Fig. 3 m o c . k c o t s r e t t u h S / a y a t t i p n a K a m a s a K © Fig. 3: Platelet-rich fi brin is used to accelerate wound healing processes and enhance the effectiveness of bone grafting material. Is autologous blood concentrate already used in other clinical areas? Concentrated autologous blood has a significant and elegant effect on patients suffering from temporoman- dibular joint problems and on patients with refractory fractures. In orthopaedics, PRP, which is nothing other than PRF in a different concentration, is used in the field of joint regeneration. In aesthetic treatment, it is used to treat a range of scar formations, acne and various other skin diseases, and as a hyaluronic acid replacement. Fur- thermore, we use the patient’s own blood concentrate for chronic pain patients. There, we do exclusively autol- ogous blood therapy indicated as pain therapy. Hence, dentistry is rather a niche area. I would like to draw at- tention to another problem, which will increasingly come up in the future: the number of cases of bisphosphonate- associated bone necrosis and osteogenic and radiogenic bone necrosis is progressively increasing, as bisphos- phonates are often administered to ageing patients as part of cancer therapy. The resulting bone necrosis can have serious consequences, such as partial resection of the jaw. In fact, the number of carcinoma patients is generally increasing. Here in Frankfurt am Main, we have already established treatment concepts that achieve great revitalisation with autologous blood concentrates. The main focus of dentistry is mostly on implantology, although this discipline is a secondary one. Periodontics, for example, is much more important because the focus is on saving the tooth. We have developed treatment con- cepts to regeneratively support periodontal therapy. How- ever, it is essential that patients assume as much respon- sibility as possible on a metabolic level. This concerns vitamin D3, proper nutrition, water balance management, etc. One can, for example, enable kidney illnesses to de- velop, simply by drinking too little water. This is exactly what is meant by “biological dentistry”, namely the pro- motion of the regenerative powers of the patient through a holistic therapy approach. The understanding of this, how- ever, should be conveyed in effective ways in the media, and the media should be committed to doing so because patients are simply unaware of many of these things. What are the major challenges associated with establishing autologous blood concentrates? In order to establish something successfully, it always requires pioneers to drive development forward. But this, of course, also has its downside: something can become excessively used as soon as everyone starts doing it. At present, there are certain things that we sim- ply don’t have. For example, we do not yet have a man- ual on how to use autologous blood concentrates for certain indications in dentistry. There is no such thing— or at least not yet. There are also no online education platforms with full-high-definition videos demonstrating the correct use of certain protocols step by step. We urgently need to make this information publicly avail- able. In addition, we need a systematic series of articles on the respective indications from the perspective of a practice-oriented scientist. There is currently no under- standing of what can or cannot be done with autolo- gous blood concentrates. In addition to which, Henry Schein has been causing confusion for several months with so-called L-PRF. This was established around 2007 and was originally obtained by a very high centrifu- gal force. After the break with Dr Choukroun, Intra-Lock declared the term “L-PRF” and trademarked it for mar- keting reasons. Of course, the question then arises: should blood prod- ucts be allowed to be legally protected through trademarks at all? Intra-Lock’s idea was to exclusively establish their own brand along the lines of the name “iPhone”, which has come to be used synonymously for smartphones. Intra-Lock also wanted to achieve this with its L-PRF, that is, that the term L-PRF would eventually be used synon- ymously for blood concentrates. However, this approach contradicts mine. I would like to teach dentists that it is not about a specific product, but only about blood con- centrates—pure contributions to wound healing. It would be fatal if companies tried to create even more confusion with more pseudo-product names. There’s L-PRF, there’s A-PRF, there’s I-PRF—and everything has a trademark. We have to rethink our approach towards blood concen- trate-based regeneration. Research and clinical applica- tion should be at the forefront. I look at this increasing commercialisation and the tendency to plunge obses- sively into a product with great concern. There is still a lot of educational work to be done. How do you meet these challenges? We can’t generate long-term data with one protocol if new protocols are added every other month. It would be like the film Groundhog Day, where the process is con- stantly repeated anew. There is no scientific evidence be- cause everyone has only pursued their own agendas so far. Dentists work a little with this PRF, a little with that PRGF, a little with this PRP, and when you then look back over ten years, private health insurance companies say: “Yes, there is available data—but it doesn’t fit together 28 4 2019