All the necessary information to smoothly transition to Augma bone cement.Read More
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Biphasic Calcium Sulfate as 2nd generation technological breakthrough in the long history of CS bone regenerationRead More
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.
Biphasic calcium sulfate is a patented formulation of calcium sulfate. This is the only formulation of calcium sulfate that has the ability to behave as a cement in the oral cavity. Additionally, the BCS is moldable and can set and harden instantly in the presence of blood and saliva. The old calcium sulfate could not set and harden when it got it to contact with blood or saliva; therefore, it could not be easily used as a suitable cement in the maxillofacial field.
3D Bond™ is a cementable, osteoconductive bone substitute, made of pure Biphasic Calcium Sulfate; the only one of its kind that can set in the presence of blood and saliva. The material is completely resorbed within 4-10 weeks, coinciding with the time period it takes for the bone to form. The outcome is a complete replacement of the graft with the patient’s own bone.
The medical use of Calcium Sulfate has the longest history in the augmentation field, with over 120 years of use in the areas of Orthopedics, Plastics, Oncology, and Maxillofacial medicine. This material has been studied and documented most extensively and is the only one that is associated with thousands of articles in various areas of medical literature.
Throughout the years there has been a constant insistence on working with Calcium Sulfate due to the extraordinary features that distinguish it from currently existing augmentation materials. Notwithstanding, the material in its basic form has two prominent drawbacks; namely, its inability to harden as a cement in the presence of blood and saliva existing in the oral environment and the materials fast resorption rate.
The development of 3D Bond™ originated from a clear clinical need to simplify the complexity of today’s augmentation procedures, shorten the working time as well as the recovery time. The development of this material was a process of over 15 years of intensive research, focusing on the use of pure raw material without any additives or accelerators. The outcome is a superior bone graft material that has the ability to set instantly in the presence of blood and saliva.
The working time with Bond Apatite® starts when the powder is mixed with saline by advancing the plunger in the smart syringe and introducing the saline in to the premeasured BCS/HA powder chamber. At this time, the material is moldable and pliable. The best pliability is seen immediately after cement activation. Thus, it is vital to have the host site completely prepared before the activation of Bond Apatite®. After the site has been prepared, activate the cement within its smart syringe and eject it into the site. As soon as Bond Apatite® is placed in the site, it should be compressed with a dry sterile gauze pad for 3 seconds, and then the material hardens in situ immediately. The compression should be done by applying finger pressure on the gauze for 3 seconds, followed by an additional few seconds' compactions with a periosteal elevator on the gauze. Once completed, remove the gauze and continue with soft tissue closure according to the protocols.
In the oral cavity, pressing with gauze for 3 seconds generates an instant primary setting. In vitro hardening takes approximately 3-5 minutes.
As can be seen in the protocols, it is recommended to activate the cement within its smart syringe after complete site preparation, injec the cement directly into the site, and immediately place a dry sterile gauze pad above and press with a finger on top for 3 seconds. This should be followed by an additional few seconds' pressure on the gauze with a periosteal elevator.
The material does not remain hard. The resorbtion process begins immediately after placement, while new bone formation simultaneously takes place.
Due to the nature of the graft, the biphasic calcium sulfate matrix within the graft is simultaneously replaced by the patient’s bone; therefore, the radiographic appearance is completely different compared to other grafts, which always appear radiopaque due to their constant presence in the grafted site.
In contrast, the radiographic appearance with Bond Apatite® is as follows:
During day one after graft placement, it appears radiopaque.
Gradually, a radiolucent appearance takes its place (reflecting the graft's transformation into the newly-formed osteoid before its calcification).
Two to four weeks after graft placement, the majority of the grafted site appears radiolucent while few radiopaque spots remain, reflecting the presence of the HA particles. Within 12 weeks, radiopacity takes place with the appearance of the native trabecular form. This is the time when the new osteoid has already calcified.