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Questions for the Bond Apatite: Bone Graft Cement

Bond Apatite is a new grafting product that combines biphasic calcium sulfate with a formula of hydroxyapatite granules in a pre-filled syringe to create a self-setting cement for bone graft procedures.

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Questions:

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    A:

    Working with Bond Apatite is beneficial in many ways, including increased comfort and handling, improved results and cost savings.

    It is important to know: The transition to working with cement requires a completely different approach than those we are used to working with when using granules or putty.

    In order to achieve the optimal result:

    • 1. *Unlike granules, cement has a defined working time and a defined hardening time, therefore it is important to prepare the lesion in its entirety before carrying out the augmentation (both in terms of hard and soft tissue preparation).

    • 2. *The flow of work should be continuous and not exceed the working time.

    • 3. *The material is activated by pushing the syringe’s shaft down towards the marked line. It is important to push until you feel maximum resistance (This will activate the cement by wetting it and expelling the excess liquid).

    • 4. *The material should be ejected from the syringe immediately after its activation and in a continuous action.

    • 5. *After placing the material on the graft site, compress it firmly with a dry gauze pad above it. Do not try to disperse the material or shape it before the first compression (If you would like to shape the material, you can do it after this step using the tool of your choice, and re-compress it again with dry gauze).

    • 6. *The material should be compressed for no more than 3-5 seconds. (Over-compressing will break the cement and prevent it from hardening). Remember: Compressing the material is necessary because it improves the quality of the cement and does not prevent the penetration of blood and cells into the graft.

    • 7. *Due to the fact that the matrix resorbs and is replaced by the patient’s own bone within 3 months, in order to maintain the final desired volume, it is important to overfill the graft site with 2-5mm (corresponding to the lesion size).

    • 8. *X-Ray Evaluation: A radiolucent appearance during the first 3 months is normal, due to the replacement of the matrix with the patient’s own bone.

     

    General surgical principles, such as proper site preparation, primary closure, and adequate suturing should be respected.

     

    This document is designed as a guideline and is not designed to substitute or replace the user manual supplied in the product’s package.

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    A: Bond Apatite® is a composite graft, made of 3D Bond™ matrix mixed with HA granules in a controlled particle size distribution, intended to fill or augment a large diversity of osseous defects.
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    A: Bond Apatite® can be used in a wide diversity of osseous defects, including medium and large size defects such as dehiscence, fenestration cases, lateral augmentations (horizontal crest widening), sinus lifts, periodontal bone defects, filling of bony defects pre-implant placement, filling a cavity post cyst removal, ridge augmentations, etc.
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    A: Bond Apatite® is a composite graft made of Biphasic Calcium Sulfate and HA in a specific particle size distribution, in a ratio of 2:1. This combination takes advantage of each part of its components. Calcium sulfate acts a short-range space maintainer scaffold. It completely degrades in strict relation to the bone formation rate (4-10 weeks), while the HA acts as a long term space maintainer. The amount of HA within the graft is a relatively small proportion (33%), and is intended only to slow down the overall resorption of the graft. The bioactivity and the graft transformation into vital bone are due to the biphasic calcium sulfate, which is 66.6% of the graft.
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    A: Yes, certainly, Bond Apatite® can be used in sinus lifts, however, it would need to be placed in increments which make the technique not comfortable to work with. Hence, our recommendation is to fill 2/3 of the sinus cavity with your preferred granular augmentation material, and the final 1/3 with Bond Apatite®. It will enrich the graft with calcium ions, and will also close the sinus window with no need for additional membrane placement.

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