How Different is the Choukroun PRF (platelet rich fibrin) Kit from the Conventional Centrifuge?

I hope you get some good answers . I am awaiting a centrifuge off ebay (nightmare but that is a different story) . It does nearly 4000 rpm , a little more than recommended 2700 . but how much does it matter ? I have read other comments from people who have used such centrifuges apparently successful , but let us see if you get a specific response of the precise importance of centrifuge . Meantime , when mine comes , I shall spin happily away at 4000 rpm .. The concept sounds great provided you can get the blood , fingers crossed Dave

There still seems to be alot of confusion about the preferred protocol for L-PRF. First, PRF is NOT a centrifuge, but rather a system. It consists of a centrifuge and a PRF fabrication box that allows you to fabricate both PRF plugs and membranes. Joseph Choukroun and his researchers spent 10 years researching the ideal parameters for the centrifuge itself. Gross deviations from these parameters (i.e. 4000 RPM) will significantly degrade the fibrin mesh and cells within it. The centrifuge should allow you to spin at the correct RPM, gforce, time AND angle of the tube for correct rouleaux formation. Once the components have been separated out, with intact platelets properly trapped within the fibrin layer, the PRF Box is used to properly compress the fibrin to enhance the handling characteristics. Take the Intra-Lock course for a proper understanding of the protocol and the use accross a wide spectrum of procedures. RJM

Thanks for the clear cut advice , sounds like intralock is the way to go . Can you give any examples of when and how you use the system , Dave

I have a complete Harvest Technologies System with all components available to interested parties.

You can log onto the Intra-Lock website and view the PRF video. This will demonstrate many of the applications of PRF in oral implantology, periodontics, and oral surgery. Also, the Harvest centrifuge is a dual spin machine that is really not appropriate for PRF fabrication. RJM

Thanks alot Dr Miller to clarify my doubts about L PRF . The webinar at Intralock explains it all.I couldnt find any Handson course at the website .Any information? I am in California. ND

I have been doing PRP and PRF for over 10 years. I helped teach the technique with Dr. Jim Rutkowski and Dr. Jim Fennell at the AAID Bone Grafting Course. They teach a specific PRP-PRF course. You can check it out on the AAID website. With the technique, I get the complete kit of components and centrifuge from Salvin Dental. The total cost of setup is about $1500, and the per use price of supplies is about $8. It is very cost effective. I use the PRP for every surgery I do, and the PRF is my main membrane. Both are leukocyte-rich, which is what you want. The healing you get with using this is significant. The membrane is made using a specific type of hemostat called a Rutkowski Squisher from Tatum Dental. If you would like to know more about the technique, you can contact me at 440-655-6512. I am a great proponent of it, and Dr. Rutkowski has done extensive research on the technique. The great thing about it is that it is very effective, it is well researched, it is easy to do, and it is VERY inexpensive.

For not much more than the instuments you quote, you can get the real thing from Intra-Lock. It seems that every company with a centrifuge and ancillary instrumentation is selling a "PRF" kit. There is only one researched system on the market and, to get the most ideal results, I recommend using it. The PRF box not only fabricates membranes, it also fabricates PRF plugs for filling extraction sites (can't do that with the Rutkowski squisher), and collects the plasma in a bottom well that is used to hydrate graft materials. Check the Intra-Lock website periodically to find upcoming PRF workshops. But start with the video portal that explains the basic theory for PRF vs PRGF/PRP. RJM

I would like toknow how long can centrifuge blood stay in the vacutainer before it should be used at surgical site so GF are potent(L PRF) .Initially i have to get a phlebotomist to draw blood till i am well versed with the technique.Is it possible to draw 2-3 same day surgical pts blood before procedure? And also any suggestions to learn blood draw easier&efficient....Thanks

You can leave the unopened tubes for up to a couple of hours before use. After the membrane/plug is fabricated, you can leave it in plasma for another hour. Just don't let it dessicate in the box prior to use. RJM

I was using prf just switched to cgf from silfredent. Handles better and has no thrombin additives. It's supposed to have more growth factors however I've seen no studies to back that up.

PRF has no thrombin additives either. Choukroun's kit controls some parameters such as spin angle, rpm and time, but does not control many other parameters such as patient serum chemistry, environmental temperature, etc. If you buy a variable speed centrifuge on ebay that will spin your vacutainer tubes at 3k rpm for 12 minutes and then create membranes using autoclavable, stainless steel screens (also available on ebay), you will find excellent regenerative results. Total cost for the system = $300. Sorry, the mark-up on Choukroun's system is excessive.

Who was it that said there is nothing in life that someone cannot make cheaper or faster? There is a reason why the PRF Box was designed in its current form. Let's review this one last time. The PRF Box fabricates BOTH membranes and plugs. It collects the plasma in the bottom tray for use in hydrating graft materials (rather than using saline). It has a weighted cover than connects to a column on the compression plate to deliver a specific force to the fibrin plug, giving your membrane a consistent thickness and better handling characteristics. No other instrumentation can fulfill all of these parameters. Outside the US, you must buy the system from Process for PRF, admittedly at a premium. Or you save a considerable amount in the US by purchasing the centrifuge, box, and instrumentation from Intra-Lock. While there are clinicians who will purchase instrumentation solely on price, I believe clinicians who demand exceptional performance will desire the features that the PRF system has to offer. RJM

I would normally agree, just not at the 1167% premium that the Choukroun kit costs. One can obtain what the Choukroun kit offers for a tiny fraction of the price. That will, no doubt, trickle down to patient savings that will likely allow patients that normally would not be able to afford this treatment actually have it performed. I've used both systems, and can say with certainty that there is no clinically significant difference between the versions.

The equipment you describe is not a "system". It is purely a collection of odd instruments where you get a "PRF like" material. The real PRF system is a centrifuge, fabrication box, AND instrumentation to securely deliver both membranes and plugs. When you add up the cost of ALL of the components that you get with the PRF system, you will find that there is not that much of a savings with equipment bought separately. One more important aspect, Intra-Lock offers a full workshop that covers the entire range of surgical procedures, both in and out of the discipline of oral implantology. As I said previously, serious clinicians will appreciate both the full range of the system and the training they receive to be able to utilize this technology to full advantage. RJM

Regardless of the carefully worded marketing hype, both versions produce the same clinical result and are simple enough for an assistant to perform with many free videos on the internet demonstrating the protocol. Last I saw, the Choukroun version was about $3500 while the ebay "collection of odd instrument" (that are more than acceptable) are about $300. In making the decision, clinician's should also verify that posters promoting a specific product or technique are unbiased. Most self-serving posters will disclose their relationship with the company they are promoting. Unfortunately this is not always the case.

Looked on eBay for the instruments you claim to exist. Want to give us a clue as to what you are referencing. What instruments are included for the cost you claim? Can you fabricate BOTH plugs and membranes? Who will warrant these instuments? Who will demonstrate the wide spectrum of uses? Are you suggesting that we simply go to youTube for our dental training? Why even get a degree if all we have to do is buy surgical instruments on the internet and then watch a single video for training? Did you do the histology of the fibrin you obtain with your instrumentation? Empirical results don't necessarily translate to biological efficacy. I'll finish with the proverbial latin axiom "Caveat Emptor" RJM

Caveat Emptor? Well said. Quite applicable to $3500 for a centrifuge, a steel box and a video. Still waiting for the disclosure of your relationship with Intralock.

I have answered this question several times on Osseonews, but it's obvious you have not read any of my previous postings, so, one more time. I do not own stock, nor have I invested in ANY implant company in 30 years. I have, however, served as a beta tester or clinical researcher for a dozen implant companies over that time, Intra-Lock included. Now, let's get back to the issues at hand. You sound a little like Jerry Niznick with your failure to answer the questions posed. We make a valid argument to purchase a system that has been clinically researched and tested, then you make the argument that a piece of mesh you buy on Ebay is equivalent? Why not post a link to your email or website so that we can find out who YOU are? When you purchase a PRF system, you will have access to a complete PRF workshop where the faculty, including me, will teach PRF applications in each of the specialties. With regard to price; $15,000 for Harvest PRP, $7000 for BTI PRGF, and $3500 for PRF? I plead nolo contendre. No wonder why our workshops are sold out in every venue where we present. Now that I have answered your questions, we are all waiting for your answer to ours. Where is this equipment you claim to be equivalent? Yes...Caveat Emptor. RJM

Gerry Niznick is a friend of mine and makes excellent implants. I have seen several of your other posts but haven't read them in detail as your lack of humility made me question the validity of the self-serving content. The issue at hand is that with a common lab centrifuge, common plain vacutainers, a "squisher" (or common sense), a reasonably prudent surgeon can fabricate a membrane with clinical results identical to what you tout. Any unbiased, experienced clinician that has tried both versions will say the same. I'll let you have the last post as I believe all the readers at this point have enough information to make an informed decision on their own which was my only purpose here.

Lack of humility for Dr. Miller? That's comical. I think you may have confused Dr. Miller with Dr. Niznick. Anyway, this is mostly a silly debate you have started with Dr. Miller. Some people love to go on Ebay and purchase what they need. I even know people who put together their own computers with parts bought on ebay. Other people don't have the time or inclination to go ebay shopping, so they go to a company, like Dell, and buy their computer at what amounts to a much higher price than they could purchase the computer parts on their own. So if others who are reading your posts decide that it's best to go on Ebay to put together their PRF kit, all glory to them. Others (and I suspect that represents the vast majority) will purchase the instruments needed from reputable companies that can provide some sort of training, education, and support. Of course, they will pay more than those, like you, who decide to use ebay to put together a PRF kit, but that's to be expected, as the price for anything you buy is not simply a function of the cost of the item.

The key to getting consistent prf clots is NOT the rpm since all centrifuges are not all the same specs, but the most important thing (excluding rotor angle) is that whatever variable speed centrifuge that you buy is spinning the serum at 400g. On the centrifuge that I purchased off of eBay for less than 300 dollars I contacted that centrifuge company and determined that 400g corresponds to 1800 rpm for that particular centrifuge. This information is available in multiple journal articles which also includes simply using wet sterile gauze to form the membranes, and using a pipette to wet your bone graft material once the clot has set in the metal dish for a few minutes. So I also disagree that you must purchase the 3500 dollar kit to get consistent prf clots, but if you want to save some time and feel you need the support than do so.

Great post Fred. You hit the nail on the head, this is simply about preferences for time savings and support needs. Those two factors determine which direction someone will choose to go in. How much is your time worth? How much support and education do you want or need? Incidentally, the first comment on this board described his centrifuge purchase on ebay as a "nightmare". One has to be prepared for the potential of that kind of stress and time drain, if you go the do-it-yourself route.

Ok. Let's forget protocols and everyone can begin to make his own clot... But if we want to have reproducible results based on solid research, we have to follow the protocol of each technique, which in this case is PRGF. Otherwise, don't name the end result with the brand name . "clot" is enough with which characteristics? Ask your research team or the judge.

Surfit Where on Ebay can I find the plates to squish the fibrin? Or what is it called? Thanks I love Ebay and have saved 10's of thousands of dollars using the source.

To all that think that the gadgets are overpriced, I say amen. There is no rhyme or reason to make a secret of the PRF, A-PRF, etc. protocols, the specification of the centrifuges. Continuing education is a rip off when you can get many times the same if not better information from excellent books written by world renowned scientists, educators, etc for 200, 300 dollars. The whole industry ssucks. And why is the million dollar question. Dentistry is like a craft with many craft magazines and classes to teach us how to make a different mouse by using different glue. I am yet to see that kind of behavior in medicine and I keep looking . No wonder we have the reputation in the medical community we have. We get out of dental schools and right away we engage in what some call surgery. If we don't take a better look at ourselves who will? We are already in shopping centers, shopping malls. Perhaps tomorrow will share space with hair stylists?