PRF CGF Sticky bone and AFG….oh my
Frios system by Dentsply Friadent
Great article by Sohn describing different types
PRP – platelet rich plasma (precursor PRF) Marx 1998 1st generation
PRGF – similar PRP – plasma rich in growth factors Anitua 2001
PRF – 2nd generation – platelet rich fibrin has many growth factors (PDGF, VEGF, TGF-β1, EGF, TSP-1, TGF-B [BMP]) (silica-coated vacutainer tubes w/o anticoagulant) spun at 2700prm for 12 minutes formation Kim 2013 Choukroun 2000. Can chop these membranes and add to bone grafts or make sticky bone with i-PRF as below.
CGF – concentrated growth factors – membrane or graft – little better than PRF, very similar just centrifuged differently Sacco 2006
CGF = Vacuette blood collection (20-60ml total) tubes x4 (silica-coated vacutainer tubes w/o anticoagulant) 9ml filled via vacuette butterfly blood collection set spun in Intraspin at variable 2400-2700rpm for 12 minutes (Medifuge another) and PRF transferred to Xpression Fabrication Kit. All Intra-Lock International products.
CGF is produced by processing blood samples with a special centrifuge device; three layers are formed: top acellular plasma (PPP), middle CGF and bottom red blood cells (RBC) layers.
Can be used to make “sticky bone” – CGF membrane and autologous fibrin glue (AFG) made same time Sticky bone article JIACD Sohn Dec 2015
- 20-60CC of patient’s venous blood
- Divided in one to two non-coated vacutainers (yellow cap) to obtain autologous fibrin glue (AFG) also known as autologous plasma, which will make sticky bone
- Two to seven glass coated test tubes (red cap) without anticoagulants to obtain CGF layer
- Centrifuged at 2400-2700 rpm (Medifuge, Silfradent srl, Sofia, Italy) with a rotor turning at alternated and controlled speed for 12 minutes
- AFG tube removed after 2 minute-centrifugation. The non-coated tube shows 2 different layers. The upper layer is AFG layer and red blood cell is collected in bottom layer which will be is discarded.
- AFG layer removed with syringe and mixed with bone or bone strips
- 5-10 minutes forms yellow sticky bone
- Vacant slot is filled with water filled test tube for weight balance
- Silica coated tube shows three different layers. Platelet poor plasma, fibrin buffy coat layer, and red blood cell layer
- Exudate from CGF membrane mixed with sticky bone and turns red
Our data show the presence of TGF-β1 and VEGF in CGF and RBC layers. In addition, we show CD34 positive cells in CGF. Rodella 2011
Which system should you get?
Choukroun has been around a long time and his system can be bought cheaper than most. Hitec sells the system for around $2,000. Miron has a nice book on the PRF topic.