PRF vs Exosomes: The Regenerative Dentistry Shift Happening Now

Hi everybody. I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy. So take care of it in the most Hi everyone. This is Dr. Sanda. I'm your host for the Holistic Dentistry Show. And today I'm super excited to talk to one of my colleagues, periodontist and PhD and very well published, Dr. Rick Myron. Welcome to the show.

Thank you for having me.

I'm super excited to finally get to talk to you because I know you're a very busy guy. And I want to tell everybody a little bit about you because I know I could go on and on and on. You are the lead educator at Advanced PRF Education. That's prfedu.com, and adjunct faculty at Bern University where you completed your PhD in 2009. You published over 400 peer-reviewed articles and written 10 textbooks. Wow. Where do you find the time?

I'm not sure, actually. You know, there's some days when I'm like, I don't know how this has happened, but it's just day by day, piece by piece. But I do work a lot. So a lot, a lot.

Yeah. So I want to start with the beginning when you were maybe in your PhD, like what did you research then?

You know, it actually started way before then. And to be honest, it started in high school and believe it or not, I grew up in a small city in North Bay, Ontario. And what happened was in my high school, there was a PhD professor that got fed up with academics and like the politics of being in university. You know what that's like, I'm sure. And he decided to just quit University of Toronto where I grew up and teach at our high school.

Oh, wow.

And so I didn't know this, but when I was 13 to 18 years old, my actual like science teacher in high school was a PhD and he had published over 100 papers. And so he wanted to continue research and he started working with like kids that had like decent grades and said, do you want to do a science fair project? And so I did that. And because we had like the best project, he basically took like PhD-level work. taught us how to do it at like 16, 17, 18. I won every national and international science fair project, and I was already traveling around the world at like 18 doing science competitions and stuff. So, I didn't know this because I just thought it was normal. And then I graduated, I got a full scholarship to go do my undergrad. And then you can imagine when you want to go to dentistry or medicine, you should do like research in the summers. I'm sure you remember that.

Yes, I do.

So, I got every single position that I wanted because I had already published and I was doing science fair projects. So it was just like one thing led to the other. And then in dental school, when I, when I got accepted, I continued doing research projects on implant dentistry. And then what happened was the Canadian government gives a full scholarship, 5 years of full funding. It's like very rare. They let you go anywhere you want to in the world. They pay for everything, tuition, living expenses, like everything. And so I basically was like a green ticket. So from like, they saw my CV, they'd be like, wow, this guy's done like all this research. He's done dentistry. I'd done a master's in science while I was in dental school. And, uh, I went to different schools, so I thought maybe I'll go to Harvard, maybe I'll go to Michigan, maybe I'll go to Italy, Germany. And then when I went to Switzerland, I was like, my God, this is the hub of like implant dentistry. There's so much there. The biggest implant companies of the world are there. Nobel's there, Straumann's there. And every single zirconia company was like developed in Switzerland.

Yes. That's right.

So like a lot of people don't know this, but like The first major implant companies were all tested in my research lab in 2009.

Wow, that's a good fact to know. Amazing. And I know Dr. Toni Sculean, which I think it's Romanian.

Yes, he is.

Yes. He's published also so many papers that I've read as a resident as well.

He was my supervisor. So, yeah, I've been to Romania many times with him. We do courses there. I've been everywhere in Romania. Oh, I love that. And it's a great, great country. But, you know, the difference was, is like going from like a small school or in Canada To like a hub of research with like these superstars that have published so much. It's like the level just has gone up so many times, right?

Yeah.

Um, you know, when I tell people, and this is kind of crazy, people are like, my God, you published so much. Like, it's nuts, especially for your age. But like, my criteria was like, we were publishing 32 articles a year when I was in Switzerland. So it's like, you know, most residents are doing like one paper in 3 years. We were doing like 30 a year.

Wow. It's like you had AI back in the day.

Yeah. I don't know about that, but we were studying and working a lot. So.

Very good. And, and how, what got you started? I know your big passion now is PRF and exosomes. Like when did you first start to look at—

We'd started actually in 2011. And the reason why Tony Sculean, as you had mentioned, was big into Endogain. So he was big into growth factors and that's kind of what led Tony to go from like Romania to be at like one of the top dental schools in Europe. And so he was always excited about growth factors. And so We started to see like this trend many years ago where PRF and using autologous growth factors could potentially help us with healing. We didn't know how much back then. Obviously there was not as much literature as today. And you know, one of the things that they want to do for me, because I have a PhD in molecular and cell biology, you know, most cell biologists are testing things that are like, you know, MAP kinase pathways or, you know, Connexin43 between cells. Like that's actually the work that I was doing in Canada. And then when I went to Bern, Switzerland, they're like, why the hell are you doing this research? And I was like, what do you mean? I'm a cell biologist. Like we test cells, we test pathways and all this stuff. He's like, and they literally told me and changed my entire career trajectory because they said, unless you can change patient care in the next 3 to 5 years, I don't want you doing that research. So, they got me away from thinking like MAP kinase pathway, do this, do that. They said, well, there's this thing called PRF. If you're a cell biologist, we'll figure out how to use a centrifuge. find a way to get more cells in this upper layer so that when you figure out how to make platelet-rich fibrin with more platelets, you're going to go out and help thousands of clinics and millions of patients, right? So it kind of changed a lot and that's where it started. So. Yeah.

And I really believe that's where the power in research is. How can we apply it, take it and apply it clinically to help more patients?

Yeah, 100%. You know, the big thing that I learned there versus here, and I'm sure you remember this, like if you look at almost every dental school in North America, Most of our researchers, because the schooling system is so different, we're taught like, you gotta go to undergrad, you gotta do dentistry, you gotta do your specialty. And like nobody goes and does a PhD, right? Like nobody does that here.

No.

But there it was like, you just go straight to dental school. And then a lot of people like to stay in academics and do things. But if you think in US, 100, I don't wanna say 100, say 95% of the research that's done, that's NIH funded, is given to PhD researchers, not dentists. They're not DDS-PhDs, they're just PhDs.

I see.

So they don't know what it's like to actually work in a practice. They don't know what it's like to try and treat patients. So they don't ask questions on how we're going to improve patient care. So to your point, it's like there's just not a lot of researchers with those dual degrees and just very different. So they trained me how to be, think very differently. So it was good.

Yeah. So, so what happened is, so you did your PhD, you published, and then How was that transition to Florida, to private practice?

Well, you know, I have a Canadian degree, so I could get my license in the United States. Obviously, they're interchangeable. And when I was there, I was working in practice there with Tony and Danny Boozer and doing mainly perio work specifically. And then when I moved, I wanted to move back because most of my family obviously lives in North America. I grew up in North Bay, Ontario, which is very, very cold. So my parents retired in Florida half the year and my brother lives in Florida. So I was like, I'm going to Florida. I actually was going either California or Florida. I wanted to go to one or the other. Uh, Florida just had lower taxes and just seemed like an easier place to live. I don't want to say anything bad about California, but it's great. And I knew I was going to be doing a lot of teaching. And as you know, most of the major conferences are either in California, Florida, like Chicago. So I wanted to be somewhere warm, but in a place that would attract a lot of big conferences. So I picked Florida and it's been the best decision ever.

Oh, I love it. And did you continue your research in Florida?

Yeah. Oh yeah. We have the Myron Labs there. So, in fact, I had brought a lot of my postdoctoral. So, by the time I graduated in Switzerland, they kept me on for a few more years and I was head of preclinical research there. So, I was the person. And if you think about this, what I try and tell clinicians is like, never forget every ceramic implant, every bone graft, every barrier membrane, every biomaterial has to be tested preclinically before human use, right? So the cool thing about my job is like these ceramic implant companies, for instance, they can't just launch a product. They decide like typically 3 to 5 years before it launches that they're going to launch a new product. So let's say today is 2026. They plan to launch in 2029. My lab is going to do all of the in vitro work and animal studies from 2026 to '28, get all of the data for the FDA, submit it with the companies, and then They'll say, okay, you can now do the very first human studies. We do the human studies. And then if everything goes well, then they get cleared in 2029.

Wow. What a process.

So what happens is in my research team, we get to see what all these companies are doing years before they get launched. So it's a really, really cool place to live. You know, I always tell people probably 90% of the work that I do in my private practice, it's like a lot of stuff is not FDA cleared yet. We have to get special like IRBs, which are called internal review boards to make sure that, you know, we can do them. We have approval, we test materials and And then if all goes well, boom, it goes to the mass market. So, yeah, it's fun.

Yeah, for sure. Now, let's talk about PRF or platelet-rich fibrin. We have a mix of listeners. We have dentists and hygienists, but we also have the regular consumer, which, as you probably know, they still don't know what PRF really is. So, what is inside PRF, platelet-rich fibrin, that really makes it regenerative?

Yeah. So it's funny that you asked this question because, you know, I'll spend like, I could spend easily like 10, 15 minutes explaining it, but like I got like a smaller version and it's the exact same thing that I tell patients, right? Because I get asked that question all the time, especially in facial aesthetics. They ask like, what's PRF? What's PRP, et cetera. So what I tell, you know, patients or even doctors is intrinsically we have an amazing ability to heal ourselves, right? So I always use the same examples. If we're in the kitchen and we're sitting there cutting cucumbers and you cut yourself, like, it's amazing to think that you can heal, right?

Yeah.

Like there's many cells, there's many pathways, growth factors, et cetera. So our body is liquid and it's circulating. And when it gets exposed to air oxygen, a clot forms and then cells and growth factors get trapped in the clot. And then over the next 21 or so days, you're going to heal.

Okay.

The problem is that like with all animals or mammals is like genetically we're designed to like go to waste and get older and, you know, die off and make way for the younger generation. I mean, That's just part of nature, so to speak, but most of that is related to blood flow. So what happens is that blood flow and muscles. So as you age, you know, your max heart rate used to be 220 beats per minute as you were 20 years old and you're a super athlete. And as you get older, your max heart rate goes down by 10 beats per minute. So by the time you're 80, your heart's beating like 150 times or 140 times a minute, and it's a muscle. And just like all your other muscles, when you're 80, your muscle can't contract as hard. So now you can't get the circulation going as effectively. It's by design that all of our important organs are right around our heart. And we have like, our brain goes right to the brain, right? Blood flow. It's not so concerned. Like when I see a cute old 80-year-old lady, she's like, Dr. Miner, I used to have the cutest, like chubby cheeks when I was younger. And it's like, I'm like, honey, like your body doesn't care if you have these cute chubby fat tissues, right? It's like, that's the last thing it cares about. So they lose volume here from the blood flow. This starts to fall. They have deeper nasolabial folds, marionette lines, jowls, et cetera. And then they complain about it and it's all related to blood flow. And so blood flow is extremely important for healing and just maintaining tissues. And if you think of diseases that affect blood flow, and the classic example is diabetes, right? Where do diabetics have issues?

Periphery.

Yeah. Always extremities, right? So mainly bottom of their feet, et cetera. So, you know, I always say you or I, we can go play tennis and get blisters on our feet. A diabetic person, they will not heal. A lot of the times that little blister can turn into like a big diabetic ulcer that's like this thick. So what is PRP? Basically the inventor who was actually from Florida, Bob Marks, and he's a dentist as well, by the way, he was working at Jackson Hospital and he basically said like, I know that defect on that diabetic person because diabetes makes blood vessels a lot smaller. That diabetic person can't get blood flow to the bottom of that person's foot. So he just thought, let me draw some tubes of blood. Let me just draw the blood, straight blood. I'll inject it around the defect and splash some blood on it. I'll just bring all the important cells and growth factors to that wound. And it started to heal.

Just blood. He just—

And then the thing that they did after was they said, well, we know what every cell type does in the body. So by the '90s, we knew platelets release growth factors, leukocytes, white blood cells fight infection. And red blood cells carry oxygen. So they started to say in a 10 mL tube, if I put it in the centrifuge, I can super concentrate all the platelets, let's say, which help with wound healing into this one layer, the lighter cells. And then, you know, the heavier cells will go here and basically you could separate all the layers. And then this 10 mL tube would have all the platelets in 1 mL. And when that was drawn up and then when that was injected around that diabetic wound, then healing started to happen much, much more effectively. And they called that therapy platelet-rich plasma or PRP. And it just exploded in medicine. Then they started to treat burn victims. They use it in dentistry to mix with bone grafts, as you know, they started doing recession coverage with it. The 2 fields I always say that made it most popular is sports medicine, because you could have a $20 million a year pro athlete. And he's told like, oh, I've got a meniscus tear, right? He's out for 6 to 8 months. They said, And they, and this actually happened for the Florida Dolphins. And they said, well, here's our $20 million a year athlete. That's out for 6 to 8 months, little meniscus tear. Why does it take so long to heal? Low blood flow, right? There's no blood flow going through your knee. So he goes to the hospital. They say, you've got a blood flow problem. We've got a blood flow solution for you. They drew 2 tubes of blood from the pro athlete, injected into his knee. He's healed in 3, 4 months. Everybody's like, what have you done? Are you doping? And he's like, no, no, no, it's all natural. It's part of my own body. And then next thing you know, it exploded in medicine. So that, and in facial aesthetics, it's mainly in California actually. There was like the Kim Kardashians, et cetera, that went online and said, this is a vampire facial.

I remember that.

And, uh, I mean, a lot of people do. And then I always joke around. I say the minute Kim Kardashian posted that, every female above the age of 2 years old now wants to do that treatment.

Yeah. I've done it. It's amazing.

I'm sure. Yeah. I mean, a lot of people have, so.

Yeah. I still remember when PRP, I was a resident in UCLA back in 2001, 2002, and we got the first Machine from like Harvest Technologies. Yeah.

Harvest.

You know, I don't even know if they're still around. But I, I remember back then, but the, it was, the preparation was so convoluted.

It was. Yeah.

Yeah. So, so how did we evolve from PRP to PRM?

Yeah, that's a great question as well. So if you think about it, you know, that was like the technology, the Harvest system. But if you just think of the basics, right? When you see somebody draw a tube in a hospital, what's the first thing you see the phlebotomist do?

What do they do? Mix it. Right.

They mix. Why are they doing that? They're mixing the anticoagulants in the tubes, right? So if you put blood in a regular tube, it will clot. There's no way you can send it to the hospital. Right. So they put chemicals inside the tubes that prevent the blood from clotting. Then they mix it.

Okay.

When you make PRP, obviously the chemicals are still going to be there. So it's not that the chemicals are dangerous because patients can take anticoagulant meds, as you know, but here's the downside. When you inject this in your pro athlete's knee, right? You get all the benefits, all the growth factors and cells, but you get a little bit of negativity here. And the negativity is that that person can't clot. Now you're putting something in there that's clotting, but just like my cucumber example, when you're cutting yourself and you, what's the first step to healing? You need to make a fibrin clot, right?

Yes.

Clotting is the single most important step for healing. And I tell patients or doctors, I'm like, if you really think about this, if you actually don't clot, you will never heal. So imagine we're making these preparations with a drug that prevents you when from clotting. So we've known from the beginning, like this is not the most optimized way to do that, but we don't have the technology to, to not do it. We need that. So the real science behind PureF is not in like the preparations, et cetera. It's really in the fact that a new tube was designed where you can now, and it's the science words are it's made very hydrophilic. Or hydrophobic, sorry. And it's very water repelling to the point where if you put blood in this tube, you can keep it there for 4 hours without clotting.

That's incredible.

No chemicals. And so, because that was developed, now we can easily draw the blood in 3 minutes, spin it for 8 minutes, draw it up, inject my Pro Athlete. And when it's injected, now it's going to make that fibrin clot, as you had mentioned. So you're going to clot and then growth factors and cells get trapped in the clot. And there's been literally thousands of studies that have compared PRP to PRF. And every single study shows PRF is better. And it just makes sense, right? So they're the same technology. This one's got chemicals that prevent you from clotting. This one has no chemicals, just a specially designed tube to prevent the blood from clotting.

Yeah. And I see also the difference with your tubes and from taking your course, which by the way, any dentist listening, I highly recommend that you look into the PRFedu courses because you make it very easy to learn. Kind of fun.

Yeah.

Great. You know, I had no idea that some of the tubes can be contaminated.

Definitely.

And it's so important, especially when we're practicing, you know, healthier level of dentistry, more integrative, to just pick products that actually work and they're clean.

Yeah. Yes.

Yeah.

I think it's important, as you mentioned, not just for dentists, but also for consumers. Because the sad part is, is that, you know, you can go buy whatever centrifuge you want to buy and then buy whatever tubes you want to buy. But the reality is, is that if it's not completely chemical-free, it's really not platelet-rich And even some of the companies that say they're pure F tubes, they still have silicone and other things on the inside. So like my research lab has done a lot of work to really make sure that we test all the different tubes to figure out which ones are completely safe, which ones are, you know, better than others, as you know. And I know you use the BioPure F tubes. So, but you know, you're somebody that likes to stay educated. You know, we're here at a conference as well. It's like you're always learning, learning, learning.

Yeah.

You are like 1% of the population learning that, dentists that are learning that much, right? So there's still a lot of mistakes that are made out there and we do a lot of like educational stuff as much as I can. But the reality is there's 220,000 dentists and even if I taught 30 dentists every weekend, it's like you're never going to teach 10% of the dentists, right?

So. That's true. That's why I'm glad you're here. And anybody listening to this podcast that you know, another dentist that you think can benefit from this information, definitely share this episode with them. Now I want to switch gears a little bit, going from PRF to exosomes, because I know you're super excited about exosomes.

Yeah.

As I am.

Yeah, I think it's, it's the, certainly the hottest topic in regenerative medicine and dentistry. Our research team spent a lot of time. So the main difference between like growth factors that we know and we've always used in whether it be dentistry or medicine and an exosome is the stability of the biomolecules. So think of like, if your body wants to tell you you're hungry or your body wants to tell you, you know, you're a diabetic and you need insulin or you need different biomolecules. Typically that's a very short-lived action. I'm hungry right now. If I eat 15 minutes later, I'm not hungry. If I need, you know, insulin right now, you got to do that multiple times a day. The exosome, the nice thing is, is the stability is very, very high. So it's not meant for short-term things. It's long-term things. So it's like saying, I want to regrow a person's hair, right? This is not going to be like a 15-minute job. It's going to be like a month-long job. So if we use exosomes with the right signaling molecules, it's much more effective that way. If we use things for skin regeneration, very popular joint regeneration, dentistry, et cetera. So there's specific exosomes for all these different applications. And, you know, just for those that are colleagues, dentists and medical doctors, there's more than 10 times more papers on exosomes today than PRF. So for the dentists that are listening that already do PRF and are like, oh, this is the latest and greatest. It's like, take something 10 times bigger and welcome to the world of exosomes.

That's pretty amazing. I was really surprised when you said that because a lot of dentists as well as patients don't know about exosomes.

No, they really don't.

So how do you, how do you know where to choose exosomes?

Like, you know, that's a, that's such a difficult question to answer. And obviously being a researcher and having a research lab, like these are things that we study, but like if I was to put things into perspective, even for you, and I know you're like, Very advanced. I think you were one of the first people to take our PRF courses many years ago. It's probably been almost 10 years, or if not more. The reality is, is that if you think of today, how many dentists are using PRF in 2026, like that PRF approved in 2—

Mm-hmm.

I started teaching courses in 2015. You know, you were already using PRF and years later, 11 years later, I still have a full-time business teaching PRF courses. And we're talking 15 years after FDA clearance. And I don't even think half the dentists use this technology yet. Right? So it just takes a really long time to, to teach these things and to adopt these things. Like PRF was very popular. And then after that, these peptide world became very popular in like 2013 to '15, '16. Today, 10 years later, we're starting to see peptides now go mainstream.

Yeah. Right.

Peptides are not the like latest and greatest things. Exosomes are a lot more stable, like they're much more regenerative, et cetera. It's just, it's a newer topic. So, you know, by the time that everybody starts using exosomes, it'll be 10 years from now. And it's just, it's a very hard process to go from like new scientific major discovery was made. Okay. Now every single dentist or every medical doctor's using these technologies. That's like, you know, a big gap. Big gap. And as you know, the universities are not always like elite to teaching you like the absolute latest and greatest. Sometimes they're a little behind as well. So.

That's true.

Yeah.

I want to back up a little bit because a lot of people are wondering what the heck are exosomes?

Yeah.

So how can we explain them in a more like general, general term?

So an exosome is a vesicle. So it's a small little, it's part of like a little vesicle. Like think of a little ball that has information inside of it. So if the body just secretes the information, then it gets degraded very quickly by the bloodstreams and different enzymes that break down these things. If it's stored in this little vesicle, it means the body wants this to last a long time.

Like message in a bottle.

Yeah, a little bit. Yeah. And so this is like something like, hey, I'm not hungry. This is more like, hey, I've broken a bone. It's obviously not going to repair in the next like 15 minutes. So I need to let my body know that there's a broken bone where the fracture is. They'll secrete a lot of these exosomes that say like to the rest of the body, like, hey, you need to come in here and fix this. And you know, that's just every single cell secretes exosomes. So the complicated thing is figuring out like which one does what and how do we use which exosome that these cells are secreting for which regenerative potential. You know, just to add to this, I know you have, I'm sure a million questions, but one thing that I find very interesting, which I'm sure you're going to find interesting. Where a lot of the research labs have gone has been in understanding exosomes within placental tissues. And this has been like really, really a hot topic in regenerative medicine. And what we find is if you actually think about this, the placental tissue gets one cell from dad and one cell from mom. And if you think about how crazy this is, it can make every single organ in the body, right? Like the placenta can literally make every single tissue, every cell type, every skin type, everything in the body.

Wow.

And so a lot of that is governed by exosome secretion. And so there's a lot of work that's trying to figure that out. And then the other thing that's like, I think it's like a miracle. If you think of the placenta, it's crazy to think that 50% of the DNA obviously comes from the mom, but 50% also comes from the dad, but the mother doesn't reject the placenta and the dad's DNA and vice versa. Like if you think of the body. There's no organ that I could take from my body and put in you and be like, that's, that's going to survive there. Absolutely not. You'd be on immunotherapeutic drugs for the rest of your life, but in the placenta that can happen. So a lot of scientists call it the perfect allograft. And if you think of even crazier, if you think of surrogate pregnancy, you can take completely different DNA from, you know, and put it in the placenta and everything grows perfectly.

It's pretty amazing.

It's amazing. So now what people are doing, and if, you know, the, even the patients that are learning, the exosomes that are coming from those tissues are the best allograft, meaning it's coming from another person because you can't have an immunological rejection to it. And it's the only tissue in the body that can do that. And it has the potential to make every single tissue in the body. We just have to figure out how that works as scientists. So it's very exciting.

That's exciting. I know we have also placental membranes that we can use in periodontics. Do those contain any exosomes? Yeah.

They would definitely contain exosomes as well. Well, exosomes, yes, and not cells necessarily, but certainly there'll be growth factors and exosomes in there.

Yeah. I can't wait to hear what you are going to be researching in the next few years.

Yeah, there'll be a lot.

Very true. Now, I know, like, people are using exosomes and you're using exosomes for oral applications.

Yes.

Like, where do you use these exosomes for oral applications?

Mainly for regenerating complex defects.

Bone and tissue?

Bone and periodontal tissues, soft tissues, et cetera. So, it's kind of the cases in like, obviously the dentist listening will know this, patients may not know, but like an extraction site with all walls, it's like, it's pretty predictable. We know it's going to regenerate. It's very different doing that than trying to regrow 5 millimeters of vertical bone or getting 6 millimeters of periodontal regeneration, right? So, Depending, the more complex it gets, the more we want to use exosomes. The complicated thing with exosomes is they're quite expensive, so that cost gets transferred to patients, obviously, right? So it's like we don't want to overcharge them just because they, you know, going to heal a little bit faster. Maybe it's more like, hey, this is a tricky case for any dentist and, you know, we want to make sure we have enough bone. We want to make sure we have a great aesthetic outcome. Therefore, We believe it's, you know, worth your money basically to use these, you know, additional technologies.

So like a vertical bone augmentation.

Yeah. Anything that we think, yeah, would require a little bit more help. Yeah.

I've noticed in some of your cases you're mixing PRF with exosomes.

Yeah.

Is that common to do that? Do you recommend that every time?

We do it pretty much every time. And it's actually amazing that you picked all this stuff up from my, our lectures, but Because, you know, these are like fine little details, but it just goes to show how great of a student you are as well.

I've always been a great student.

Yeah, you can tell. But the reason why is if you think of it, the exosomes are liquid, right? So let's say you were going to do a bone augmentation in the posterior mandible. The problem with using just the exosomes, it's liquid. And so being liquid, you can't really keep it there, right? So if I use it, some of the exosomes might go elsewhere and I waste them. If we actually use the PRF and it clots within the bone graft, the nice thing is, is you're sure that it's going to stay there. So we use it not because, you know, there'll be some additional advantages to have PRF with angiogenesis and blood flow, et cetera, but it's mainly just to be like, hey, we're going to make sure that everything stays here. The exosomes get clotted within the fibrin matrix, and then we're sure that it stays.

I see. Very good. So, so we have to take one of your courses, obviously, if we're going to start to attempt to do all these regenerative procedures.

I would recommend, yeah, or learning from somebody that's doing it already. But yeah, it would be a good idea. Yeah.

Yeah. By the way, you are also supplying the perio— periosomes, is it?

Periosomes. Yeah.

Yeah. How are those different from exosomes?

Yeah. So basically, you know, exosome is this big world of, you know, lot of products. And I think the mistake that people make is that there are many, many growth factors, many biomolecules, right? So like, let's say for example, in our field, perio, there's MDOF. gain for periodontal regeneration. There's BMPs for bone regeneration. There's GLP-1 for semaglutide to lose weight, right?

Yeah.

There's others, insulin for diabetes. So, a lot of people make the mistake of saying, I'm a med spa or anti-aging, we use exosomes. And they just use the same exosomes for X, Y, Z, Z. And that's a big mistake. That would be the equivalent of me saying like, okay, I'm a periodontist. I'm going to go take semaglutide. And I'm going to go mix up my bone graft and try and make more bone. Like, it's completely stupid, right? Like it's not meant for that. Right. So it's meant for weight loss. So the difference is, is that we're trying to figure out which exosome subsets are going to be best to regenerate each tissue. And so the real research that's being done with a lot of different major, the major players in the exosome world is like our research lab, you know, we can get exosomes from all these cells or different tissues and We can freeze them and then reuse them in different like cell models or animal models where we say like, okay, here's 20 exosomes. Here's 20 osteoblasts that make bone or 20 bone animal models that we're going to do research on. Which one of these exosomes, when we mix it with a bone graft, makes bone the best? And then we say, okay, it's this one. So this is going to be the exosome we're going to use for bone regeneration. And then we do the same thing for hair and then for skin and then for— IV treatments and for anti-aging : and for joints, right? So the exosomes are really, when you hear the word like periozome, it's the exosome specific for periodontal regeneration and for periodontal applications. When you hear hair zomes, it's the one specifically for hair. Dermosomes are the ones specifically, and our research lab is doing all the testing for that. And so yeah, and there's just the reason why there's literally 6,000 papers per year is because there's just so many options and So many teams that are measuring all these things and we're learning as we go. And so, yeah, but almost any of them will help with regenerating tissues. It's just some work better than others for specific though.

So I foresee another book in your future about—

You know, we are currently editing a Perio 2000 complete issue, which is 600 pages on exosomes.

Oh, amazing. I can't wait.

It's coming out in 2027. Yeah, it was a lot of work. I already beat you to it.

Now, 10 years in the future. Okay. Where will regenerative dentistry be and what would it look like to practice as a regenerative dentist?

Yeah, and that's a great question as well. So, you know, it's actually interesting because I've lived and spent some time in Europe, almost 10 years there, and then of course in North America. In Europe, the one big difference between periodontists in Europe versus here is that in Europe, a periodontist does zero implants. Interesting. They don't learn how to do implanting at all. Oral surgeons, they place implants and do GBR, and the periodontist just does save teeth and recession coverage and intrabony furcation defects. So that's what they learn. Very, very different. And so like Tony Schooley doesn't place any implants, never has, never trained me how, like doesn't do any research really in that place apart from like recession coverage around teeth. So I've focused a lot of my research on trying to save teeth. I think it's an important field as well. But what I would say, what I think is going to happen is that if you think of how many implants and how great that industry has been, it's been fantastic. A lot of people have missing teeth, et cetera. But think of people that are 40 years old or younger, and then think of how many of them are missing teeth. Like when I actually think about this, because, you know, I'm in my mid-40s and I don't have a lot of friends that are missing teeth. Right. And people that are like, I'm the eldest, like none of my sister's friends are missing teeth. And I don't know any of my brother's friends. Like they would have asked me, they'd have been like, hey, my buddy's missing a tooth. It's very rare. Yeah. So what's going to happen is a lot of these people are going to have a lot of their teeth. And what's going to happen is they're probably all going to have periodontal disease, right? A lot of them are going to have all their teeth and they're going to start having 3, 4, 5, 6 millimeter pockets. And I think what's going to happen is that there's going to be a lot more focus on trying to incorporate regenerative therapies to treat periodontal disease. So the one thing that we focus a lot on actually is trying to figure out, you know, what, what my research team focuses a lot on is How can we treat a 4 to 6 millimeter pocket non-surgically? And the way that we do a lot, and everybody in Europe believes this, the way that this is going to get done is energy-based devices. We don't know exactly what it is, but some form of like laser therapies, et cetera, in combination with some type of biologic. I don't know if it's PRF. I don't know if it's Endogain or exosomes or combinations thereof, but like, I think in 10 years from now, we're going to know the answer to that question.

Mm-hmm. And in 10 years, nobody's going to be doing flap surgeries.

So that's the thing, right? So we're going to— it's going to be less barbaric, like, let me cut you all open, et cetera. It'll be like, we'll be able to detect things a lot faster. And then, we'll be able to, you know, that 4-millimeter pocket before it gets worse and you need a dental implant, it'll be like, oh, we have all the protocols established for how to regenerate that. So that's one area. And then, I think that the collaborations with our medical colleagues is going to become a lot stronger. We know, you know, this, like the oral cavity is so important for systemic health and overall health that like, you know, I always say like 30 years ago, if you were a dentist and you said like, oh, you know, you have periodontal disease, there's a chance that you could have like a heart attack or you have increased chance of Alzheimer's. Your patient would be like, you're absolutely outta your mind. Like you're just nuts. Right. But we have all those links now. Right. They all exist. We know all this stuff. So I think that the collaboration and partnerships with medicine and like really treating dentistry as like a part of medicine, really, you know, I think that in 10 years is going to— is going to shape the future of healthcare.

I like that. And I really believe that I'm with you there. And it's so needed because the separation for the mouth, the body's over here, the mouth is over here, and we don't really communicate as much as we should.

Yeah. So that hopefully, oh, I'm sure it's going to get a lot better with time.

Yeah. Very good. So where can people find you?

Yeah, we do courses almost every weekend. As you know, I travel a lot. So Um, at PureFEDU, we have courses all over the country at all times. So we have online programs as well. And, uh, yeah, our website's, uh, purefedu.com and we teach everything in regenerative medicine, biomaterials, exosomes, et cetera.

So, and even facial aesthetics.

Well, you know, that's, we haven't even talked about that. Believe it or not. I know, you know, it breaks my heart because you know how hardcore of a basic researcher I am in my lab and I've written so many papers.

Yeah.

And it's like crazy for me because my favorite course to teach is like a longer biomaterial exosome PureF course, which which is 3 days. And as I was teaching more and more of like my 1 or 2-day PRF course, people would ask like, don't you do that stuff in facial aesthetics and facial aesthetics? And I would get asked every single weekend from like 10 years ago till now, to the point where, you know, one day I asked Catherine Davies, who's a plastic surgeon that I wrote a facial aesthetic book with. She did all the injections and everything else. I asked her, I'm like, I know you're one of these experts in platelet concentrates, PRP, PRF, and facial. Do you want to teach a course? I'll teach the biology. You teach the facial, how to inject, where to inject, how to do vampire facials. It is by far our most popular course from the get-go. And it like—

Amongst dentists?

Amongst dentists.

Yeah.

And so the hard thing for me to believe is my favorite course to teach is my biomaterial ones, which I teach like 2 or 3 times a year. I'll get like 18 people that go to that program. And then we have this facial aesthetics course and there's like 150 people that want to sign up with like a waitlist of 500 people. And I'm like, what is going on with The world, right? Everybody wants to look younger. And, you know, I do treatments like that now because, you know, we, we've done a lot in that space too. And it's pretty easy to learn, like when you think about it. And like California is like the craziest state in my opinion, because like there's a lot more regulations there than most states. But if you think of the ability for a dentist to do one, how much they know about facial anatomy, like I can't think of a single specialty that knows more than us about head and neck anatomy.

I agree.

And, you know, I tell patients when they ask, like, why would I want to do this with a dentist? And I say, do you know, like, when I was in dental school for a whole semester, I had to take a course for 4 hours in the morning with a cadaver, and we would spend the full semester every week learning from here to here. Then even the medical doctor would spend the same amount of time in the cadaver lab, but they had to learn everything from here to the bottom of the toe. And so we learned way more about this than any other profession. And then if you think of like, which specialty has done more injections than dentists?

Nobody.

Nobody. We do literally tens of thousands of injections in complex areas bent over. So like to like tell somebody like, okay, you gotta inject here, put 0.5 cc's here, here, and here. We're gonna increase the cheeks. Like for a dentist, it's a, it's a joke, right?

Yeah. Makes sense.

You know, in United States it's kind of crazy because like Every, like a lot of patients think like, oh, but no, it shouldn't be you to do this. It should be not even a plastic surgeon, which I'd be fine with, but no plastic surgeon does these types of procedures or very limited. They want to do the big surgeries and the facelifts and, you know, and there's only 6,000 in the whole country. The majority of Botox and fillers injected is done by nurses.

True. And they don't even know how to do a dental block. No, it's true. 'Cause I get asked by them to show 'em how to do it.

They have not taken head and neck anatomy like we have.

Mm-hmm.

You know, they have not injected like we have. And it's not to say that they can't be great. I mean, I have nurse practitioners that are great. They work literally in my practice and I hire them. But, you know, the day that I first hired them and they never did that before, like it was a lot of work to literally show them how to hold a needle and how to inject properly, et cetera. Like they have no training, right? They can get really good, but nobody will ever convince me that the day a dentist graduates and a nurse graduates, that the dentist is not way more qualified. And so I explain that to patients and then patients are like, you know what? I never thought about that. Like, that makes so much sense. Right?

Yeah.

So we can take the same weekend courses that nurses take or curriculums that they take at the same education, but our foundation is just so much stronger. Right? So I explain that to patients. They're like, you know, I never really thought about that. That makes so much sense. And then, you know, the difference between that and working in perio especially is like, Nobody wants to come in and be like, okay, I want to do my surgery today. I got a 7 millimeter pocket, like, just go ahead and do the surgery. And like, when it's done and I see a great result and my x-ray has like a 2 or 3 millimeter pocket, I'm like, man, I did a great job. They're like, can I get out of here, Dr. Myron? This is nonsense, right?

Yeah.

But if you do a facial aesthetic procedure, just like you said, I did a vampire facial, your face lit up, you're all excited, right? Imagine all the patients that think the same way.

So Tricia, you train now dozens of practices around the United States.

Oh yeah. I mean, you know, the one thing that we, that PureFEDU and my team really tried to establish with dentists that really helped them was that I was doing all these courses for many years with the plastic surgeon. I was like doing the courses and sometimes we'd see these nurses and I was like, I would be scared to be treated by her on Monday morning. Oh, you know, because like they just injected the first time ever for anywhere. And then did microneedling. But you know what happened? They would go back to their practice. They were starting a new med spa. They'd bring in their sisters into practice or their mom or their friend. They'd post on social media and then they'd do 50 to 100 cases and then they'd get really good at it. Right. And they're promoting it all over social media, et cetera. What does the dentist do when he went back Monday morning? Oh, I had to miss Thursday, Friday. I got to make production. I get back busy with dentistry, et cetera. And some dentists would call back to Pure FUE and be like, can I speak to Dr. Maron? And I'd get on the phone like 3 months later. And And they'd say, you know, I got a patient that wants to do a vampire facial. Like, how do I do that again? And what should I charge? And I was like, the course was literally 3 months ago and they haven't even unboxed it. Right. So they just get back in the flow of just being way too busy and you know what that's like.

Yeah.

And they miss out on a huge opportunity. And then what I was doing was I started to call the nurses and I was like, hey, I've seen you done like 100 great cases. Can you come be my educator and start training and helping my dentist learn how to do this? Right. Because they were actually doing it.

Yeah.

So what we did differently was that in my practice, I realized that Lakewood Ranch Dentistry, it was kind of weird to run marketing and say like, come to Lakewood Ranch Dentistry and do your Botox and your PRF and your vampire facials. So we just created like a little side division called Kerasthetics. And you know, it had a nice ring to it. We made it very like holistic looking. It was all natural sciences, et cetera. And it worked out very well. You know, people no longer saw the Botox ads with like Lakewood Ranch Dentistry with this big tooth beside it, right? That was our logo.

Yes.

So they, they would be like a nice little flower that was like greenish and, and it worked out very well. And so over time, what I did was with these dentists, I said, hey, listen, if you don't really know what you're doing in your practice, I'll tell you what, I built the whole platform for marketing. I know all the banners that work, all the tri-folders, all the videos. I know what to post to social media. I know what before and afters are working, how to run an open house. I'm like, you can be CareAesthetics in your city. And so it's not a franchise, you know, I didn't wanna make a lot of money from it. I just wanted to like help other dentists out. And so they basically buy into this marketing package. It's $5,000 and they get everything.

That's great.

And that allows them to like really start up and like build their, boost their practices. Because I promise you, the minute you put up banners that you're doing aesthetics and you look the part, patients are gonna ask you questions about it.

Yeah, absolutely. And you know, we know how busy dentists can get and just for you offering this like in a box.

Yeah, that's what it is. Marketing in a box.

Yeah. Amazing.

It's literally like the, you know, the key. It's just the key to you start it.

Like, I love it.

The minute you put up the banners, there's, there, you're gonna get asked and like you're basically forced to start doing the treatments basically.

So, yeah. Dr. Rick Myron, thank you so much for being with me today and chatting. It was amazing.

Yeah, it was fun. It was a lot of fun.

So, yeah. Good. So everyone out there, we're gonna put all the information where to find Dr. Rick Myron below in the show notes. And if you know anybody who could benefit from listening to this show, please share it with them. And until next time. Keep learning.

Bye, guys.

Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @DrSanda. This is Dr. Sanda, and remember, your Your mouth is the gateway to your health, so take care of it in the most natural and best way possible.