DetailsPlease be sure to read our Protocols and Tips Section below for important advice on using Bond Apatite. The videos below also provide important tips and training.
Bond Apatite Videos
Bond Apatite Tutorial on Socket Grafting
Bond Apatite Case: Bone reconstruction in the aesthetic zone using Lateral Augmentation
Bond Apatite Case:Close Sinus lift
Bond Apatite® is a combination of biphasic calcium sulfate with a formula of hydroxyapatite granules. This is a cement-based osteoconductive composite, synthetic bone substitute that is used for bone reconstruction in a range of dental applications and is intended for filling, augmenting and reconstructing the wide diversity of defects in the maxillofacial bones.
Bond Apatite® is FDA cleared and CE approved. Bond Apatite® is delivered in a dual-chamber,prefilled syringe, containing the granulated powder and physiological saline. Mixing the powder component with the liquid in the driver results in a viscous composite that is suitable for injection into the graft site.
Compared to prior versions of the driver, in which additional accessories had to be used to inject the saline into the driver’s head, this new development of the Bond Apatite® driver ensures easy and more convenient handling by the clinician.
Bond Apatite Clinical Applications
Sinus floor augmentation
Periodontal bone defects
Alveolar ridge augmentation
Horizontal defect (and crest widening)
Filling bony defects pre implant placement
Filling of cyst cavities
Augmentation of large bone defect using Bond Apatite
Bond Apatite Protocols and Tips
- Socket grafting with 4 bony walls 1. There is no need to reflect a flap after ejecting the cement into the socket, Place above it a sterile dry gauze and ,
- 2. Press firmly for 3 seconds. Do not use an instrument to push and compact the cement into the bottom of the socket . Remember that ,the cement during the first stage of healing should not be left exposed therefore ,
- 3. Protect the cement by covering it with a collagen sponge and secured it in place with the surrounding soft tissue by the first suture ,thereafter with a cross stich above .
- Socket grafting (single or multiple extractions) when the buccal plate is missing and the bony walls frame exists. 1. Raise a flap –eject the cement into the site, place above with a dry gauze and press firmly for 3 seconds on the buccal and occlusal aspects.
- 2. Reposition the flap directly on the cement and suture it in place with tension .(That will stabilize the flap in place, without being influenced by the muscles movements.)
- 3. Bridge the exposed gap by covering the cement on top with a simple Collagen sponge and secured it in place by sutures to the surrounding soft tissue followed by a cross stich above .
- Defects with no bony walls frame. (Lateral augmentation, ridge widening) 1. Raise the flap ,the flap should be minimally dissected for release in order to have Moderate tension during closure( not tension free as we used to when we use membranes and other grafts. )
- 2. place the flap directly above the cement and close to gain maximum closure.( Minimal exposure such as 2-3 mm exposure is fine, but not more than that.)
- Radiographic appearance ** Due to the replacement of the cement into the patient own bone the Radiographic appearance is different as well .
- a. During graft placement –Radiopaque
- b. 2-3 weeks post op –Radiolucent
- c. 12 weeks post op- Radiopaque
Bond Apatite: Additional Tips
In cases of four bony walls socket grafting, eject the material into the socket, and press frmly with dry guaze above the material; however, do not use any tool to push the material toward the apex as you are used to when working with granules (doing so will exert pain to the patient).
In case of socket grafting, if you choose not to refect the flap, do not leave the material exposed to the oral cavity. The material should be protected with a collagen sponge or a membrane which must be stitched together with the surrounding tissue (lack of physical graft protection will cause material and volume loss).
In cases of periodontal defects, prior to graft placement, thorough debridement by scaling and root planning should be done. In cases of tooth mobility, the teeth must also be stabilized before graft placement.
Dehiscence and Fenestrations
The cement should be placed above the bone and the exposed threads of the new placed implant or above the exposed root after scaling and root planning. Remember to slightly overfill in order to compensate for graft shrinkage during the healing process. The cement is not indicated in cases when there are implant threads exposure of a previously (old) placed implant. In such cases, the outcome might be compromised as with any other grafts.
Lateral Augmentations & Crest Widening
Hard tissue preparation and soft tissue release should be done before activation of the cement (Decortication is optional). Place the cement into the augmented area and slightly overfll. Then press above firmly with dry gauze for 3 seconds to stabilize the material. You might shape, if required, and press again for 3 seconds. At this point, close the fap. (In large lateral augmentation cases we recommend to use additional horizontal mattress sutures for better soft tissue stabilization above the graft). Membrane coverage is not essential as long as your soft tissue is well stabilized, completely closed, and well sutured.
In your first few cases, we defnitely do not recommend to use the material for vertical augmentations. After gaining experience with the cement, vertical augmentation can be done only if you are familiar with vertical augmentation techniques. As well, you must remember it is obligatory to use a rigid graft stabilization techniques (such as rigid bariers) to protect the cement from lateral movments during the healing phase. If you place the graft without rigid stabilization, your outcome will be completely compromised.
Open sinus lift
In a small to medium sized sinus cavity, you can use Bond Apatite® for fillng the sinus cavity and window closure as well (no need for membrane). In larger sinus cavities, it is less comfortable since you will need to place the material by incremental steps. In such cases, we recommend you to use your prefereable granules to fill 2/3 of the sinus, and the last 1/3 fll with Bond Apatite® cement as a graft enhancer and for window closure. This will save you time, save membrane cost and will enrich the sinus with ions of calcium.
Close sinus lift
Due to the large size of the syringe opening, it is not recommended to eject directly the material from the syringe into the drilled cavity. The graft can be ejected into a dish and should be left for 3 minuets to set, and then can be crushed into small fragments that will be used in such case.
1. 4Matrix is a registered trademark of MIS Implants.
Research No Weight No Volume No Dimensions No Size No Manufacturer Augma Biomaterials
- Great success clinically and radiographically. Review by Dr. Mark Shultsman
I would like to share with you my experience with new bone graft cement called Bond Apatite. I started using this product six months ago and now I am getting my first results. As with any new material, I used Bond Apatite in the beginning with small number of cases: four cases of lateral augmentations in different levels. In all of them I had great success, clinically and radiographically. However, one of the cases even surprised me.
The case involved placed implant in the inferior molar area 36 with large deficiency of the buccal plate, which required bone grafting and augmentation procedure. After placing the implant and decortication of the bone I augmented with Bond Apatite .Since this case involved just a single implant and the quantity of the material’s syringe is 1 cc (there is still no smaller packaging), excess material was left in place. I removed some excess and with the rest I covered the ridge and the head of the implant. In this particular case I didn’t use a membrane, however I closed passively and hermetically the soft tissue. Reentry and implant exposure was preformed after 4 months. In the radiography, before the exposure, I distinguished a radiopacity layer above the implant head. As well, while elevating the flap there was a respectable amount (1-2 mm height) of hard vital bone, that required certain effort from me in order to discover the head of the implant. In fact, I also got a vertical height of vital bone with good mechanical properties. I will be glade to share with you additional interesting and surprising cases in the future. (Posted on 6/25/2017)
- Exceeded my expectations Review by Dr. Isaac Goldschmidt
When I began using Bond Apatite, I was impressed, as it exceeded my expectations. Not only was it user-friendly and highly conducive to use in a clinical environment, it provided predictable and top-notch results. (Posted on 6/25/2017)
- Delivery and ease of use are excellent Review by MICHAEL KATZAP DDS
I have been using augma Bond Apatite bone cement for over two years. The main reason I decided to use augma was the fact that I have an osteoconductive material that I can safely and predictably bring to the surgical site and could expect bone. The delivery system and ease of use are an excellent benefit. Grafting large posterior sockets is done easily and FAST. I even uses the cement as a membrane over a sinus window, or other large defects that needed support. In many applications no tacks or screws required. I highly recommend adding augma bond apatite bone cement to one's clinical grafting armamentarium. (Posted on 3/14/2017)