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The course is aimed to provide all the necessary information to smoothly transition to Augma bone cement from traditional grafting and shorten the learning curve to minimal.
Cover the socket and the implant and overfill (1-2 mm).
There are no specific torque indications. Use the same torque as with native bone according to the bone type.
Augma Bone cement is a bone regenerative material. Thus, if an implant is placed in an osteotomy, with a bony defect or gap within the bony frame, Bond Apatite bone graft cement can be placed to augment and regenerate the bone around the implant.
It is not easy to convince the patient to go for three months without teeth, but this is the best option to achieve bone growth. In some cases, if 2-3 temporary narrow implants can be placed in the anterior part and loaded immediately, this can provide the patient with a fixed temporary partial bridge in the anterior zone. Patients accept this more readily than no teeth at all. If this option is not feasible; however, the patient should be supported in managing the entire healing period without teeth, as any removable denture risks the outcome. In general, noncontact and lack of movement on or of the grafted site is of paramount importance no matter what graft material is used. It is up to the clinician to have a conversation with their patient and guide them during the healing process and oral maintenance following a GBR procedure. Some options to consider are tooth, or provisional implants supported fixed partial (or complete) dentures ( without soft tissue contact and support). For optimum success, NO PROSTHESIS is the recommended approach.
The key to any successful graft procedure ( irrespective of material or method used) is stability during the healing period. Using removable prosthetic appliances, and especially appliances with direct contact of the tissue overlaying the graft site, will cause disruption of proper osteogenesis. In the case of Bond Apatite, any movement and pressure of the appliance on the graft site will disturb the compacted cement matrix and will result in diminished graft volume.
Yes, make sure to respect osseodensification protocols and bone cement protocols. Osseodensification best used on available medullary bone. Particulate graft does not predictably covert to the medullary bone in 3-6 months period. Thus osseodensification of a grafted site (especially xenografts) could be counterproductive. Augma bone cement completely disappears after 3-6 months and is replaced with the patient’s own bone, thus permitting osseodensification.
The key to working with Augma bone cement is the attainment of a compact cohesive cement matrix prior to suturing. Thus, if the cement breaks when compacting, simply place a dry sterile gauze above, press firmly for one second, and continue.