Working with Augma Biomaterial’s biphasic calcium sulfate cement
(3D Bond and Bone Apatite):
Socket grafting with 4 bony walls
• No need to raise a flap
• Eject the cement into the socket.
• Press firmly over the cement for 3 seconds using dry sterile gauze
and finger pressure. Do not use an instrument to push and
compact the cement into the bottom of the socket.
• If the interdental space is too narrow to accommodate direct finger
pressure on the sterile gauze, then a mirror handle or similar
instrument can be applied to the top of the gauze.
• Protect the cement by covering it with a collagen sponge and
secure the sponge in place to the surrounding soft tissue by an
initial suture thereafter with a cross stitch above – During the
initial stage of healing the cement should not be left exposed.
During immediate implant placement when 4 bony walls socket exists do not use an instrument to push down the cement between the socket walls and the implant
Eject the cement above –press firmly with dry gauze pad above for 3 seconds and close the flap with a moderate tension
In cases after flap reflection, it should be slightly and minimally released.
The release cut should be at the base of the flap and minimal as possible, so during the closure itself, the flap should be placed directly above the graft without using any membrane while there should be maximal closure with moderate tension. (shouldn’t be tension free as we are used to with granules and membranes).
It will provide less pain to the patient, less swallowing, stability to the graft during healing and higher predictability.
Exposure of maximum 1-3mm is not an issue. The soft tissue will proliferate rapidly above the cement and bridge the gap. Do not leave it exposed more than this as you may lose volume.