Ridge Augmentation: Thoughts about Bond Apatite synthetic Bone Graft?

I would like to ask if any of you have experience using synthetic bone augmentation materials, like Bond Apatite (also sold as 4MATRIX by MIS Implants) for lateral ridge augmentation or ridge widening? Thanks in advance!

Bond Apatite combines calcium sulfate with hydroxyapatite granules in a pre-filled syringe to create a self-setting cement for bone graft procedures.



25 thoughts on “Ridge Augmentation: Thoughts about Bond Apatite synthetic Bone Graft?

  1. Michael Katzap DDS says:

    Hi. I have been using Bond Apatite over three years, including for lateral ridge augmentation. Most cases done simultaneously with implant placement. Two main things to do are closure WITH tension ( so no large flap release needed) and no removable prosthesis on the surgical site

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    • Michael Katzap DDS says:

      Another addition to my comment…. at the application of the bond apatite….. no placement of membrane is needed. Just place the cement press in to place and close. Makes it much simpler to accomplish the case.

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      • Dr. Fotis Roilos DMD says:

        When do you shape the material? Before you apply the dry gauge? And you over countour alot? About the flap no releasing incisions? Primary closure?

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        • Michael Katzap DDS says:

          I shape the material with the sterile gauze. I strive for primary closure but it’s not needed as long as the gap is under 3mm. Haven’t left that large though. I am not saying not to do a releasing but that it’s not as routine as with particulate and a membrane ( especially if one has to tack it). Like with any graft. I overbuild.

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          • Dr. Fotis Roilos DMD says:

            dry sterile gauge immediately after placement? No use of a spatula or other instrument? How long do you wait for the reentry? What is the quality of the new bone?

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          • Michael Katzap DDS says:

            I don’t manipulate the material with instrument too much. I reenter at 4 months. Type 3-4 bone.

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        • Dr. Fotis Roilos DMD says:

          Thanks again for the reply! One more question! In case that you want to use bondbone or 3dbond (pure CaP) and add your own graft to create your own mixture. What is going to be your preferred ratio and the granules size of the e.g. xeno graft? (for lateral ridge augmentation)

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          • Michael Katzap DDS says:

            I don’t mix the grafts because it takes away from the results. Calcium sulfate needs to crystallize at the host site. Mixing it with another particulate graftvwill damage the cohesiveness of the crystal which will result in graft failure. If you need to use both types of materials then use them separately

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  2. Tim Carter says:

    I think it is safe to say that all materials work it is just a matter of preference. Also when posting on a site like this you will likely get responses from others as if their preferred technique is “the only way”. Personally I still use Allograft sometimes with the addition of xenografts for better space maintenance. Find something that works and stick with it.

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  3. Paul says:

    Synthetics take longer to resorb. Without perfect closure there is nothing to keep the graft in situ. These materials have been used for a long time and their shortcomings led to the development of alternatives. The success of the graft many times depends on the site it is used. Sometimes no graft produces similar results to placing grafts.

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    • Michael Katzap DDS says:

      I completely agree with your stated. However , This is not a synthetic like other. It does not resorb. It actually dissolves. The main component is calcium sulfate. It has unique characteristics that are well documented in the orthopedic and maxillofacial literature to allow bone formation and regeneration.

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  4. Maciej Nowinski

    I usually do not leave any comments, but in this case I will. I used 4matrix and bondbone (which is pure biphasic calcium sulfate) a dozen times in different cases (ridge augmentation, socket preservation, sinus lifts and after I’ve seen outcomes I’m not using it anymore. Be very careful with these materials, read articles (EBM) and then choose if You want to use them or not.

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    • Michael Katzap DDS says:

      I have the exact opposite effect and so I totally agree with the last part of your comment. Read articles, learn the science , techniques and protocols and then decide.

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      • Maciej Nowinski

        I’ve got a feeling that only doctors who work for Augma Biomaterials or MIS, in their practice use these kind of biomaterials. Any others who actually do the whole spectrum of augmentation techniques do not use them.

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        • drphil says:

          Calcium sulfate, or plaster of Paris, has been used successfuly as a grafting material for almost a century, in dentistry and orthopedics, well before either of these companies even existed. In fact, there are references of the use of calcium sulfate use in medicine from way back in the 10th century. There are also other brands of calcium sulfate on the market, like Dentogen. There is also a product called Ethoss in Europe, which is a calcium-sulfate base product (it’s a composite of ß-TCP and Calcium Sulfate, while Bond Apatite/4Matrix is a composite of HA and Calcium Sulfate). I assure you that most clinicians using these biomaterials, and there are alot, have nothing to do with MIS or any other company.

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  5. drphil says:

    Calcium sulfate has been around a long time. Like any other grafting material, it has its positives and negatives. On the positive side, in addition to the regenerative properties, it also functions well as a hemostatic and a soft tissue barrier, which is why, depending on the case, and your experience, you don’t necessarily need to use a membrane when using calcium sulfate . On the negative side, it requires specific handling techniques, and more importantly Calcium sulfate resorbs rapidly, which is why it is often used in a composite with other graft materials. Bond Apatite/4Matrix, for example, is a composite of HA and Calcium Sulfate.

    In terms of your question, about ridge augmentation, others may disagree, but due to some of the disadvantages of the Calcium sulfate, I don’t think using a calcium sulfate material alone, like Bond apatite or 4Matrix, in ridge augmentation will produce the results you want. Also, due to the handling issues, I think it would also require alot of experience with the material before you could use it successfully in a ridge augmentation. Personally, I think it’s good to use alone in simple extraction cases. But for ridge augmentation cases, I think you will see the best results when using calcium sulfate in conjunction with your preferred allograft or xenograft.

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  6. Dr Amos Yahav says:

    Working with Biphasic calciume sulfate Bone cement is different than with conventional grafts, therefore understanding of the concept is important as well respecting the protocols .otherwise,
    it will compromize the outcome .in the following video, you can see a lateral augmentation procedure when it is done properly . See this video https://www.youtube.com/embed/RZsYtkzXg5o

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  7. Peter Fairbairn says:

    Having done over 4,500 graft cases over a 15 year period with synthetics with CS involved , there seems to be many benefits for the Patient and Dentist Alike ..for my research just look at Pubmed . Regeneration is the key

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  8. Peter Fairbairn says:

    Kay as I said You can look on Pubmed or visit the EthOss website or FB site and see for yourself , if you are a Dentist you will be impressed . Regards

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