Use of biphasic calcium sulfate bone graft cement in GBR

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Posted on By Michael Katzap In Bone Grafting

Hi everyone,
Hi...First post on DentalXP.
The patient had two failing lower left premolars. There was a buccal plate defect. The teeth were extracted and granulomatous tissue removed. No flap was elevated. The patient is phobic and did not want any unnecessary surgical manipulation next to the nerve. The sockets and defects were grafted with Biphasic Calcium Sulfate/ HA ( Bone cement). Three months post-op, implants were placed in the area and additional bone cement was used to cover the partially exposed threads of one of the newly placed implants. The implants are still healing ( sx was performed in October). Thank you

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4 Comments

Great post and thanks for sharing. The material is very easy to use and seems to stabilize well when placed into the defect. Why did you not add bone and use the CaS as a bone binder "carrier" for the graft to offset any resorption issues? regards Dr. Salama


Reply

Hi Dr. Salama and thank you for the comment. The material does not need a bone binder. The syringe contains biphasic calcium sulfate and HA ( about 33% by volume). The HA particles are various sizes by design and act as a space maintainer. As the calcium sulfate dissolves the HA continues to maintain the graft volume. Due to the HA various particle sizes, it gets reabsorbed over time as well, as the area turns over to bone. The key to using this material, in my opinion, is to leave it alone as is when its immediately placed in to the defect. Adding allograft in to the mixture will interfere with the cohesiveness of the original matrix formation as the calcium sulfate hardens in place and may detract from the conversion of the graft to bone. Calcium sulfate will dissolve, generate a high concentration of calcium ions, then will precipitate as calcium phosphate, which will turn to bone ( From Ricci). Thus it makes the procedure simple, fast and effective. More importantly, as a secondary benefit, it minimized surgical trauma to the patient due to its ease of use. All the best :) Michael


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Nice post, thank you for sharing.
Recently I`ve done some augmentations with Bond Apatite. First impressions are positive (easy to handle, uneventful early healing). As soon as patients come for re entery I`ll share results.
Best regards
Snjezana


Reply

Thank you for your comment. I am confident you will be happy with the results. All the best, michael


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