Platelet-Rich Fibrin and Platelet-Rich Plasma (PRF/PRP)
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Direct answer
Spin a tube of the patient's own blood and you can harvest a concentrate of platelets and their growth factors for the surgical wound. Platelet-rich plasma (PRP) is the first-generation liquid product: blood with anticoagulant, centrifuged, then activated with thrombin or calcium chloride at the chairside. Platelet-rich fibrin (PRF), developed by Choukroun in 2001, is the second-generation version — blood spun in a plain tube without anticoagulant, so a fibrin clot forms that traps platelets and leucocytes and releases PDGF, TGF-beta, VEGF and related factors slowly over days to weeks. In oral surgery both serve as adjuncts — socket preservation, graft stabilisation, membrane sealing, sinus perforation cover — not as bone substitutes in their own right.
What you must remember
- Preparation of PRF: about 8-10 mL of blood drawn without anticoagulant and centrifuged immediately at roughly 400 g (commonly quoted as 2700-3000 rpm) for 10-12 minutes; the middle layer between the red cell base and plasma yields a fibrin clot that is compressed into a membrane.
- PRP versus PRF in one line: PRP needs anticoagulant (citrate) and bovine or autologous thrombin activation and remains liquid; PRF needs neither and sets into a resilient fibrin matrix with sustained growth factor release.
- Growth factor cargo: PDGF, TGF-beta1, VEGF, EGF and IGF — attracting cells, driving angiogenesis and matrix deposition; the fibrin scaffold also carries leucocytes (hence L-PRF), adding an antibacterial component.
- Variants: injectable PRF (i-PRF) spun at lower speed for a liquid rich in cells; A-PRF protocols at reduced centrifugation force to preserve more leucocytes and release factors longer.
- Established uses: extraction socket filling to reduce dry socket and support ridge preservation, stabilising particulate bone grafts, covering Schneiderian membrane perforations, sealing oroantral communications, and dressing after third molar surgery to reduce trismus and pain.
- Honest limits: PRF is an adjunct — it does not replace graft material in volumetric reconstruction, and clinical evidence across its uses varies from moderate (socket healing) to weak.
- Practical appeal: no disease transmission risk, no preparation cost beyond a centrifuge, and simple chairside handling — the reason it has become routine in Indian implant practice.
A worked extraction example
A 28-year-old returns for removal of a deeply carious mandibular second molar, having suffered a dry socket after a previous extraction that took three weeks and repeated dressings to settle. Before surgery, two 10 mL tubes are drawn while venepuncture is easy and the local anaesthetic is taking effect. The extraction proceeds atraumatically; the socket is curetted clean and irrigated with saline. By now the centrifuge has stopped: the fibrin clots are lifted free of the red cell base, and one clot is placed whole into the socket while a second is pressed into a membrane to overlay the wound edge before a figure-of-eight suture. The biology behind this: the fibrin matrix gives the clot mechanical stability so it is not lost, platelets release PDGF and VEGF over the first days, angiogenesis and epithelialisation accelerate, and the alveolus is less dependent on the fragile patient-formed clot that fails in alveolar osteitis. The same logic scales up — membrane strips laid over a perforated sinus membrane during a lift, or clots mixed with xenograft so particulate graft handles like a putty instead of scattering.
Where students slip
The classic error is reciting "PRF is better than PRP" without knowing why — the examiner wants the mechanism: no anticoagulant means natural, slow polymerisation into a tight fibrin network, which traps growth factors and leucocytes and releases them gradually, whereas thrombin-activated PRP sets fast into a brittle clot that dumps its factors within hours. The second slip is overclaiming — describing PRF as osteoinductive or as a bone graft substitute. It carries no osteoprogenitor cells or mineral scaffold; it is a healing adjunct that improves soft-tissue and early wound biology. Finally, remember the time factor: PRF must be centrifuged immediately after collection, because the clotting cascade starts in the tube the moment blood is drawn — a delayed spin gives a poor, fragmented clot, a practical detail that distinguishes a candidate who has actually worked with it.
Frequently asked questions
Who described PRF and in which year?
Joseph Choukroun in France, 2001, as a second-generation platelet concentrate requiring no anticoagulant or thrombin.
What is the standard centrifugation protocol for PRF?
Approximately 400 g for 10-12 minutes (commonly quoted as 2700-3000 rpm) from 8-10 mL of blood, spun immediately after venepuncture.
Which growth factors does PRF deliver?
PDGF, TGF-beta1, VEGF, EGF and IGF, released slowly from the fibrin matrix over one to two weeks, along with leucocytes in L-PRF protocols.
List three chairside uses of PRF membranes.
Extraction socket preservation, covering sinus membrane perforations or small oroantral communications, and stabilising or covering particulate bone grafts.
Is PRF a bone graft substitute?
No — it is an autologous healing adjunct without mineral scaffold or osteoprogenitor cells; it supports and enhances grafts rather than replacing them.