Benefits of the Ocean Protocol

Adding saline solution provides several practical advantages compared with traditional PRF:

Optimized Sticky Bone: The combination of saline, liquid PRF, and biomaterial creates a larger, more cohesive graft that is easier to handle. Saline also helps growth factors distribute more evenly throughout the graft particles.

Extended Cell Survival: Leukocytes are extremely sensitive to dehydration and osmotic pressure changes. Saline maintains critical hydration, helping preserve cell viability on the surgical tray.

Improved Post-Operative Inflammation Management: By diluting certain early pro-inflammatory mediators, PRF Ocean may help reduce immediate swelling and discomfort for the patient.

Better Healing in Open Environments: This protocol is especially effective in cases where the site cannot be closed hermetically, as the hydrated matrix performs better when exposed to the oral environment.

Physiological Mechanism: Osteoimmunology

One of the most fascinating aspects of PRF Ocean is its interaction with the immune system, a field Dr. Choukroun describes as osteoimmunology.

1. Osmotic Balance and Neutrophils

Physiologically, a cell placed in a dry or hypertonic environment quickly undergoes apoptosis. By maintaining PRF in an “Ocean” state—hydrated and saline-rich—the integrity of neutrophils and monocytes is preserved. These cells play a central role in bone regeneration.

2. Macrophage Polarization (M1 to M2)

The presence of saline and the preservation of cell viability support the transition of macrophages from the M1 phase, which is pro-inflammatory, to the M2 phase, which promotes healing and tissue remodelling.

M1 Phase: site decontamination and inflammatory response following surgical trauma.

M2 Phase: stimulation of osteogenesis and angiogenesis.

PRF Ocean physiologically supports a faster shift toward the M2 phase, helping shorten the painful inflammatory period.

3. Fibrin Release Dynamics

Saline hydration changes the physical structure of the fibrin network. It becomes less dense, allowing growth factors such as VEGF and TGF-β to diffuse more smoothly and consistently into surrounding tissues instead of remaining trapped within the clot.

Specific Equipment

To support this protocol, PRF Ocean Kits are now available with Teflon cassettes and multi-dishes specifically designed to saturate PRF membranes and plugs with saline solution while preserving valuable exudates.