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I C.E. article_ platelet-rich fibrin Figs. 7-9_ Plain natural glass tube vs. silica coated tube Fig. 7 Fig. 8 Fig. 9 of bone and teeth extraction. Two fields protocol will eliminate the risk of contamination of the PRF membranes, PRF sticky and PRF steaky bone that is going to be used for bone augmentation, as well as the PRF exudate that can be used as a sealant of the surgical site. Tourniquets, bandages, gauze, needles and blood collection tubes should be single-patient-use packs only. I use the blood collection tubes steri-pack (BCTSP) from Boca Dental Supply, LLC. BCTSP tubes are the only single-use, medical- grade packages for blood collection and manufac- ture of PRF existing in the market globally. After a tubes pack is open, any unused tubes should be discarded. The manufacturing of PRF membranes and plugs is a simple, four-step protocol 1) Venipuncture for blood collection using needles and glass tubes from single-use packs only (medical- grade packs). 2) Use the centrifuge to obtain separation and clot of the blood components. 3) Obtain the PRF clot from the tube and process it in the PRF box to produce membranes or plugs. 4) Use membranes and plugs to mix with bone. The doctor usually expends less than two minutes drawing blood, and the rest of the procedure to manufacture PRF can be performed by a properly trained staff member. _How is PRF clot formed? After the blood is collected into the glass tubes and during the eight-minute centrifugation, the contact of blood coagulation factors with the natural hydrophilic glass surfaces activates the clotting cas- cade leading to the conversion of fibrinogen to fibrin forming a natural PRF clot. If plastic tubes were going to be used for PRF clot, PRF membranes and PRF plugs, such tubes would likely have additives like silica and other dangerous chemical products to simulate the clothing charac- teristics of the natural glass, and the final product would be a chemically induced artificial PRF clot that will produce artificial PRF membranes and plugs. The use of plastic tubes with silica coating and other chemicals to simulate the natural characteris- tics of the glass brings the challenge of not knowing what kind of damage the dentist would be causing to the patient’s health. The literature and research evidence has shown that silica and other coating with chemicals or additives used in laboratory blood- collection tubes increase the risk of cancer and dam- age the DNA. The use of plastic tubes silica and other hidden additives could be detrimental and contra- dictory to the basic philosophy of PRF when it was adapted from cardiovascular and general surgery to dentistry: “No anticoagulants and no additives.” More research is needed to determine the fi- 06 I implants 4_2017