Training Kit
Table of Contents Training kit-introduction 3 How to Activiate 4-5 Expert Tip 6-7 Indications Tips 8-9 Sinus Lift 10-11
Augma Biomaterials 3 Augma Biomaterials invites you to join the circle of cutting-edge clinicians who are using the next generation of bone graft cements. Our bone graft cements are fundamentally different than the granules or pastes that you re currently using in your augmentation procedures. Augma s bone graft cement will upgrade you and your practice by changing the rule of the game. Augma s bone graft cements will offer you and your patients the following advantages: The purpose of this training kit is to familiarize you with this revolutionary concept and enable you to get hands on training prior to clinical use. This Bond Apatite Training Kit is not for human use! (Prior to clinical application review the instructions of use included inside our product s packaging). In order to view the related training videos scan this barcode: Ease of use and simplicity Dramatically reduces procedure time Improved outcomes Shortens Healing Time Significant reduction in overall cost Membrane use is not essential
4 How to Activiate How to Activiate In order to activate Bond Apatite, secure the cap with your finger and simply press the shaft forward until the first piston meets the blue line. After activation simply follow three easy consecutive steps: PLACE, PRESS, CLOSE
How to Activiate 5 PLACE Place the syringe at a distance of approximately 2mm from the defect, eject material and condense with the end of the syringe in a continuous movement until the desired amount is applied. and then CLOSE Simulate a complete soft tissue closure (*) PRESS With a piece of dry gauze firmly PRESS on the material for (3) seconds, Due to Bond Apatite s short and easy learning curve, you will be able to place and stabilize your graft in under a minute. Please refer to the next expert tips in this training manual.
6 Expert Tip Expert Tip Working Techniques Tips 1. Due to a working time of 3 minutes, please prepare all hard and soft tissues for final coverage prior to activating the material. 2. The material should be ejected consecutively and slightly overfilled. After ejecting the material, press firmly with a dry gauze for just 3 seconds to stabilize the material.* Then, if shaping is necessary, you may shape to the desired form. Keep it slightly overfilled and then press again with a dry gauze for an additional 3 seconds. Flap closure should be done right after and according to primary soft tissue closure techniques. 3. If a fragment of the cement has accidentally detached during the suturing process, press again with dry guaze and continue with soft tissue closure. 4. Membrane coverage is not essential as long as primary closure is achieved and soft tissue can be stabilized. * In the oral cavity, Bond Apatite will harden and stabilize in the presence of blood and saliva; however, it will not match the rigidity on your training model.
Expert Tip 7 Radiographic Appearance Due to the graft nature, the biphasic calcium sulfate matrix within the graft is simultaneously replaced by the patient s own bone; therefore, the radiographic appearance is completely different when compared to other grafts, which always appear radiopaque due to their constant presence in the grafted site. In contrary, the radiographic appearance with Bond Apatite is as follows: During day one after graft placement, it appears radiopaque. Gradually, radiolucency appearance takes place, reflecting the graft transformation into the new, formed osteoid before its calcification. 2-4 weeks after graft placement, the majority of the grafted site will appear radiolucent while few radiopaque spots remain. This reflects the presence of the HA particles. In 12 weeks post-op, radiopacity with native trabecular form is expected to be seen after the new osteoid has already calcified.
8 Indications Tips Indications Tips Socket grafting 1. In cases of four bony walls socket grafting, eject the material into the socket, and press firmly with dry guaze above the material; however, do not use any tool to push the material toward the apex as you are used to when working with granules (doing so will exert pain to the patient). 2. In case of socket grafting, if you choose not to reflect the flap, do not leave the material exposed to the oral cavity. The material should be protected with a collagen sponge or a membrane which must be stitched together with the surrounding tissue (lack of physical graft protection will cause material and volume loss).
Indications Tips 9 Periodontal Defects In cases of periodontal defects, prior to graft placement, thorough debridement by scaling and root planning should be done. In cases of tooth mobility, the teeth must also be stabilized before graft placement. Dehiscence and Fenestrations The cement should be placed above the bone and the exposed threads of the new placed implant or above the exposed root after scaling and root planning. Remember to slightly overfill in order to compensate for graft shrinkage during the healing process. The cement is not indicated in cases when there are implant threads exposure of a previously (old) placed implant. In such cases, the outcome might be compromised as with any other grafts. Lateral Augmentations & Crest Widening Hard tissue preparation and soft tissue release should be done before activation of the cement (Decortication is optional). Place the cement into the augmented area and slightly overfill. Then press above firmly with dry gauze for 3 seconds to stabilize the material. You might shape, if required, and press again for 3 seconds. At this point, close the flap. (In large lateral augmentation cases we recommend to use additional horizontal mattress sutures for better soft tissue stabilization above the graft). Membrane coverage is not essential as long as your soft tissue is well stabilized, completely closed, and well sutured.
10 Sinus Lift Sinus Lift Open sinus lift In a small to medium sized sinus cavity, you can use Bond Apatite for filing the sinus cavity and window closure as well (no need for membrane). In larger sinus cavities, it is less comfortable since you will need to place the material by incremental steps. In such cases, we recommend you to use your prefereable granules to fill 2/3 of the sinus, and the last 1/3 fill with Bond Apatite cement as a graft enhancer and for window closure. This will save you time, save membrane cost and will enrich the sinus with ions of calcium. Close sinus lift Due to the large size of the syringe opening, it is not recommended to eject directly the material from the syringe into the drilled cavity. The graft can be ejected into a dish and should be left for 3 minuets to set, and then can be crushed into small fragments that will be used in such case.
Sinus Lift 11 Vertical Augmentation In your first few cases, we definitely do not recommend to use the material for vertical augmentations. Peri-Implantitis cases Periimplantitis cases are generally not predicteable due to implant contamination and the defects morphology. After gaining experience with the cement, vertical augmentation can be done only if you are familiar with vertical augmentation techniques. As well, you must remember it is obligatory to use a rigid graft stabilization techniques (such as rigid bariers) to protect the cement from lateral movments during the healing phase. If you place the graft without rigid stabilization, your outcome will be completely compromised.
G_TrainingKitBA Rev 1 Manufactured By: Augma Biomaterials Ltd. www.augmabio.com info@augmabio.com Alon Hatavor 20 St. P.O.Box 3089, Caesarea Southern Industrial Park 3088900,Israel Tel:+972(0)77-5591945 Fax:+972(0)77-5591042 For further information please visit: www.augmabio.com or contact us directly for any further questions and we will be happy to assist you.