Lateral Augmentation with Bond Apatite

Lateral augmentation can be a challenging procedure when it is performed using conventional bone grafts and conventional techniques. However, when the procedure is done with bone cements, like Bond Apatite, it becomes a very simple and predictable procedure, as long as the protocol is respected. The clinician has to change his “granules” state of mind and work with the cement in a simple 3 step procedure: place, press, and close. This means: Place the cement into the grafted site, Press with dry gauze for 3 seconds , and Close the flap. Graft placement and stabilisation can be done in less than a minute.

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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11 thoughts on “Lateral Augmentation with Bond Apatite

    • Baranes says:

      Peter how are you?! I m pleased to read you.
      This clinical case is the result of protocole respect. The flap is tension free but no more, and the simple use of bond apatite :place press and close. Without any membrane.
      Verry happy to see you soon.
      David Baranes

      (0)
      • Dr amos yahav says:

        well done Dr David you turn a challenge procedure into a simple one .
        i think it is important to mansion that the flap is primary closed with moderate tension in contrary to the cases that are done with membrane and granules where tension free is essential . here we prefer a slight tension which keep the stability of the flap .is that so with this case ?

        (0)
          • Mark Lubitz says:

            Is the reason for moderate tension to gain keritinized tissue between flaps and also not raise the muccogingival junction as high?

            (0)
  1. Dr.Amos Yahav says:

    The main reason is to gain stabilisation of the flap above the graft during the healing process .when we release too much the flap it might be loose,so its movement can jeopardise the graft .when we work with granules and membrane we must assure that the flap will be tension free if not we will gain exposure that might lead to contamination .
    here, due to the cement characteristics this is not the case .minor exposure(2-3 mm) will be covered rapidly by the proliferation of the soft tissue above the cement. in larger exposures some of the cement might wash out and you might lose volume .from my experience if you don’t use a membrane ,contamination due to exposure never happened .
    and as additional benefit is indeed as you said we almost don’t move the vestibule and the muccogingival junction .

    (0)
  2. peter Fairbairn says:

    Well said Amos , we have done research on healing by secondary intention over a stable graft ( as Apatite is here) and small dehisences will granulate over …. the bacterio-static nature of CS is also a great benefit …
    Peter

    (0)
    • Dr Amos yahav says:

      I definitely agree with you Peter
      CS has some advantages that non of the others have .such as complete transformation simultaneously into the patient own bone, cementing properties,excepional biocompetability ,bacteriostatic ability .and the mechanism of bone formation is not integration as with others granules. It is true regeneration by a biological process , due to the precipitation of HA forming a
      latticework of the new formed bone by the released calcium ions
      As well this presence of calcium ions provide a favorable environment for the defferentiation of the ossteoblasts
      That why it is not just an osteoconductive it is a bioactive as well

      (0)
      • Peter Fairbairn says:

        Amos , there are over 200 high Impact factor journal articles showing CaP materials to have high Osteo-inductive potential ……. and 2 recent ones from Richard Miron and Danny Buser …… so the potential of synthetics are finally being realised in Dentistry as well as Medicine …
        Peter

        (0)
        • Dr.Amos yahav says:

          Peter ,
          i think that there is a huge misunderstanding among clinician regarding products categories .
          when we say human source ,xenograft source ,synthetic source ,within each of those categories there is a tromendous different between the products .
          for example allografts are not the same ,as well xenograft products are not the same even if they might be from the same animal .
          and of course synthetic materials are completely deferent one from the other
          there are many clinicians who believe that all synthetic are the same ,it is like saying all metals are the same .or all polymers are the same .
          no doubt that today we have some amazing synthetic product
          and any combination with calcium sulphate mineral will improve the outcome by far

          (0)
  3. Jkdmd says:

    You first said tension free flap and the video also shows periosteal release. And in your next comment, you said you want tension. Could you tell me which one you recommend? And could you tell me why you would want tension on your flap? I dont see the reason not to make it tension free.

    (0)

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