PRF (Platelet-Rich Fibrin) is a 100% autologous biomaterial produced by centrifuging the patient's own blood without chemical additives. The result is a three-dimensional fibrin network with a high concentration of platelets, white blood cells and growth factors. The network releases those growth factors gradually over roughly 10–14 days, and it is used in dental practice to support healing in extraction, implant surgery, bone augmentation and soft tissue surgery.
What is PRF (Platelet-Rich Fibrin)?
PRF stands for Platelet-Rich Fibrin. The material is obtained directly from the patient's own blood and is therefore fully autologous. Blood is drawn by ordinary venipuncture into tubes without anticoagulant and centrifuged immediately afterwards. Because the blood is allowed to clot naturally during centrifugation, a coherent fibrin network forms rather than a liquid that has to be activated chemically.
This fibrin network acts as a biological scaffold. It holds a high concentration of platelets and white blood cells, and it binds the growth factors the platelets release — among them PDGF, TGF-β and VEGF. The network protects those growth factors against rapid degradation, so they are released gradually over roughly 10–14 days instead of within a few hours.
A second-generation platelet concentrate. PRF is described in the literature as a second-generation platelet concentrate. The first-generation products (PRP) required anticoagulants and activators; PRF is prepared without either. The classification of the different concentrates was formalised by Dohan Ehrenfest and colleagues, who among other things introduced the term L-PRF (leucocyte- and platelet-rich fibrin).1
PRF vs. PRP — what is the difference?
The question we meet most often is how PRF differs from PRP (Platelet-Rich Plasma). Both make use of the patient's own blood, but the preparation and the properties differ:
- No chemical additives. PRP requires anticoagulants to prevent clotting during handling, and usually an activator afterwards. PRF is centrifuged without either.
- A solid fibrin network rather than a liquid. Because coagulation is allowed to run its natural course, a coherent fibrin matrix forms that can be pressed into membranes, trimmed and sutured. PRP is liquid to begin with.
- Slower release of growth factors. The fibrin network acts as a reservoir. Where PRP releases its contents quickly, PRF supports the healing process over a longer period.
- White blood cell content. L-PRF contains leucocytes, which are credited with a role in both tissue healing and the defence against infection.1
Which types of PRF are there?
In practice you typically work with three forms, produced with different centrifugation protocols and tube types:
- Solid PRF (membrane)
- Centrifuged in glass tubes with no additive. The clot is pressed in a PRF box into a thin, uniform membrane that can be laid over a defect or used as a barrier.
- Liquid PRF (i-PRF)
- A shorter spin in plastic tubes gives an injectable liquid that can be used on its own or mixed with bone substitute material.
- Sticky bone
- Liquid PRF mixed with granules. The fibrin binds the particles into a mouldable, coherent mass that is easier to place and keep in position in the defect.
What is PRF used for in dental practice?
The range of applications is broad. A systematic review of randomised clinical trials on PRF in dentistry grouped the literature into exactly the indications that are also the most widespread in Danish practice:2
- Socket preservation. Preserving bone volume after an extraction.
- Bone augmentation and implantology. Supporting healing in sinus lift and GBR, often combined with bone substitute material as sticky bone.
- Soft tissue surgery. Covering exposed root surfaces, treating recessions and healing donor sites.
- Periodontal defects. As an adjunct in the regenerative treatment of intrabony defects and furcations.
A practical advantage in daily work. Because the material is autologous there is no cost for the biomaterial itself beyond the consumables, and no questions around donor material. In return it requires the clinic to be able to perform venipuncture as a matter of routine — see the section on training.
What equipment does PRF require?
A complete PRF setup is manageable. It consists of a centrifuge, the right tubes, blood collection equipment and instruments for handling the clots.
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PRF Centrifuge BP 200
Horizontal swing-out centrifuge developed specifically for PRF. The heart of the setup.
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Glass tubes for PRF membranes
10 ml vacuum glass tubes without anticoagulant — for solid PRF and membranes.
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PRF instrument set
Dedicated instruments for handling and preparing clots and membranes.
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Training and courses
Two things have to be in place before PRF can become a routine part of the clinic: the staff must be able to draw blood safely and confidently, and the clinician must know the protocols for the different PRF types.
Blood collection courses. Three to five times a year we run dedicated blood collection courses for clinic staff. The courses combine theory and a walkthrough of the equipment with supervised practical exercises among the participants, so that dentists, dental hygienists and dental assistants alike gain the routine to carry out the procedure in a busy working day.
PRF courses. Through PRF-Academy we run hands-on courses and masterclasses on an ongoing basis, among others in collaboration with Dr. Richard Miron, one of the most cited researchers in the field, and with international teachers such as Professor Marc Quirynen.
See upcoming PRF courses, masterclasses and blood collection coursesFrequently asked questions about PRF
What is the difference between PRF and PRP?
PRP is prepared with anticoagulants and usually requires an activator, and the product is liquid with a rapid release of growth factors. PRF is prepared without additives, forms a solid fibrin network and releases the growth factors gradually over roughly 10-14 days.
How long does it take to prepare PRF in the clinic?
The centrifugation itself typically takes between 5 and 12 minutes depending on the protocol and which type of PRF is being prepared. On top of that come the blood draw and the processing of the clots. In practice the blood draw is scheduled so that the centrifugation runs in parallel with preparing the patient.
Does PRF require special training?
There is no formal certification requirement for using PRF in Denmark, but the clinic must be able to perform venipuncture safely. We recommend a blood collection course for the staff who will carry out the procedure, plus a protocol course for the clinician.
What is sticky bone?
Sticky bone is liquid PRF mixed with bone granules. The fibrin binds the particles into a mouldable, coherent mass that is considerably easier to place in a defect and keep in position than loose granules.
What equipment is needed as a minimum?
As a minimum: a centrifuge intended for PRF, tubes of the right type for the PRF form you want, a blood collection set, plus instruments and a PRF box for pressing membranes. See PRF equipment for the full range.
References
- Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends in Biotechnology. 2009;27(3):158–167. PubMed
- Miron RJ, Zucchelli G, Pikos MA, et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clinical Oral Investigations. 2017;21(6):1913–1927. PubMed
- Dohan DM, Choukroun J, Diss A, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2006;101(3):e37–e44. ScienceDirect
- Miron RJ (ed.). Understanding Platelet-Rich Fibrin. Quintessence Publishing. See the book at Puredent
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