L-PRF, CGF, A-PRF and finally A-PRF+ and they all seem to be an improvement over the latter. Did an A-PRF+ and extraction less than an hour ago on a lateral incisor, part of everyday practice and would not want to practice without it.Saves much dineros on biomaterials, especially collagen membranes for extraction socket preservation. Must have for every implant practice!
Michael Shnayder
5/9/2016
Cliff, sounds like you have been using these for a long time. Are you not using bone graft with the A PRF or are you just not using the membrane when doing socket preservation? Thanks for your input. I have just purchased Dr. Choukroun's machine and waiting for it to be shipped.
Cliff Leachman
5/9/2016
Hi Michael, it really depends on the defect, size of the defect and where the defect is and whqt I'm doing. Still use collagen membranes to prevent down growth of tissue, just no longer in most socket preservations. Use to charge almost $800 in materials, now $200 for A-PRF+. Sometimes in Socket preservations I use cortico-cancellous Raptos, CaSO4 and more recently Osteogen. I find in the maxilla if there is a large oral-antral communication a plug of Osteogen helps me sleep that night. I soak it in i-PRF+ and then place it while the A-PRF+ is still spinning. I have 2 centrifuges, too lazy to leave the line in and clear it! I'm also too clumsy, might bump the patient as well. Over that I place plugs and or membranes of A-PRF+. Patients love it and the price of socket preservation has greatly decreased in my office because if it. Sometimes all I place are plugs of A-PRF+. Each case is different and sometimes I just do it for free, to avoid complications, especially if the patient can't afford additional charges. Last patient an emergency on Friday at 4:30 with a raging infection, came by earlier in the day for meds. Had a slight headache on Saturday, pretty much normal today, Huge cyst attached to palatal root! She can't believe how much pain she was in before and how quickly it healed especially such a polluted site. If you want pics dr.leachman@mac.com or my website Cheers CLIFF
choukroun joseph
9/29/2015
Greg Steiner is always prompt to show his lack of science or knowledge... We are in use.. CGF is a pure copy of PRF.. Do not change the system please! You can produce all the différents products present in the market with your machine... from A-PRF to i-PRF etc...
Don Rothenberg
9/29/2015
We have been using Choukroun PRF for almost 2 years now with wonderful results. The system is a superior product, backed up by good, honest science. I would highly recommend this system to anyone of my colleagues. It has changed the way we practice!
Ruumi Daruwalla
9/29/2015
I have been in implant business since 1989 and in the journey seen a lot. PRF from Choukroun is the "real" game-changer as it gives new potential to implantology that didn't exist. For example, one can hydrate the implant before placement with the exudate collected when pressing the PRF membrane. This gives the implant surface growth factors and clinically it is being seen that osseointegration improves. The PRF membrane is used for soft-tissue closure and faster healing. The above technique can be used in every day implantology in each and every case to give a better outcome than what is being done today. What is the cost? Just the A-PRF tubes. With I-PRF, it is again a game-changer in the way one handles bone materials as one can get sticky bone that allows easier handling. Let me inform one and all that we have more than 50 active users in India and all of them swear by Choukroun's PRF technology. I have evaluated both Choukroun's PRF and Silfradent's CGF and whatever, and chose Choukroun's for the following reasons: 1. With Choukroun's technique, with just one centrifuge, one can achieve both PRF (with A-PRF tubes) and stick bone (with I-PRF tubes). Whereas with Silfradent, one has to buy 2 machines. One is a centrifuge and the other is a binder which I have failed to understand how it works. The cost, needless to say, is at least 3x or 4x more than Choukrouns. 2. With Choukroun, you are working with the inventor of the system. He is a walking-talking thinker and in the past 2 years has continually researched to bring huge developments and I can only see more developments and refinements coming in the future. However with each refinement, there is no need to change your centrifuge. You continue to use your initial investment. 3. Choukroun has rightly understood that viable cells have to be preserved and not destroyed during the entire process of harvesting and generating a membrane. Therefore the new modalities he has recently introduced of A-PRF and I-PRF take into account less time, less RPM and a smooth rotation to preserve maximum viable cells. This gives the key advantage and difference between Choukroun, Silfradent and others. 4. There are many new applications and techniques that are being found by some of our users and which are promising but I won't mention them here as they are not validated. But I can tell you they are very promising. Hope this explanation helps.
Dr.Dr.Hossam Barghash
9/30/2015
back to science of molecule biology of healing,the first stage is angiogenesis, the growth factors (PDGF) is main player, so I wounder how to say that growth factors are interfering with bone formation, or to put fibrin without growth factors,which will then act by entrapping the growth factors, may I ask Greg, what are the growth factors that interfere with bone healing and should be removed
greg steiner
9/30/2015
Everyone here talks about how great these material are but no one is listing clinical studies that establish clinical effectiveness. I have read everyone one of the clinical studies on PRF and the clear conclusion is that there is no benefit for bone regeneration. I was on stage with Dr. Choukroun and I listed the studies that show that PRF is of no use in bone regeneration and his response was that he does not pay any attention to clinical studies. If I was promoting PRF I would not pay any attention to clinical studies either. Greg Steiner Steiner Biotechnology
Cliff Leachman
9/30/2015
OBVIOUSLY Greg you have something to sell and it is not PRF, look them up yourself, there are so many, go to my website, go to Process for PRF, go to the library, there are hundreds. The Flat Earth society is looking for a new president, you might give them a call.
Don Rothenberg
10/6/2015
The fact is that we do clinical dentistry. I leave the research to doctors like Choukroun and others, who do wonderous research. All I can say is what I have seen with my own eyes in my own patients over a period of almost 2 years now. With PRF we are able to regenerate bone as we have never been able to in all the time I've been involved with dental implants which is been since 1986. It is beyond a doubt something that works and predictably works every time we use it. There is no argument here...there is only clinical findings in our patients which we see every day. I would welcome any of my colleagues to visit me in my office and we can show you what we do and show you our findings on a predictable basis. I am not only grateful for this but my patients are grateful... what used to take a 6 to 12 months to regenerate bone of a poor quality, now takes us 3 to 4 months to get bone of a very good quality every single time we use PRF. We should all stop arguing and work together to help our patients improve their lives!
Frankin D Niver
10/8/2015
I have been practicing as a periodontist for 46 plus years and have been placing implants for the past 28 years. I started using Dr. Choukroun's PRF six years ago and have evolved to the newer APRF and APRF+ protocols; I have now used it on several thousand paients with incredible success. As reported above by others, soft tissue healing is incredibly fast, socket repair is amazing with zero infections, and sinus bone grafts heal faster and more predictably. I cannot imagine doing any surgery without the use of this wonderful natural supplement and anxiously await Dr. Choukroun's next innovation.
Ramesh Bulbule,Dubai
10/15/2015
I have been a PRF user since 2008. Have recently switched to A-PRF/I-PRF. Would not practice without one of these. I have collected data on over 400 patients covering extractions, third molar extractions, socket preservations, implant placement, sinus augmentations. I have had zero percent complications in extractions including third molar extractions. I have been doing sinus augmentations with simultaneous implant placement with PRF as the sole grafting material with as little as 2mm of residual bone. I have had one failure out of 40 cases. I cannot be convinced about ineffectiveness of PRF.
Ruumi Daruwalla
1/11/2016
Well said Dr Ramesh!
Jawdoc
10/28/2015
Clinically PRF has been shown to work. In my practice, at least. Biomolecularly, osteoblasts have surface receptors for factors like PDGF & be activated, differentiated & aggregated by intracellular signaling pathways that involve Protein Kinase C. The science seems to back the clinical results.

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