The Fixed Podcast

From Classroom to Clinic: Dr. Rick Myron's Journey with PRF: Part 2

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Ready to transform your dental practice into a facial aesthetics powerhouse? This eye-opening conversation reveals how implant dentists are perfectly positioned to tap into the $120 billion facial aesthetics industry—a market 24 times larger than implant dentistry itself.

Dr. Soren Paape and Dr. Tyler Tolbert explore how incorporating PRF (Platelet-Rich Fibrin) treatments can create substantial recurring revenue streams while delivering exceptional results for patients. The discussion unveils the stark contrast between one-time implant cases versus aesthetic patients who typically spend $3,000 annually on treatments, returning every 4-6 months like clockwork.

The conversation takes a fascinating technical turn with the introduction of the "PRF poncho technique"—a game-changing approach that dramatically reduces bacterial infiltration around implants. Learn how this simple yet powerful method creates a protective barrier of leukocyte-rich fibrin that significantly improves long-term implant success rates, especially for immediate placements.

Dental professionals will appreciate the detailed breakdown of PRF processing protocols, including critical insights about tube surface properties, oxygen exposure, and temperature control. The experts share practical tips for optimizing PRF quality, avoiding common mistakes, and efficiently integrating these services into your existing practice flow.

Perhaps most compelling is how these regenerative treatments can be partially delegated to trained dental assistants who are already comfortable with blood and sterile procedures. This creates new career advancement pathways for team members while maximizing practice productivity.

Have you considered how adding facial aesthetics could revolutionize your implant practice? Could the skills you already possess be worth considerably more in this expanding field? Listen now to discover if this could be your practice's next evolution.

Speaker 1:

My name is Dr Tyler Tolbert and I'm Dr Soren Papi, and you're listening to the Fixed Podcast, your source for all things implant dentistry. Why.

Speaker 2:

And, honestly, the reason why, before we even started, I asked you right away about it is because I get I mean, especially this podcast is mainly full arch like implant dentistry, right, mainly full arch like implant dentistry, right. But we do like a lot of what I'm doing is, um, the patients that come in. They just, they want to look different. You know they, they're sick of their teeth, they want to replace their teeth, they want them to look nice. They've been dealing with these teeth for for so long and they finally reach a breaking point where they're like, hey, I want a new set of teeth, right? Um, I think my teeth are at the point now that we can, we can get to that point.

Speaker 2:

And a lot of these patients too. They're older females and they're like hey, dr Poppy, do you do Botox? Can you do my Botox too? Because they trust me. I just took out all their teeth and did a big surgery on their mouth and they're like oh, botox is going to be easy for him to do. So I do Botox on my patients and I think that this would be a huge practice builder for full arch clinic, specifically because that patient already is trusting you, right, and this is probably why it's so popular in plastics as well, because they already trust you. You already did a surgery on them. If you can incorporate doing, you know, like a lot of I get a lot of patients that want that don't like the bags under their eyes, right, so they want they want to do like under eye treatment, um, and I would love to incorporate this into our offices.

Speaker 2:

I think it'd be super easy practice builder and a lot of our, a lot of our assistants they are, um, super comfortable around blood. That's all. That's all we do all day. So adding something like this in having them pull blood, spin it and then do some filler with PRF throughout the face probably would be huge for implant clinics in particular.

Speaker 3:

You know, absolutely 100% right. We have many clinics doing this and I'll talk a little bit about Karasetix and what we created there. But if you had to guess the size and billions of dollars of implant dentistry, I don't know, you guys know what it is.

Speaker 1:

Five, just just to do it. Oh, is it really? It's?

Speaker 3:

exactly five. Yeah, it's fine, I probably heard that somewhere implant dentistry is a five billion dollar year and all of dentistry is 25 billion. Okay, so implants is 20 of what we do in dentistry is $25 billion. Implants is 20% of what we do in dentistry. It's a faster-growing market than dentistry. It's growing at 9% per year. Dentistry is growing at about 6% per year. Guess what facial aesthetics is?

Speaker 1:

I'm already one for one, so I probably shouldn't guess I'm going to say 20. Oh, I thought we were doing percentages.

Speaker 2:

I was going to say $120 billion right after that.

Speaker 1:

Actually, that's insane, that's ridiculous.

Speaker 3:

So you're talking about a field that's more than 20 times bigger than implant dentistry. Okay, this is a point that I always make and you know I had a couple of experience with this and one of the reasons why I've shifted my practice to be a lot more heavy on the facial aesthetic side, for several reasons. But when you and this way I tell especially cosmetic dentists when you do a great case okay, let's say you do a full set of veneers, you do a full arch case, etc. Yes, it's very profitable, absolutely, I agree, right, I don't know what you guys. You do a full arch case, etc. Yes, it's very profitable, absolutely, I agree, right, I don't know what you guys charge for your full arch cases, but let's say 25, 000 and after all the expenses, etc, you know your take home was 10 15k. Let's say, you know less the complications that may happen, etc. But this is one time. You will make that money one time, if you've done your job correctly, that should stay in the mouth for at least 10 years at least and ideally 15, 20, I would say right. So now you're just doing hygiene on them, not making a whole lot of money, and that's your, that's your, you know recourse to see these patients. But that same person you just like you said, is probably, if they're spending $25,000 to get a full set of veneers done because they want to look better a nice full arch case that's the exact same person that is going to spend and Allergan has done all this research the average person in a set expense $3,000 per year, every year, right. So that means that over 10 years they're also going to spend $30,000 in facial aesthetics. And if you can convert those people to go more natural by doing PRF and lasers and things that don't cost our practice that much money, right.

Speaker 3:

And we have a protocol where we've developed, actually, where we combine laser therapy with pure F. It takes us one hour to perform. Half of it's done by my dental assistant. The blood draws, the microneedling, et cetera Takes one hour okay, $1,400. And we recommend the patient do it twice per year to be more youthful. So they're spending $2,800. It doesn't even cost us $50 to do the treatment. Half the treatment's being done by my assistants and I'm sitting there racking three thousand dollars a year every year like I work in our practice. We actually had to hire another associate period honest because I was getting busier and busier doing the facial stuff and I was like man, this is way, way, way easier, way easier and more profitable yeah, I mean I don't have to go chasing yeah, that's the central large case.

Speaker 1:

It's brutal. You guys know what?

Speaker 3:

that's like right you gotta. You know it is right, it's. It's a war out there. And the problem is and the thing that I hate about dentistry is a lot of lawsuits are created because of fights between dentists, and usually it's specialists, usually it's oral surgeons, right, you make one mistake and now all of a sudden, oh, the oral surgeon's pissed off. Oh, you're a GP and you're stealing all of our big full arch cases. We're pissed, let's go create a lawsuit. It's your own freaking colleague that's putting you down. It's brutal out there. And we're doing all this for $5 billion a year industry, right. So in the facial field, I just said like, wow, this is so easy, like I'm competing against nurses and PAs because no plastic surgeons doing Botox, right, they want to do big surgeries, right, they always delegate. So I'm like I'm competing mainly against nurses and PAs. I've got way more facial anatomy training. I've done tens of thousands of injections in complex places in the oral cavity. You guys know, especially you doing Botox.

Speaker 2:

You know how easy.

Speaker 3:

Botox is. It's the easiest thing in the world, so it's super easy and it's repeat business. So I had my schedule starting to go and fill up and the craziest thing for me was if I did two treatments a year. Here's my 10 patients that I'm going to treat January 1st $1,400 each. That's a $14,000 a day. It's all profit.

Speaker 3:

And guess what they all rebook for July 1st and six months from now so I don't have to go july 1st. Go find a bunch of new patients and beg my gp colleagues like please send me connective tissue grafts or please send me those intrabony defects. I'm really good at all this stuff I graduated from bernard switzerland.

Speaker 3:

Please, please, please, let's go for dinner, please. Right, and that's what it's like. So when I switch from that to like holy shit, my schedule is full. I was doing one day a month on, just fridays. Now it's completely full and now I'm opening two fridays a month to do it. And then it was every friday month. And then at one point I was making so much money for dr canner's practices with during covid, where we were not allowed to do research anymore because of covid, so we had to stop all these animal projects. I went and worked four days a week in private practice and two days in a perio practice, two days with dr canner. Dr canner said dr myron, you are making so much more money in facial aesthetics than as a periodontist. I don't want you to do any more perio in my practice anymore. You focus on facial. I'll go hire another periodontist and I just did facial aesthetics.

Speaker 2:

So I'm definitely going to be very, very I definitely will be uh, kind of starting to work on incorporating this change. I do have a question trajectory we were going to go do some zygos down in brazil.

Speaker 1:

He said screw that, why am I doing?

Speaker 2:

why don't you do zygomatic implants? I am curious when you have these patients come in like what's your, what's your general protocol? I mean, you like what? What exactly are you doing? Where are you injecting? Is it patient dependent? Are you kind of like generalizing it for every single patient? Like, do they all kind of get the vampire facial with? Certain TRF in certain places and then are you doing Botox on all these patients. Is that like an added benefit for those patients? What are the fees you're charging for those? I'm definitely curious.

Speaker 3:

So we always like to do the regenerative protocols before Botox. And the reason why is because, let's say, I want to regenerate tissue. So let's say, I can see somebody who's got visible crow's feet. I want them to like, make the motions and I want to be injecting the pure F in the right location. Right. If they do Botox first now they're paralyzed, I can't tell where those lines are and I don't know, I can't inject as precisely. So we always do the protocol and then Botox. After all my patients I see one week after the regenerative protocols see how they're doing and one week after the regenerative protocol to see how they're doing.

Speaker 1:

And in that follow-up appointment that's when I do the botox and we charge 12 units for botox, which I think is probably pretty common across the united states, and, uh, about 40 50. In terms of how things are so like with botox, you're depending on what you're using, I suppose, and a person's metabolic function, how active they are. They probably have anywhere from two to four months before they're coming back for more Botox. Do you have a longer relapse period with some of the more regenerative protocols or is it still kind of a similar cycle?

Speaker 3:

Six, now we would say six months, which is pretty common in the regenerative world. So even most laser companies recommend every six months and puref same thing and this is not coming from me necessarily. It's like the micro needling companies that have been done it, doing these vampire facials for years and years. They always say start with two or three treatments about a month apart to get the body going, making some collagen and then at your facial aesthetics course do you go over, like um, the vampire facial.

Speaker 2:

Do you go over the where to inject prf and and botox, all of that stuff there okay, not, not botox in that course.

Speaker 3:

No, we teach that in a more advanced course. But if you already do it, you know, already know where to inject botox. Oh yeah, we have an uh. We have like a series of a couple courses that people kind of gradually get better and better. The nice thing with the uh prf is, you know, it's so safe that nobody feels uncomfortable going back to their mind. So you actually have people before botox so yeah, and botox is very easy, like it's um, yeah, definitely that's.

Speaker 2:

That's. That's really cool. Uh, I'm definitely impressed by that um yeah yeah, I actually the the reason. Yeah, like one of my assistants in particular, she has really really bad bags and that's like a huge concern for her and she keeps asking me. She's like, doc, can you please do the prf, please do the prf. And to me I was like, oh, I don't know the under eye area, like I don't really want to mess with that, you know.

Speaker 2:

Meanwhile, of course, we're in the full mouth uh but but uh, I think taking a basic course like this and like you said, it's super safe if you're following the right protocols and everything like that is such a game changer for dentists and it's such an easy value add. Any single cosmetic case that you come into the office. You could easily be like, hey, you're coming in every six months anyways for your follow-up to get x-rays done. Let's just quick, put you down, we'll do the full facial. Maybe we'll even give you a little bit of a discount if you accept treatment with us for the full arch and then go from there, and then you have a continual patient that's paying. You know, at my office I charge 250 for the x-rays and everything, and then and it added 1400 on top of that that's really nice continual revenue for an office.

Speaker 3:

Yeah, you know, dr Canary set this up so smartly because he would tell the hygienists look and actually gave them bonuses.

Speaker 3:

But he would say what I want you guys to do is start learning how to do microneedling with Dr Myra.

Speaker 3:

Okay, because then what I want you to do is, if your patients are coming in every six months to do dental hygiene, I want you to add skin hygiene, and that's going to be a one-hour appointment.

Speaker 3:

So these hygienists, what they would do is if they had an eight-hour day where they were going to do eight patients, eight hygiene appointments, they could actually do four patients and do one hour of dental hygiene, one hour of skin hygiene, one hour dental hygiene for the next patient, one hour of skin hygiene, and he paid them $10 more an hour to do the skin hygiene. So when those hygienists were with the patients, they were constantly talking to patients yes, dr Myron does my Botox, dr Myron did my microneedling, these are great services, et cetera. And then that's how we started to get it rolling, because the hygienists are spending so much time with the patients and most of these hygienists want to have these treatments done themselves that it's really good when they're just like yeah, he does me and you know if you've done their surgeries already. Of course it's going to be a very easy sell, yeah.

Speaker 1:

That's fantastic, yeah. So I do kind of want to pull a little bit back into dentistry itself, right? So obviously we've talked a lot about facial aesthetics, a lot more than I ever anticipated, and perhaps I was wrong in that, but I'm glad we did because it's actually opened up probably the next course that Soren is going to drag me to, so but but seriously I do appreciate the perspective and I didn't realize how transformative that could be. I always just kind of saw it as an adjunct to the dental stuff. But who knows, I mean, if you get really into it, the dental stuff can be an adjunct to the uh, to the facial aesthetics.

Speaker 1:

But, um, so in terms of you know, we talked a lot about what PRF can do for um you, you also mentioned soft tissue around implants, and so my curiosity about that is is that typically something where I've already placed the implant and maybe I have a soft tissue defect and I'm trying to improve the soft tissue around that? Is there something that I can be doing intraoperatively when I'm placing the implant at immediate placement? I've heard of PRF ponchos and things like that. Can you talk about intrasurgical application and then post-surgical recall application?

Speaker 3:

Yes, okay, yeah. So it's much better to use it during surgery. And exactly for those that don't know what the poncho technique is, it's a great technique. Oh, wow, in fact, if there was only one place in all of dentistry where puref was used, that would be it. It is my, it is my favorite. Okay, you take the puref membrane, you fold it in half, you take a you know 15 blade and just punch a little hole through it and then you put the abutment through the puref. And when you place it.

Speaker 3:

Now, you know, especially on immediates, you know what I try and uh tell people is like immediate implants come with more risk than delayed implants. Without a doubt, right, there's a higher prevalence of early implant failure and higher prevalence of perimplantitis. You know, years down the road and let's say you're just doing a very simple basic case right, lower first molar, most common tooth that's extracted. When this tooth comes out and you place an immediate in there, that implant, the defect size is like 10 millimeters, let's say right, and you're placing a little five or six millimeter implant, which means that you have two millimeters, let's say, of space all around this implant for bacteria to get in there. Right, so if you did this case delayed, right? You'd put the bone graft in membrane weight when that implant would be placed. Let's say you're placing a bone level implant, right, the entire implant is going into the bone and the roughened portion of the implant is embedded in bone already. And if you use the tissue level implant, the entirety of the roughened portion of the implant would be buried in bone and what would be exposed for the bacteria would be only the polished surface, which bacteria don't like as well. Right, so you're very safe there.

Speaker 3:

When you do the same thing and you got this little six millimeter implant inside this big 10 millimeter hole, okay, you're engaging, obviously, in the frication area, but all the space now exists and every single when we go to aap meetings and we discuss this among periodontists, everybody agrees we're going to pack the gaps with allograft, right, so everybody agrees on the material to use there. Yeah, what to do with soft tissues? Man, you get 10, 20 different answers from different people. Everybody. Everybody says we develop this technique, we do it this way, do we do it that way? You know, some people say you need a connective tissue graph. Some people say unless it's this height you need you need a connective tissue. If it's like this, you do this. So there's all kinds of you know, different ways to do this, and even if, let's say, you placed a abutment, uh, you know an abutment there and you approximated the tissue as best you can, or you made a custom abutment, etc.

Speaker 3:

Like the reality is, is that you don't really have true primary closure. Yeah right, like a little bacteria that is literally five micron in size.

Speaker 3:

If you don't think that it can just go, we's down there. And then now where's the bacteria? He's floating around down here in a space where there's two millimeters of open space. He can literally go float right to the roughened portion of an implant and, boom, he's now connected to it, attached to it. And I tell the residents in the peri department, like, if this happens, you just started peri implantitis. There's no going back now, very difficult to treat. We don't want bacteria. And I always tell the residents the day you place the implant is the most important day of that implant's life, because the decisions you make today are going to affect what this person's going to have to live with for 10, 20, 30 years from now.

Speaker 3:

So the guy that invented the poncho technique it was a brilliant, brilliant idea he said well, I don't know, the goal was just where this abutment is, whether it's custom or not. When you're trying to get approximation of the tissue, why don't we just put puref everywhere around here? Okay, and by doing so now you've put like a super concentrate of leukocytes as well. That's why they call it leukocyte and platelet-rich fiber, or l-puref, as you guys know. Now the bacteria that's trying to get in there. That's the worst place the bacteria wants to be, because that's where uh, you know you're better at fighting infection. You have more leukocytes there. So I think the technique is brilliant and amazingly, it literally you just need one tube, you can use one tube, balance it with a tube filled with water, and the tubes cost $1 each. And if you did that for every implant you placed, man, I'm sure you'd have much better outcomes.

Speaker 1:

I got to do that. I want to start doing monday. Uh, what does the armamentarium look like? What is just like a brief description of that protocol, to do just the prf poncho part yeah, so you know all these companies that have puref equipment.

Speaker 3:

Um, they always sell them as a starter package, right where typically the kits are anywhere from. You know three thousand bucks roughly, and it'll include the centrifuge, you know the two tube types to make the solid puref and the liquid puref butterfly needles, and then all of the uh, all of the hand hand instruments the puref box, the tray, the bowl, the tube holders. You know everything else that's included. So literally, when you buy one of those kits, you get everything you need, um to start, and the bio puref kits, which is the ones that we developed in switzerland. Those ones actually come with my online training program. It's eight hours, it's my actual puref course. It was just recorded for online and it comes with everything. I mean everything from you know how to turn on your machine and program it, to what is pure F, why it's different than PRP, to all the clinical indications. So it's literally our full day program and that's included with it, as well as a copy of my book, understanding platelet rich fibrin. So you literally get like a lot of information, yeah and uh the course.

Speaker 3:

The reason why we did this, you know, for me, doing a lot of the research in the space you guys can imagine. I want puref to be successful in everybody's practice, because when people associate puref, they think of you know, dr myron, so to speak. Right, so if everybody's having bad experiences and it's not working well, they're going to be like well, dr myron is full of shit, right? So, um, I don't want that. So we try, and, you know, put as much of uh material in in these uh uh when they purchase that, and the course we made it. It used to be one year only, but we now made it lifetime access. So the doctor that has it in his practice it's lifetime access, which means that maybe you hire a new dental assistant because one of one of them left you in three years from now and you want her to be your puref queen and do help you with puref and all your surgeries. You say three years later.

Speaker 1:

I need you to go watch this. Where can they purchase that from?

Speaker 3:

and then they still have access to it so yeah, that's a bio PRF, yeah, the website's a B I O dash PRFcom. And yeah, the starter package and for those that take courses, that would be a single unit application, do you like?

Speaker 2:

what are your thoughts on application for for full arch treatment? Are you an advocate? For you know, I see some people who, because a lot of times we're sedating these patients anyways, right, so they just pull, they just draw blood as soon as they get an iv in and then, um, but like are you an advocate for layering prf everywhere prior to closure? Like, where do you see it being the most applicable for full arch based cases?

Speaker 3:

Yes. So if you're doing bone grafting adding it to make your sticky bone keep your particles there a little bit better and then, yes, during closure, we just literally put pure membranes everywhere. The goal is, and what we teach people in courses anywhere you make an incision in surgery, you want to have, when you go to close this, you want to have a pure membrane laid here. So if this is my incision, right, I open up, I do this big bone grafting, place some implants, put a collagen membrane or whatever you're using. When I close up, I have a membrane that's here all the way down.

Speaker 3:

Okay, and so that if there is bacteria that want to go in there and try and contaminate what you've done because, again same thing, yes, you have primary closure, but it's not, it's not true, primary closure A little bacteria that's five microns in size can go squeeze in there. So rule of thumb and this is in all fields of medicine ortho, plastic surgery, et cetera Anywhere you make an incision when you close up, there's a puref membrane there. So even our plastic surgeons that do rhinoplasties etc.

Speaker 2:

And they make very little incision lines here when they close that up so you're using a puref membrane right there, solid prf tubes to make the membranes. You're using the liquid prf tubes to use a sticky bone correct. So it coagulates and forms that. Um, if you're like in the beginning of a case, at what point do you really recommend spinning that? Because I've run into the issue right where maybe I'll spin my PRF and then it coagulates too much prior to getting to using the sticky bone. When is kind of like the optimal timing for like spinning the solid and liquid PRF?

Speaker 3:

Yeah for for like spinning the the solid versus in liquid prf.

Speaker 3:

Yeah, so what's you? You obviously don't have a bio system because you're you probably fixed angle, I'm assuming. Yes, is your machine like a 45 degree angle? The tube is going like this. So when you use a fixed angle, you're actually driving. When the centrifuge is spinning, you're driving the cells against the back ball. Okay, when this thing's spinning fast, right, the g-force is pushing the cells towards the back wall. But you actually want to clot? You don't want to clot. And where does clotting always start? On a wall surface. So by forcing them there, yours is probably going to stay liquid for about 15, 20 minutes. Okay, when you spin it horizontally, so the tubes they actually go like this. There's no more g force that's pushing it against the walls. Okay, so on a horizontal system it'll stay liquid for four hours, probably better for full launch so you got.

Speaker 3:

You got way more time, and so that's a modification that was made. Another Another thing too that, yeah, yeah, definitely. Another thing that you can do as well is we've realized there's three main things that affect clotting, okay. So the first being the tube surface the more hydrophilic it is, the more water loving. The faster it clots. The more hydrophobic, the longer it's going to stay liquid loving. The faster it clots, the more hydrophobic, the longer it's going to stay liquid. So, number one if you use um with the better tubes and you can get those and use them in your machine right now at biopuref you're going to get it to clot faster and you're also going to get it to stay liquid longer. That's number one.

Speaker 3:

Number two we know and I don't know if you're doing this already oxygen is one of the drivers of clotting. So the red top tubes we always pop the lids and we want to expose them to oxygen, even if it's clotted and I spun, did my eight minute protocol or 12 minutes, whatever you're spinning at when it's done, even if it's clotted already, I still pop the lid and I want to expose it to air for another five minutes. The air, the oxygen, induces it to clot further On the liquid puref tubes. Never pop the lids until you're ready to use it. Okay, the third thing, and this will help you out tremendously. The third thing we realized that the conversion of fibrinogen plus thrombin into a fibrin clot is enzymatic and enzymes don't work well at colder temperatures. So we actually created what's called a bio cool device. It's a little like cup shaped device and when you put the tubes in there it keeps the liquid puref tubes between 8 to 10 degrees celsius and then the enzymes can't convert as efficiently. So even on our horizontal systems it'll push from like an hour that it stays liquid all the way up to more than four hours and on a fixed angle you'll go from 15, 20 minutes to like an hour and a half. So that'll give you just by cooling it. And if you want to make your clots clot faster and we bought, we bought this you buy a tiny little incubator and keep your incubator set at body temperature, 37 degrees Celsius. That's when enzymes are most effective. So when I have the red top tubes pulled, my team they pull off the lids, oxygenate the red top tubes, they put it in the incubator until we're ready to use it. That'll make it clot a lot more effectively and the clots will be stronger.

Speaker 3:

Related to your question on timing I have my dental assistants do all of this. Okay, they do it all 15 minutes before any procedure starts for me. They're in the room, they're doing the blood draws, they're doing the spinning, they do all that stuff. Okay, my whole team does all the blood draws and all the spinning and we've trained them, obviously, how to do that. If I have a patient that's on anticoagulant therapy, typically people will say like, oh, should I do like double spin or triple spin or spin faster, this that a person that's on anticoagulant therapy will not have different levels of platelets and leukocytes or red blood cells. So if the role of the centrifuge is to separate cells based on their density, the protocol is the same. The difference is it's going to take them longer to clot.

Speaker 3:

So what do you need to do? You need to do three things you need to make sure you're using the hydrophilic tubes, you need to pop the lids and instead of waiting for five minutes, maybe we need to wait for 20 minutes Okay, but they'll always clot. And you need to use an incubator, okay, so that's. That's basically our protocol. There are little you know, when you talked about doing it from the IV line, we actually sell them also at biopuref, but there are little like adapters that you can use and then you just do the blood draws. We do that all the time in sedation.

Speaker 3:

Okay, you draw that blood just like you're doing before. Okay, and don't do. I hope you're drawing them in one of the vacuets. Is that how you do it? Or draw it in like a tube and then you do it that way? Yeah, that's the right way to do it. Some people they'll grab like a big 40 cc syringe and drop 40 cc's that way from the line and then inject 10 cc's into each tube. I tell people try to avoid doing that because, um, the proteins the reason how clotting starts is from the proteins that are found which will absorb to the surfaces. So if you fill a 40 cc syringe just by drawing it, some of those good proteins that are needed are now binding to the syringe wall and then you go into each of the 10 cc tubes.

Speaker 1:

What are some other common mistakes that you see, maybe specific to dentistry, in terms of the blood draw, how things get spun, how it's processed? I mean, you talked a lot about the sort of post-process and there were some other things that are affecting the effectiveness of the PRF.

Speaker 3:

Yeah, I would say that there's a lot of people don't. Well, there's three things really. First, people don't understand the difference between RPM and RCF, and so there's a G-force and an RPM, and what happens is, let's say I have my centrifuge and I'm spinning. There's a certain amount of spinning that's going to occur at a certain G-force. So let's say I invent a perfect protocol and my protocol is designed only for this machine. So let's say it's 1,000 RPM and it creates a certain G force that will separate. If we start to do a machine that has is like twice the size and you still spin at a thousand RPM, you're actually going a lot faster, right, you're actually going a lot faster this way. And so what happens is what happened. I don't know is my video still going okay or is?

Speaker 1:

it.

Speaker 3:

It's getting a little choppy, but it'll be okay um, so the rotor size from here to a bigger size. You cannot use the same rpm. You need to specifically design a protocol here and use it there. So I see a lot of people they'll go to facebook groups, let's say, and they'll say hey, uh, I just bought a centrifuge. What, what's protocol would you recommend using? You get all these answers a thousand for 10 minutes 1300. And that's completely incorrect because every protocol is designed specifically for one machine. Okay, so that part there is very, very important. Um, and then additionally, um, the tubes matter way more than the centrifuge and people buy the tubes for like a dollar, right, and that decision you make with the tubes will matter much more than the centrifuge. So those are the two most common errors that I see hey everyone.

Speaker 2:

I apologize for this quick interruption on the podcast, um, dr myron's video actually uh, stopped working at this point, um, due to just running out of battery. So I'm going to try to give you a quick summary of his final points and then I'll talk a little bit about how to get in touch with him or his program. So the last thing he was really talking about was actually heating PRF, and when we heat PRF it goes from lasting from two to three months to five to six months. Through Bio PRF or PRF-EDU, they actually have a heating element that you take the PRF, put it in there and it allows those membranes or solid PRF to last quite a bit longer. That was his first point.

Speaker 2:

The next thing he started talking about was I actually asked him what the biggest change he's seen in the dental or blood environment is and he said exosomes and what those are. There's a lot of future potential for these to change how medications react. They're something that can prolong certain medications, let's say insulin. If a patient needs to take insulin every day, it might change to taking it every week using these. So he thinks it's the biggest thing he's seen in regenerative medicine and we're really excited for the potential of this to come.

Speaker 2:

Finally, he discussed how to get in touch with him and how to learn a little bit more about PRF, and the best thing you can do is go to PRFEDU or BioPRF online and he has multiple courses on there that you could sign up for and take. I actually, since recording the podcast, I went to his course and it was excellent and we purchased all this stuff and we are doing PRF. We were doing PRF before, but we're doing a lot more of the facial PRF stuff in my office and it's been excellent. So we wanted to just thank Dr Myron again for coming on the podcast. Thank you, dr Tolbert, for doing another wonderful podcast. If you guys have any questions for Dr Myron, you can reach out to him on Instagram and hopefully, once again, you enjoyed our podcast. Thanks again, bye.