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Extending the working properties of liquid platelet-rich fibrin using chemically modified PET tubes and the Bio-Cool device

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Abstract

Objectives

Platelet-rich fibrin (PRF) has been utilized in regenerative medicine as a concentration of autologous platelets and growth factors that stimulates tissue regeneration. More recently, liquid-PRF (also called injectable-PRF; i-PRF) has been brought to market utilizing PET plastic tubes. Due to new advances made in tube technology, the first aim of the present study was to investigate the liquid consistency of liquid-PRF utilizing both standard and chemically modified PET plastic tubes. Furthermore, it is well known that the conversion of PRF into a fibrin matrix is derived from the temperature-controlled enzymatic process that converts liquid fibrinogen and thrombin to solid fibrin. This study also investigated for the first time the use of a cooling device (Bio-Cool) to extend the liquid working properties of liquid-PRF.

Materials and methods

In total, 30 participants enrolled in this study. From each patient, four tubes of liquid-PRF were drawn, two standard white Vacuette tubes and two blue chemically modified hydrophobic tubes. Following centrifugation at 700 RCF-max for 8 min in a Bio-PRF horizontal centrifuge, one white and one blue tube were kept upright at room temperature, while the other white and blue tube were placed within the cooling device. Thereafter, the liquid-PRF layers were monitored over time until clotting occurred. Patient gender, age, and altitude above sea level (+ 5000 ft) were recorded and compared for clotting times.

Results

The findings from the present study demonstrated that the chemically modified PET tubes performed 37% better than the control tubes (extended the working properties of liquid-PRF by over 20 min). Most surprisingly, tubes kept in the cooling device demonstrated an average of 90 min greater working time (270% improvement). While patients living at altitude did significantly improve the clotting ability of liquid-PRF, no differences were observed when comparing male vs female or younger vs older patients in liquid-PRF clotting times.

Conclusions

Cooling of blood following centrifugation represented a 270% improvement in working properties of liquid-PRF. Optimization of liquid-PRF tubes utilizing chemically modified hydrophobic PET tubes also delayed the clotting process by 37%. Patient gender and age had little relevance on liquid-PRF.

Clinical relevance

The present findings demonstrate for the first time that cooling of liquid-PRF is able to extend the working properties of liquid-PRF by over 90 min. Thus for clinicians performing longer clinical procedures, the cooling of blood may represent a viable strategy to improve the working time of liquid-PRF in clinical practice.

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Author information

Author notes

  1. Richard J. Miron and Nicholas A. Horrocks contributed equally to this work.

Authors and Affiliations

  1. Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland

    Richard J. Miron & Anton Sculean

  2. The Miron Research Lab, Fort Lauderdale, FL, USA

    Richard J. Miron, Nicholas A. Horrocks & Giles Horrocks

  3. Department of Oral Implantology, University of Wuhan, Wuhan, China

    Yufeng Zhang

  4. The Pikos Institute, Trinity, FL, USA

    Michael A. Pikos

Authors
  1. Richard J. Miron
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  2. Nicholas A. Horrocks
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  4. Giles Horrocks
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  5. Michael A. Pikos
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  6. Anton Sculean
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Corresponding author

Correspondence to Richard J. Miron.

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Ethics approval

No ethical approval was required for this study, as human samples were not identified.

Consent to participate

For this type of study, informed consent was provided prior to blood draw to conduct the outlined experiments.

Conflict of interest

Richard J Miron holds intellectual property on the production of PRF. All other authors declare that they have no conflict of interest.

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Miron, R.J., Horrocks, N.A., Zhang, Y. et al. Extending the working properties of liquid platelet-rich fibrin using chemically modified PET tubes and the Bio-Cool device. Clin Oral Invest 26, 2873–2878 (2022). https://doi.org/10.1007/s00784-021-04268-x

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  • DOI: https://doi.org/10.1007/s00784-021-04268-x

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