L-PRF vs. PRP:
Evolution of platelet concentrates:
1st generation: Platelet concentrates such as PRP (Platelet-Rich Plasma) and PRGF (Plasma Rich in Growth Factors) have been used worldwide. However, the clinical benefits were inconsistent due to the complexity of preparation and variation in protocols.
2nd Generation: Platelet concentrates such as L-PRF (Leucocyte- and Platelet Rich Fibrin) offer a more promising alternative. L-PRF is easier to prepare and use clinically, more cost-effective (10% or less than previous products) and safer (no blood manipulation or additives except a 12-minute centrifugation). Its versatility goes beyond oral surgery and is used in a variety of medical fields, including brain surgery, wound care, alternatives to skin grafts and fistula closure.
This highlights advances in platelet concentrate technology and the potential of L-PRF as a valuable tool in regenerative surgery, offering simplicity, cost-effectiveness and safety while addressing the challenges of previous generations of platelet concentrates.
L-PRF Cloth Formation: L-PRF cloth is obtained without any manipulation of the blood, fully complying with European directive 2004/23/EC, while PRP requires the addition of biochemical additives.
Composition of L-PRF Cloth: After centrifugation, the L-PRF cloth contains the highest concentration of platelets, growth factors (PDGF, VEGF, TGF), fibrin, fibronectin, vitronectin, and Thrombospondin, along with about 65% leukocytes.
Natural vs. Additive-based Process: L-PRF production process is entirely natural, without the use of anticoagulants during blood harvest, bovine thrombin, or calcium chloride for platelet activation and fibrin polymerization. It's often regarded simply as a natural optimized blood clot.
Preparation Comparison:
Simplicity of L-PRF Preparation: L-PRF preparation is extremely simple, with no additives used, representing a selection of the most valuable components of the patient's blood.
Complexity of PRP Preparation: In contrast, PRP preparation is more complex, with a variety of protocols proposed. This complexity can lead to inconsistent observations due to errors or shortcomings in the procedure.
Reduced Possibility of Error: The simplicity of L-PRF production reduces the likelihood of protocol alteration due to operator error, ensuring more consistent results.
Illustration of L-PRF Preparation:
These comparisons highlight the advantages of L-PRF over PRP, particularly in terms of simplicity, natural composition, and reduced susceptibility to errors during preparation.
Comparison between L-PRF and PRP
Figure 2 shows the tube (a) after centrifugation (with a separation between PPP (better called supernatant or serum), platelet poor plasma, the L-PRF cloth, and the red blood cells. After gentle compression, a strong membrane is obtained (b).
