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Differences and clinical applications of PRP, APRF, iPRF, CGF

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  1. Platelet-rich plasma (PRP)

PRP stands for Platelet-rich-plasma, and PRP refers to platelet factor-rich plasma, also commonly known as youth in fresh blood. Through the collection and centrifugation of one’s own blood, the upper supernatant, i.e. platelet-rich plasma, is obtained and injected into the human body to activate growth factors, thus achieving a comprehensive skin revitalization and anti-aging effect. This technology is currently used mainly in medical aesthetic hospitals in liquid form with a high degree of translucency.

PRP technology requires the least centrifuges, and the centrifuges currently available on the market for less than 2,000 yuan can also extract PRP. It should be noted that the blood collection tubes used in PRP technology are specially made blood collection tubes containing specific additives. This type of centrifuge is called a cosmetic centrifuge.

 

  1. Platelet-rich fibrin (PRF)

PRF stands for platelet-rich-fibrin, and was first introduced by Choukroun in 2000. Unlike PRP, PRF does not require anticoagulants or thrombin. Blood is collected in 10 mL tubes, no anticoagulant is added, and the blood is immediately centrifuged in a centrifuge. During centrifugation, platelets passively hit the tube wall so that stepwise coagulation is activated. Fibrin clots mixed with plasma and platelets collect in the middle of the tube. Some argue that PRF not only enables osteogenesis and wound healing as PRP does, but also functions as a mucosa. After extrusion of the fluid from the fibrin block, the autologous fibrin block appears to have some resistance to tensile shear, which would also allow it to be used in the oral environment to protect plants. Moreover, this should be attributed to the natural polymerization process of slow thrombin concentration, which allows the establishment of good and flexible fibrin network isofacial junctions. This allows it to support the migration of cells.PRF technology is currently divided into two main types according to clinical use: APRF and IPRF, the former in gel form and the latter in liquid form. Clinical differences and applications.

 

  • The clinical form of APRF is gel, which is rich in platelets, leukocytes, especially various growth factors and cytokines, which can promote the movement, proliferation, and differentiation of stem cells, promote new angiogenesis and bone collagen synthesis, and can greatly accelerate the growth of bone when placed in the dental implant site. The blood collection tube used is the same as that of CGF, but there are only differences in the centrifugation procedure. It is generally used clinically for mixing with bone powder.

 

  • The clinical form of IPRF is liquid, which is an injectable PRF extracted by changing the extraction process. It contains various growth factors, such as platelets, transforming growth factor, vascular endothelial growth factor and insulin-like growth factor, etc. Some studies have shown that it has the function of promoting new bone when it is mixed with artificial bone powder to present a jelly-like mixture, which is easy to plasticize and maintain the alveolar ridge.

 

PRF technology requires relatively little centrifuge, and doctors who know more about this technology can even extract PRF through a partial fixed-speed centrifuge, because its classification of APRF and CGF clinical morphology is more similar, both gel-like, often confused by doctors, the biggest difference is the depth of pulling the gel, APRF is easy to break, not suitable for pressing into a film, generally used to fill with bone powder mixture and extraction of site preservation. The centrifuge that can prepare PRF is generally marketed at 2000-5000 RMB, which is basically an ordinary fixed-speed centrifuge. At the same time, some brands of centrifuges do not distinguish between APRF and IPRF, there is only one option of PRF, which refers to the PRF is actually APRF.

 

 

  1. Concentrate-growth factor (CGF)

CGF stands for Concentrate-Growth-Factors and, like PRF, does not require the addition of bovine thrombin or any anticoagulant. CGF uses a variable speed of 2400-2700 rpm to separate cells from venous blood, resulting in larger, denser, growth factor-rich fibrin clots than even conventional PRF. It showed good regenerative properties and functionality. The quality of the fibrin clot was good due to the fibrinogen, XIII factor concentrate and the thrombin obtained. The thrombin-activated XIIIa factor, which is laterally attached to the fibrin clot, increases stability, strength and prevents the mediated degradation of hemofibrinolytic enzymes. For clinical purposes, the clot after this conversion has high tensile strength (1.5 kg vs. 500 gm after 1 hour), adhesive strength, and shortened hemostasis time (105 seconds vs. 360 seconds). In addition to stretchable fibrin membranes, the red portion of red blood cell concentrates and platelets are obtained. It is often mixed with autologous or other filling materials and used as an easy-to-use method for filling large cavity locations. Basically, CGF is an upgraded version of PRF with enhanced fibrin clots and growth factors and cytokines. Because of its good stretchability, it is used clinically to create CGF films to cover wounds. CGF technology can be used for implant, periodontal, maxillofacial and apical procedures such as GBR, maxillary sinus lift, peri-implantitis, immediate implant placement, rapid post-extraction regeneration, site-preservation, aesthetic zone implants, superior frontal sinus membrane repair, resorptive osteochondral replacement, etc. It is currently the most widely used procedure in dental clinics.

 

CGF technology requires the highest centrifuges, which must be variable speed centrifuges. The most essential difference between CGF and PRF is the strength, the better the variable speed centrifuges, the higher the CGF content (CGF gel content as a percentage of the total volume in the blood collection tube) and the better the stretchability, the higher the content means that the CGF content is sufficient and the patient can obtain more CGF concentrated growth factor in one blood draw. At the same time, high stretchability means good CGF quality, good toughness, and better clinical coverage of the wound.

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