Step by Step guide in preparation of "PRF".

How is "PRF" prepared?

by Abhishek Mogre DMD, Board Certified Oral and Maxillofacial Surgeon

"PRF" or Platelet rich fibrin is used in Oral Surgery for assisting in mucosal healing and faster angiogenesis and maturation of bone grafts. It is also used in third molar surgeries or "Wisdom Tooth" surgeries to reduce post surgical pain, and reduce the dependance on post surgical narcotic medications. 

Following steps are involved in the preparation of PRF.

• Collection of Venous "Autologous" (patient's own blood): In the picture below, Dr Abhishek Mogre is seen collecting patients own blood in a test tube (without any anticoagulant) using a 21g Vacutainer. The crucial step here is locate an appropriate peripheral vein, and the amount of blood required for the particular surgery has to be collected in less than 2 minutes. If the blood collection time increases, it will affect the quality of the PRF that is generated. 

• Transporting the collected blood and running the Centrifuge: As explained in the previous step, the tubes with collected blood have to placed in the centrifuge within 2 minutes of the start of the blood draw, and the centrifuge has to be run in a very specific setting. Dr Abhishek Mogre has chosen to use the original "Dr Choukran" concept and his centrifuge setting to generate the optimum quality of PRF product. It is very important to understand that the final product will vary if the centrifuge protocol is not followed. See the picture below of the centrifuge used by Dr Mogre in Shoreline Oral Facial Surgery & Dental Implants office.

• Opening the caps of the test tubes and allow the PRF to self coagulate: Once the centrifuge has completed its appropriate cycle, remove the tubes, open the caps and let them stand in the test tube holder until the final product of PRF coagulates or "clots". It is important to understand that we are allowing "Physiologic" clotting process without any additives while preparing the PRF. The time for this step could vary between 5-15minutes. 

• Remove the 'PRF" from the test tube and place it in the PRF container for compression: The PRF is the middle layer in the test tube, and is gel like in consistency. It is carefully removed from the tube and placed in a PRF container and then compressed into flat membranes. During this process, the exudate rich in Fibronectin, Vitronectin, Stem cells and growth factors is collected in the bottom of the container. This exudate is used to hydrate any Allograft or "Cadaver Bone Graft" or Xenograft or "Bovine or Equine bone graft". See the pictures below, where Dr Mogre carefully removes the gel like PRF and then places in the container. The final product after compression looks like flat membranes.

• Using the Final compressed PRF for surgical use: The final PRF membranes can now be used for variety of oral surgery procedures. Commonly they can be mixed with the bone graft materials, used in extraction sites/lower third molar or wisdom teeth sites etc. In the picture below Dr Mogre is mixing the PRF membrane with the bone graft material to improve the success of the grafted site.