Algipore Plant-Based Hydroxyapatite for Sinus Lifts: Any Experience with this Material?

I have used it in several sinus lifts and got great results. When I used the material it was called C-graft and was put out by a company called clinicians preference that is now out of business. There is plenty of research in Europe to support the use of this product. Ewers has put out a number of articles. C-graft Algipore had rapid turnover to bone from 4-6 months. I even have some great histo samples to show this. Since I used it, C-graft has disappeared in the United states but It worked well in the sinus applications. I would definitely buy it again if densply marketed her in the United States.

I know that Algipore (C-Graft) is now being marketed in the U.S. as Algisorb by Osseous Technologies of America.

thanks for the responses! Isn't the turnover of Bone slower than DFDBA? Isn't the quality of bone created poorer than DFDBA created bone?

Keep in mind that C-graft (Algipore) had been recommended by it's previous marketing company (Clinician's Preference)for use with autogenous bone not alone. So mixed it worked quite well in my hands but just about anything will work well mixed with autogenous. I tried it alone on one occasion with poor results (bone was mushy at 6 months). I wonder why you would want to use it when dfdba and bovine HA have such excellent track records.

In my cases, I used it alone in the sinus and it worked very well. But everything tends to work well in the sinus so the real test would be gbr or socket in which I never used c graft.

Dear Dr. S thank you for your interest on AlgiPore / Algisorb this material is since 1987 on the European market by Dentsply Friadent. Since 2003 it is FDA approved and was first sold as C GRAFT by clinician Preference and is now sold by Osseous technology of America under the brand name algisorb. This material which is originated from marine algae and is a very porous pure HA is just a osseoconductive scaffold and should always used with at least of 5% autogenous collector bone or also could be mixt with small portions of demineralised bone. This materials keeps very good the volume and resorbs in about 2 to 3 years almost completely. There are many publications about this material, especially by now in combination with BMP's. If you have further questions please do not hesitate to contact me Rolf ewers

Simply tenting the membrane with the implant will allow bone to form. No graft material is needed but it can speed things along. My preference is to use mfdb (mineralized freeze-dried bone) for it's osteoinductive properties in healthy patients (patient's with no history of sinus infections). Patient's with a history of sinus infections get gelfoam or collagen foam only. It takes a bit longer but, imo, decreases likelihood of infection. If there is a perforation when lifting the membrane, I also only use gelfoam or collagen foam. Just my .02.

Paul who is the gelfoam and collagen foan manofatcturer? Thanks in Advance. Berto

Berto, You can get the collagen foam from Zimmer Dental or Ace Surgical. I think Patterson Dental or Henry Schein sell the gelfoam. I get the mfdb from Salvin Dental - the brand of the mfdb is Lifenet. Paul

Hi Paul, Thanks a lot for the info.Here in my area we have the same aproach, doesn't matter if the patients have or not have history of sinus infection,i mean we use some graft material into the sinus. So, could you elaborate more your rationale for use this tecnique, why it decreases infection rate? Thanks for your time. Berto

Berto, My opinions are based on the research and experience of Professor D.S. Sohn, an oral surgeon/PhD in Daegu, Korea and a leading researcher of sinus augmentation procedures. Here is a recent article from Implant Dentistry. www.implantdent.org (Search for Sohn) New Bone Formation in the Maxillary Sinus Without Bone Grafts [Basic and Clinical Research] Sohn, Dong-Seok DDS, PhD*; Lee, Ji-soo DDS†; Ahn, Mi-ra DDS‡; Shin, Hong-In PhD§ Abstract Purpose: Various sinus augmentation procedures, using bone substitutes, have been used to place dental implants in the atrophic posterior maxilla. The aim of this article is to evaluate the possibility of new bone formation in the maxillary sinus without a bone graft. Materials: Ten patients without significant sinus pathosis were selected for this study. The bony window was prepared in the lateral wall using the ultrasonic piezoelectric bone surgery device (Surgybone, Silfradent srl, Sofia, Italy). The sinus membrane was elevated superiorly and implants were placed simultaneously to maintain the space under the sinus membrane for new bone formation. As the methods of sealing the lateral access window of the sinus, patients were divided into 2 groups. Nonresorbable membrane was used to seal the lateral access window of the maxillary sinus after implant placement in 5 cases (group A). Replaceable bony window was used to seal the lateral wall of the sinus in another 5 cases (group B). Computed tomograms were taken immediately before and after surgery, at the uncovering of the implant, and after a 6 month healing period. A bone biopsy was taken on the previous bony window area to evaluate new bone formation. Results: A total of 21 implants in lengths of 10 to 15 mm (mean, 13 mm) were placed, with an average residual bone height of 5 mm (range, 1-9 mm). All implants remained stable during the study period in clinical evaluations. New bone formation and new sinus floors were found in radiographic and histologic evaluations. Conclusions: The human study showed the capacity of new bone formation in the maxillary sinus with membrane elevation only and simultaneous implant placement beyond the original sinus floor. New bone formation without additional bone graft in the maxillary sinus is revealed from the clinical, radiographic, and histologic results, but furthermore long-term studies are needed to confirm this. I have seen his results first-hand and many of his videos (he videos almost every case). One of his residents has posted a few of his videos on youtube. Here is the link: http://www.youtube.com/profile?user=profsohn&view=videos Regarding your question, I believe that Dr. Sohn's research (he has more than this 1 published article) suggests that as long as you have primary stability of the implant and tenting of the membrane, no graft material is needed for new bone formation. However, I do think that graft material (I like mfdb) helps to speed up the new bone formation. My opinion that graft material may be more likely to cause infection is based on my visits with Dr. Sohn and his experiences. If you are not having problems with post-op infections, I see no reason to change your protocol. I prefer to use collagen only in patients with a history of sinus infections but that is just my personal opinion. Take care, Paul

Dear Dr Paul many thanks for your enlightening posts and for keeping the thread alive. My original question was about Algipore and most dentists here have put sufficient light on it. Thank you to all of you for that. Dr Paul I have a case to discuss where I had opened a lateral window to do a direct sinus but the sinus lining was friable though thick and it tore to length of about 15 mm. It was duely patched up with Collatape from Zimmerman. I followed steps similar to what Dr Satish Joshi,Dr Miller and Dr Mehdi Jafri mention here often. I was even successful in putting one 5.0. Vicryl suture (one stitch only) and then cover the lining with collatape. Considering the length of the tear I closed up without graft or implant. Patient healed uneventfully and absolutely comfortably. Now 2 months post operatively with a plan to reenter the operated sight I took a film to see that that the bony window which I had pushed in to be exactly where I had left it! My guess is that I am going to get a graft less sinus elevation with new bone formation! It's 2 months and too early for me to predict the outcome, but would doctors like to discuss the case here, since we have gone beyond Algipore any way? Now it is 2 months post and some suggestions and discussions are in order.

Well no one answered my query. It seems recession is hitting too hard and implants are probably no longer popular! It's 5 months and my patient's graftless inadvertent sinus lift is showing evidence of bone. Can some one tell me what kind of bone I should expect in 5 months time? Is it going to be well calcified d2 d3 type or mushy d5 kind of bone?