Dentaltown January 2021 - 57

Fig. 4a

Fig. 4b

Fig. 4c

Fig. 4d

Creating and using platelet-rich
fibrin membrane
On the day of surgery, I always start by drawing
blood and spinning it down to create a platelet-rich fibrin
membrane (PRFM). We often spend a lot of money on
biological products from bone to membranes, but for less
than $2 per case and 3 minutes of extra chair time, you
can create a valuable adjunct to your armamentarium.
The most obvious benefits are as follows:
1. A pliable membrane with almost 20 times the
concentration of platelets that release growth
factors, compared to a natural clot for more than
10 days postsurgery.7
2. A viscous plasma is collected at the bottom of
the tray and can be used to hydrate your bone
graft particles, which makes them easier to
manipulate. This plasma is also rich in platelets
and subsequent growth factors.
3. A high concentration of fibrin, which serves
as a matrix to keep these growth factors in the
surgical site for a longer period of time to enact
their effect.
Doing this in the beginning saves time, because
the tubes can spin in their cycle-spin settings will
depend on your particular brand of centrifuge and the
desired type of membrane-and sit for a few hours in
stable form while you perform surgery (Figs. 4a-4d).
Different states have different regulations regarding
phlebotomy: Some require a special phlebotomy permit,
while in others, being a licensed provider (with training)
is enough. I would recommend taking a PRF course that
teaches drawing blood hands-on, as well as the different
spin protocols that have been developed.
These protocols should not be thought of solely
in terms of " spin speed. " The speed is the setting, but
depending on the design of the centrifuge (radius of the
rotor and angle of the tubes slots), the speed correlates to
a centrifugal force-g-that is produced. That g-force
on the blood in the tubes is what causes the separation
of the red blood cells from the plasma that will include
platelets, leukocytes and fibrin.7
In the early 2000s, higher-speed protocols produced
g forces in the range of 700-800g. Newer slow-spin
recommendations allow for a spectrum of different
platelet products to be produced. Choukroun's low-spin
protocol of 700 rpms creates only 60g of force and
allows us to create what has been termed " injectable

In cases of trauma
or infection on
the affected site,
it is paramount
to compare the
level of the buccal
plate to that of
the neighboring
teeth, because
there often can be
some bone loss.
dentaltown.com \\ JANUARY 2021

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Dentaltown January 2021

Table of Contents for the Digital Edition of Dentaltown January 2021

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