Keywords
Platelet-Rich Fibrin
Centrifugation
Surgery, Oral
How to Cite
Abstract
Platelet concentrates (PCs) have been described since 1954 as a means to stimulate tissue healing and regeneration, and have been used in both medical and dental fields. The growing interest in their application led, in the early 2000s, to research focusing primarily on the elimination of anticoagulants in order to achieve natural coagulation, a crucial initial step in the wound healing process. This advancement resulted in the development of platelet-rich fibrin (PRF), in which solid fibrin clots are formed through a highly polymerized three-dimensional fibrin network after centrifugation, thereby reducing production time and cost. Despite these apparent advantages, continuous advances and modifications in preparation protocols have led to the development of several types of PRF, without the establishment of standardized guidelines for the fabrication of this biomaterial to date. Therefore, this literature review provides an overview of the evolution of PRF preparation protocols over the years and describes the fundamentals of centrifugation, including the role of relative centrifugal force (RCF), rotations per minute (RPM), tube angulation, and tube material. Conclusion: The evolution of PRF protocols has not only aimed to reduce production time and costs, but also to enhance their biological and regenerative properties. These efforts have resulted in higher concentrations of leukocytes and platelets by decreasing centrifugation time and relative centrifugal forces, and by using uncoated glass tubes without silica or antiaggregant agents, with a horizontal angulation.
References
1. Calciolari E, Dourou M, Akcali A, Donos N. Differences between first‐ and second‐generation autologous platelet concentrates. Periodontol 2000. febrero de 2025;97(1):52–73. doi:10.1111/prd.12550 PubMed PMID: 38487938; PubMed Central PMCID: PMC11808449.
2. Miron RJ, Fujioka-Kobayashi M, Sculean A, Zhang Y. Optimization of platelet-rich fibrin. Periodontology 2000. 2024;94(1):79–91. doi:10.1111/prd.12521
3. Quirynen M, Sculean A, Blanco J, Wang H, Donos N. Introduction and overview on Autogenous Platelet Concentrates. Periodontol 2000. febrero de 2025;97(1):7–15. doi:10.1111/prd.12607 PubMed PMID: 39258791; PubMed Central PMCID: PMC11808457.
4. Krings-Arratia J, Salgado-Chavarría F, Alonso-Moctezuma A, Esquivel-Chirino C. Conceptos actuales de los concentrados plaquetarios y su aplicación en la preservación alveolar ósea postextracción. Revista Mexicana de Cirugía Bucal y Maxilofacial. 2025;21(1):18–31. doi:10.35366/119807
5. Zwittnig K, Mukaddam K, Végh D, Herber V, Jakse N, Schlenke P, et al. Platelet-Rich Fibrin in Oral Surgery and Implantology: A Narrative Review. Transfusion Medicine and Hemotherapy. 2023;50(4):348–59. Located at: Scopus. doi:10.1159/000527526
6. Bains VK, Mahendra J, Mittal M, Bedi M, Mahendra L. Technical considerations in obtaining platelet rich fibrin for clinical and periodontal research. J Oral Biol Craniofac Res. 2023;13(6):714–9. doi:10.1016/j.jobcr.2023.09.003 PubMed PMID: 37731846; PubMed Central PMCID: PMC10507643.
7. Schleinstein CPE, Freitas AC de, Silva VP da, Cerqueira N de S, Cangussu MCT, Ramalho LMP. CHARACTERIZATION OF PHYSICAL AND CELLULAR PROPERTIES OF MEMBRANES OF L-PRF PRODUCED BY DIFFERENT CENTRIFUGES/ CENTRIFUGATION PROTOCOLS. Brazilian Journal of Implantology and Health Sciences. el 24 de enero de 2024;6(1):1773–90. doi:10.36557/2674-8169.2024v6n1p1773-1790
8. Castro AB, Andrade C, Li X, Pinto N, Teughels W, Quirynen M. Impact of g force and timing on the characteristics of platelet-rich fibrin matrices. Sci Rep. el 16 de marzo de 2021;11:6038. doi:10.1038/s41598-021-85736-y PubMed PMID: 33727689; PubMed Central PMCID: PMC7971031.
9. Miron RJ, Estrin NE, Ahmad P, Farshidfar N, Fujioka-Kobayashi M, Zhang Y, et al. Thirty Years of Autologous Platelet Concentrates: From Platelet-Rich Plasma to Platelet-Rich Fibrin. Journal of Periodontal Research. 2025. Located at: Scopus. doi:10.1111/jre.70013
10. Fujioka-Kobayashi M, Kono M, Katagiri H, Schaller B, Zhang Y, Sculean A, et al. Histological comparison of Platelet rich fibrin clots prepared by fixed-angle versus horizontal centrifugation. Platelets. el 3 de abril de 2021;32(3):413–9. doi:10.1080/09537104.2020.1754382
11. Agrawal AA. Evolution, current status and advances in application of platelet concentrate in periodontics and implantology. World J Clin Cases. el 16 de mayo de 2017;5(5):159–71. doi:10.12998/wjcc.v5.i5.159 PubMed PMID: 28560233; PubMed Central PMCID: PMC5434315.
12. Herrera-Vizcaino C. Systematic review of platelet-rich fibrin (PRF) centrifugation protocols in oral and maxillofacial surgery and the introduction of AR2T3: an easy to remember acronym to correctly report vertical and horizontal PRF centrifugation. Frontiers of Oral and Maxillofacial Medicine. el 10 de marzo de 2023;5(0). doi:10.21037/fomm-21-40
13. Blanco J, García A, Hermida‐Nogueira L, Castro AB. How to explain the beneficial effects of leukocyte‐ and platelet‐rich fibrin. Periodontol 2000. febrero de 2025;97(1):74–94. doi:10.1111/prd.12570 PubMed PMID: 38923566; PubMed Central PMCID: PMC11808445.
14. DALLOSTO JZ, SOUZA MA, PRADO LD da S do, SIQUEIRA L de O. Analysis of different platelet-rich fibrin processing. Revista de Odontologia da UNESP. 2022;51. Located at: SciELO Brasil. doi:10.1590/1807-2577.00422
15. Farshidfar N, Apaza Alccayhuaman KA, Estrin NE, Ahmad P, Sculean A, Zhang Y, et al. Advantages of horizontal centrifugation of platelet-rich fibrin in regenerative medicine and dentistry. Periodontology 2000. 2025. Located at: Scopus. doi:10.1111/prd.12625
16. Miron RJ, Kawase T, Dham A, Zhang Y, Fujioka-Kobayashi M, Sculean A. A technical note on contamination from PRF tubes containing silica and silicone. BMC Oral Health. el 19 de marzo de 2021;21:135. doi:10.1186/s12903-021-01497-0 PubMed PMID: 33740959; PubMed Central PMCID: PMC7980632.
17. Song P, He D, Ren S, Fan L, Sun J. Platelet-rich fibrin in dentistry. Journal of Applied Biomaterials & Functional Materials. el 1 de marzo de 2024;22:22808000241299588. doi:10.1177/22808000241299588
18. Fan Y, Perez K, Dym H. Clinical Uses of Platelet-Rich Fibrin in Oral and Maxillofacial Surgery. Dental Clinics of North America. 2020;64(2):291–303. Located at: Scopus. doi:10.1016/j.cden.2019.12.012
19. Shirbhate U, Bajaj P. Third-Generation Platelet Concentrates in Periodontal Regeneration: Gaining Ground in the Field of Regeneration. Cureus. 14(8):e28072. doi:10.7759/cureus.28072 PubMed PMID: 36127983; PubMed Central PMCID: PMC9477433.
20. Anegundi RV, Shenoy SB, Kaukab SF, Talwar A. Platelet concentrates in periodontics: review of in vitro studies and systematic reviews. J Oral Med Oral Surg. 2022;28(4):42. doi:10.1051/mbcb/2022025
21. Feng M, Wang Y, Zhang P, Zhao Q, Yu S, Shen K, et al. Antibacterial effects of platelet-rich fibrin produced by horizontal centrifugation. Int J Oral Sci. diciembre de 2020;12(1):32. doi:10.1038/s41368-020-00099-w
22. Chmielewski M, Pilloni A, Adamska P. Advanced Platelet-Rich Fibrin Plus (A-PRF+) as an Additive to Hard Tissue Managing Protocols in Oral Surgery: A Systematic Review. Journal of Functional Biomaterials. 2025;16(4). Located at: Scopus. doi:10.3390/jfb16040145
23. Simões-Pedro M, Tróia PMBPS, Dos Santos NBM, Completo AMG, Castilho RM, De Oliveira Fernandes GV. Tensile Strength Essay Comparing Three Different Platelet-Rich Fibrin Membranes (L-PRF, A-PRF, and A-PRF+): A Mechanical and Structural In Vitro Evaluation. Polymers. el 29 de marzo de 2022;14(7):1392. doi:10.3390/polym14071392
24. Liu M, Liu Y, Luo F. The role and mechanism of platelet-rich fibrin in alveolar bone regeneration. Biomedicine & Pharmacotherapy. diciembre de 2023;168:115795. doi:10.1016/j.biopha.2023.115795
25. Erdur EA, Karakaslı K, Oncu E, Ozturk B, Hakkı S. Effect of injectable platelet-rich fibrin (i-PRF) on the rate of tooth movement: The Angle Orthodontist. el 1 de mayo de 2021;91(3):285–92. doi:10.2319/060320-508.1
26. Lourenço ES, Rocha NRS, De Lima Barbosa R, Mello-Machado RC, De Souza Lima VH, Leite PEC, et al. Investigating the Biological Efficacy of Albumin-Enriched Platelet-Rich Fibrin (Alb-PRF): A Study on Cytokine Dynamics and Osteoblast Behavior. IJMS. el 27 de octubre de 2024;25(21):11531. doi:10.3390/ijms252111531
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