Which Centrifuge should I use for PRF?

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A question we get repeatedly is which Centrifuge is best for creating PRF, for either Solid PRF or Liquid PRF applications.

There is No Best Centrifuge for PRF

The simple answer, even though we do sell a Centrifuge (Horizontal Centrifuge for PRF), is that there is no best Centrifuge. Any Centrifuge from any reputable manufacturer will create PRF, as long as the machine is set correctly to spin blood at the proper RCF (Relative Centrifugal Force) and time, and the other protocols are followed, i.e. blood drawing, tube type etc.

More specifically, PRF is a protocol for using a Centrifuge to spin blood in a certain manner to separate out the blood components for use in various clinical applications. The PRF protocols simply provide the Relative Centrifugal Force (RCF) and time required to spin the blood in order to obtain the proper separation to produce components that are clinically beneficial. In addition, the PRF protocols require the use of certain types of tubes, i.e. plain glass or plain plastic, depending on the application. But, these other requirements are not related to the actual centrifuge. As such, every single Centrifuge, as long as it is from a reputable manufacturer, can produce PRF and no company can ever claim that only their centrifuge can properly create PRF.

Studies Show that the Centrifuge has Negligible Effects on the Final PRF

Furthemore, it has been proven in studies that the Centrifuge itself has little effect on the quality of the final PRF.

The PRF centrifugation device had little effect on the final size outcomes of PRF membranes (~ 15% differences between various fixed-angle centrifuges) However, the differences in the PRF clots produced in the different tubes had a marked and pronounced effect on the final size outcomes of PRF tubes. (1)

Centrifuge Settings Confusion is the Real Culprit Here

The challenge in using most centrifuges for PRF applications is that the clinicians who publish research on PRF protocols use specific centrifuges (incidentally these researchers often also sell the Centrifuge in the study, which creates massive conflicts of interest, but that’s for another post). The settings used in the studies often reference RPM (rotations per minute), which does not translate to other machines. So what happens is that people who use the RPM values in studies on a different machine, end up with sub-optimal results and then think they need the machine from the study to create PRF. Of course, this is inaccurate because RPM is not the right value to use, so it is inevitable that simply copying the RPM used from one centrifuge to another centrifuge, will not work.

The measurement, however, that must be used to determine the proper setting is the Relative Centrifugal Force (RCF) , not the RPM. RCF is calculated based on the centrifuge’s rotor radius and RPM. There are various online tools to quickly perform the calculation for RCF. But, the important thing to remember is that RCF is a value that is independent of the centrifuge’s specific rotor. Using RCF ensures consistent separation results when using different centrifuges or rotors.

So if a study mentions an RPM value that is required for PRF, that RPM value is ONLY relevant for that particular machine. You would have to find out the RCF value for the specific protocol in order to determine what RPM can be used on another machine. Fortunately, more recent studies in PRF will provide the RCF value, as opposed to the RPM, making it easier to prepare any machine to produce PRF. However, if the study does not provide an RCF value, you can find out which machine was used in the study and calculate the RCF on your own.

Factors that Should Influence your Decision for Buying a Centrifuge

So if any machine can produce PRF, what should guide your decision for buying a centrifuge. Here are the top factors:

  1. Reputable Manufacturer: Most vendors who sell centrifuges do not manufacture them. They just private label centrifuges from larger manufacturers. So it is important to find out who the actual manufacturer of the centrifuge is and ensure they are reputable.
  2. Local Support: As centrifuges are electrical devices, stuff can go wrong. And, actually you need to check the calibration on a centrifuge approximately every 2 years. As such, you will want to buy a machine from a manufacturer that provides local support in the US, so you can easily ship the machine back inspection, if that is needed (e.g. for calibration). Unfortunately, most centrifuges nowadays are produced overseas, either in China or Germany, and it is extremely difficult to get support for the centrifuge, unless the local rep provides that support.
  3. Price: Obviously, everyone considers price when making a large purchase. It is important to keep in mind that nowadays with increasing tariffs worldwide, the centrifuges that are manufactured in the US will nearly always be less expensive for those in the US, than those manufactured overseas. Just because a machine is less expensive, doesn’t mean it is of lower quality. In general, all the US-based manufacturers produce centrifuges that are of better quality and are much less expensive than their foreign competitors.
  4. Custom Settings: Since PRF protocols are constantly changing and clinicians often have their own custom settings for various PRF applications, it is important to make sure the machine provides an easy to create and save several settings.
  5. Ease of Use: You will want to be sure the centrifuge has a digital display, that provides quick notifications on RPM/RCF values and and allows for easy switching between various settings.

References

  1. Comparative Study Clin Oral Investig. 2020 Mar;24(3):1171-1182. doi: 10.1007/s00784-019-02981-2. Epub 2019 Jul 19. # Comparison of platelet-rich fibrin (PRF) produced using 3 commercially available centrifuges at both high (~ 700 g) and low (~ 200 g) relative centrifugation forces

Related Products

Looking for a Horizontal Centrifuge? Learn more about the DALI Horizontal Centrifuge. Manufactured in the US by Drucker, a company with over 50 years of centrifuge manufacturing expertise. Centrifuge offers 10 custom settings and local support!

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Thank you for the information. I have gone back and forth over the years with the use of PRF and have finally settled on the realization that, for me in my hands, it is just another step and another expense that does little to nothing to improve outcomes. What I have observed is that, in my opinion, the quality and/or possibly manufacturer of the actual collection tubes makes all of the difference and not all like color top tubes are the same. In other words the collection tube is just as important, if not more important, as the machine that spins it…..

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Thanks for your feedback. We totally agree that the quality of the collection tube is extremely important. Unfortunately, for many years now (since Covid caused a huge supply chain shake up), it has been very difficult to get tubes for PRF as they need to be either plain glass (for Solid PRF) or plain plastic. The plain glass is especially difficult, as OSHA rules do not really allow plain glass to be used, and so manufacturers don’t produce that many. Given the lack of manufacturers, the fact is that nearly all of the tubes are now produced in China, and the quality is suspect. Very often the vacuum on the tubes is below standard, and this effects the final result. So probably, PRF doesn’t have much effect on the outcomes in most real-world cases, because it’s very difficult to produce it properly, as the conditions are rarely ideal. It is also important to note that dental applications are probably just a tiny subset of the clinical uses for PRF nowadays. Primarily, PRF is used an injectable liquid for cosmetic applications.

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PRF is just another hocus pocus gimmick. something to frivolously charge patients extra w/o any clinical improvement in ridge augmentation procedures. If you have lots of time during clinic and want to earn some extra cash, want to place a venous catheter, or just want to play w/ a centrifuge. Go ahead and use PRF since you probably have nothing else better to do. I’m sure you also force patients to bone graft wisdom teeth extractions. however, I did read PRF is very beneficial for burn victims.

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Thanks for your comment. I wouldn’t go so far as to call PRF, hocus pocus. The basic idea behind it is quite simple and scientifically sound. All you are doing is using proven centrifugal forces to separate out the components of blood, and then applying a concentration of “good” blood components to a site. It certainly is reasonable, and actually quite expected, that applying a concentrated form of leukocytes to an area will help in healing. The “hocus pocus” in PRF is this nonsensical idea that only certain types of centrifuges can produce PRF or that some “magical” technique is needed. What’s truly astounding in PRF, is that the same people who publish research on PRF, sell the Centrifuges for PRF creating an impression that only the centrifuges they sell can produce PRF (even if the centrifuges sold are just regular centrifuges). These egregious conflicts of interests would never be tolerated in any other scientific field, and kind of cast a serious doubt around the research.

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Sounds like about 99% of the propaganda that we pass off as science in the field of implant dentistry….. and dentistry as a whole. Dentistry, particularly implant dentistry, is a deep well of manufacturer funded opinion based examples disguised as science and I too have been guilty of chasing the bait. As cluttered and self serving as this profession has become I think it is past time for us to start trusting our own clinical experience because the “science” is nothing more than company approved protocols.

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Says the doctor that successfully treats burn victims and chooses to charge his patients extra for the addition of PRF…… I think it probably has a lot of potential at the cellular level but “we” can never consistently reproduce the product with the available materials so it becomes another graduate research project with very little clinical relevance. This is my opinion and in no way would I fault someone if they use it and believe in it because at the end of the day, just like if I am fishing for crappie, I have to have confidence in what I am throwing at them.