Used Easy-Graft: When Should I Place the Implants?

Dr. DG asks:
After I failed to obtain adequate primary stability due to an unfortunate mistake in the drilling protocol, I decided to not place the implant and graft the implant socket before suturing. I used Easy-Graft (TM) [synthetic, resorbable graft material] for the first time. The brochure that came with the product states that I could place implants again in 3-4 months because the graft will have undergone osseointegration. The sales representative says I could place implants again less 6 weeks. What would be your advice?

6 Comments on Used Easy-Graft: When Should I Place the Implants?

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Peter Fairbairn
5/4/2010
Dear Dr. I have used this product extensively in often extreme graft senarios and here where you have used it in socket grafting some of the best results are achieved . I usually place the implants at 4 months post the graft and have had no issues with the subsequent loading of the Implants at another 3 to 4 months. Having initial also been a socket grafting sceptic I am now routinely graft sockets especially the lower molar area and place later in a ridge that has lost very little of the bucco-lingual dimension even when the buccal plate had been lost. The Baterio-static nature of the bio-linker also has benefits where ther may be residual infection . The other benefit as you now know is that soft tissue closure is not necessary as the graft will not be lost and the tissue will granulate over the graft. Patient pyhsiology is variable as we know as this can vary the timescale hence the reps caution. Trust all will go well. Regards Peter
Dr. Hamp
5/4/2010
First of all... Protocol depends on patient profile. Overall you should wait 4-6 months before placement. I In the future, you should use allografts for sites that will need implants. All alloplasts have shown to have low vascularity in thir sites, because they turn over at a slower rate. They are also a more osteoconductive material. Allografts will turn over faster into host tissue, and they will deliver a more secure foundation for an implant. A good provider I use is a large tissue bank due to rheir safety, efficacy, and spotless track record... Also they are about 30-50% less expensive than any other provider. Good luck!
Andriy Yegorovykh
5/5/2010
I think you have extended the treatment time for this patient. If the walls of the over-sized osteotomy were thicker than 1.5-2mm I would have left it without graft and returned at 10+ weeks. With bTCP I would wait no less than 4month before implantation, and than do a staged approach (3month+). I have noticed granules of EasyGraft to fill at least 50% of volume at 4 month in maxilla. You torque implant at 45ncm it reaches that value, wait 2 minutes and you can torque again - there is a decrease in stability when you insert in partially absorbed graft, so don't be too tempted to do an immediate loading after bTCP. That's, at least, what i have learned. Don't see the point to graft every future implant site. Waist of resources.
DR KURIEN
5/13/2010
i agree with dr hamp its better we use allograft or autografr .alloplastic material is not commonly use now .its better we wait for 4 to 6 mos for xenograft [bovine] and around 4 mos for allograft . acc.to BLOCK . ALL TOGETHER ITS BETER WE GIVE 4 TO 6 MOS FOR GRAFT TO FORM BONE
Peter Fairbairn
5/14/2010
Having used allografts in the past (up to 8 years ago)we are well aware of their abilities which were even better 20 years ago (less extensive irradiation)but started using alloplasts when the bone theft issue arose. Sure all materials work but synthetics have changed and are changing further to be the option of choice with no donor site morbidity or foreign donor material anxiety for the patient. The graft is also more stable and bulky thus reqiring less material and no membrane thus dimished cost outlay. We have extensive extreme cases which we show ( Delhi on Sunday and Poznan (Poland) next Saturday )and whilst they are just another graft material we think there is a strong future in their use. Regards Peter
Dr.Amit Narang
9/30/2011
Hello Peter. . . I heard you speak on Easy graft in New delhi recently, Thanks for an eyeopener lecture, it was fabulous.. I had a doubt.. Have you tried using Easygraft mixed with autogenous bone or else What do you recommend, should it be used that way, mixing with autogenous bone, or else can we do layering, say autogenous bone at the defect first and then on top easygraft ?

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