I have heard about the benefits of using PRP [platelet rich plasma] and PRF [platelet rich fibrin] but I am not clear on exactly how these can improve the healing process of bone grafts and what the differences are between the two protocols. I understand there is some controversy of which stimulates osteogenesis and soft tissue growth. Which method is preferable? Can these be used with an alloplast?
Key Differences between PRP and PRF
Throughout the years, there have been several different techniques proposed for drawing a patient’s own blood to obtain beneficial platelet concentrates. The two more popular methods are known as platelet rich plasma (PRP) and platelet rich fibrin (PRF), which is the newer, and quite frankly, simpler, technique.
Without getting too technical, PRP is done by adding anticoagulant to the drawn blood and then spinning that in a centrifuge. After this initial spin, the material is aspirated and put in another tube without anticoagulant, and spun again in a centrifuge, which provides 3 layers of platelets. Finally, cPRP (concentrated platelet rich plasma), is obtained from the tube and mixed again with bovine thrombin and calcium chloride prior to application.
As opposed to PRP, PRF is extremely simple. There are no anticoagulants, no need for thrombin additives, and no need for a 2-spin centrifugation. The simple protocol for PRF is just this: “A blood sample is taken without anticoagulant in 10-ml tube which is immediately centrifuged.” 1 The interaction of the blood with the silica in the glass tubes starts a process of natural polymerization, and fibrin clot can be obtained in the middle of the tube following the spin. The success of the PRF process “entirely depends on the speed of blood collection and transfer to the centrifuge. Quick handling is the only way to obtain a clinically usable PRF clot.”2 There are different guidelines as to the spin cycle required for PRF creation, though recently new centrifuges have been developed with one-push buttons for specific spin cycles. Interestingly, because PRF is performed according to a completely natural process, without any modifiers, it is not considered a blood-derived product. It is in essence similar to any totally autologous material prepared extemporaneously, like a bone harvest (chin) or palatal connective tissue harvest.3 This fact alone has important implications for the choice of PRF over PRP, especially in dental settings.**References:** 1\. [Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution.](https://www.ncbi.nlm.nih.gov/pubmed/16504849/) Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar; 101(3):e37-44. 2\. Prakash S, Thakur A. [Platelet concentrates: Past, present and future.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177496/) J Maxillofac Oral Surg 2011;10:45-9. Back to cited text no. 3 3\. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. S[afety Issues Associated With Platelet-Rich Fibrin Method ](http://www.francescoinchingolo.it/media/OOOOE_Cytotoxicity.pdf)
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