Bondbone calcium sulfate for socket preservation?
I am planning to install an implant in the #31 site [mandibular right second molar; 47] at the time I extract the remaining root tips. I plan on debriding the socket, installing an implant and then using Bondbone [MIS] a biphasic calcium sulfate artificial bone graft material. According to the manufacturer, this material can be left exposed to the oral cavity and does not require covering with a membrane or primary closure. I would like to find out from the users of this material if this product works well and whether it is accurate that it does not require covering?
5 Comments on Bondbone calcium sulfate for socket preservation?
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Peter Fairbairn
12/17/2012
Just been at the Beach for a few days so refreshed for the final push to X-mas.
Having used CaSo4 products extensively for many years I can say that this is a fine product BUT caution must be exercised to attain the desired results as their used can be more technically demanding than appears.
We have recently published some very interesting studies using CaSo4 to "bond " the graft particules and that is what I suggest here if you wish to use this product .
MIx it with you favourite particulte ( as to Manufacturer protocols )and after effective curretage graft the site using a layer of pure Bond Bone over it or even a collagen fleece if you are still new to the products.
As to socket grafting , benefits are clearly seen and we have a case photographed every day 3 months until the Implant was placed where these ridge maintaining effects are clear .
But as you are correctly placing the Implant at the same time as removal of the roots then you should have soft tissue closure , but again mix a longer term product with the Bon Bone as in some patients it may bio-absorb too quickly . I have mixed it with many products including Bio-Os (once ) and had good results .
Another thing is the assess the root tips well and beware of any acute infection which may ruin your day.
Regards
Peter
Dr L
12/17/2012
Please note- i do not intend to place the implant at the time of extraction/grafting. It will be done few months after. The editors had changed some of my original question
Peter Fairbairn
12/18/2012
Dr L agreed , although it can be a good idea to place at the same time in these situations if the root tips are small and deep . When you make the osteotomy between the tips it gives great access to the tips for removal and then place and graft .
But very case dependant .
My main advice here is to mix a longer lasting material ( BTcp , HA etc ) with the bond bone until experience levels improve.
Good Luck
Peter
DrT
12/18/2012
Perhaps my technic is lacking, but in my experience, I get quicker and better healing in grafted sockets with DFDBA and FDBA as compared to mixing CaSO4 with autograft material.
DrT
Peter Fairbairn
12/19/2012
Yes Dr T allografts are great graft materials and I was a User of Rocky years ago .
But generally the key is to return the diseased area to what it would have been and hence to me fully bio-aborbed materials are more interesting .
We have cores and micro CT studies of sockets and at 8 weeks up to 85 % of the graft has been turned over to new host bone . Obvoiusly host physiology is a critical factor which varies dramatically and renders most research to light reading.
Peter
