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Video Details
Bone Graft Cements: A New Advance to Augmentation Solutions

Description:
The purpose of this lecture is to shed light on the evolution of raw materials in order to find the ultimate bone graft cement, exploring the potential and the new opportunities of using cement-based augmentation materials in the maxillofacial and dental fields, and emphasizing the advantages, disadvantages and methods of use from the scientific and clinical points of view.

Date Added:
7/27/2022

Author(s):

Amos Yahav, DMD Amos Yahav, DMD
Dr Amos Yahav DMD graduated from the Carol Davila University of Medicine in Bucharest Romania in 1992. In 1993 he established a private clinic, limited to Imp...
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Questions & Comments
Mouhamad Ahmad - (11/9/2017 1:03 PM)

thank you for the video

dr Amos yahav - (11/5/2017 11:36 AM)

Dr Balk, thank you for your question ,our cement is not biphasic calcium phosphate (HA /bTCp) many make this confusion . our cement is Biphasic calcium SULPHATE .which is completely deferent material with different behaviour and characteristics .BCP is granules ,and the BCS is cement . actually it is not necessary to decorticate since the periosteum is not isolated by membrane, the perfusion of cell and blood into the graft is not disturbed .

dr Amos yahav - (11/5/2017 11:28 AM)

Thank you Dr KIm for your Questions .my answers hopefully will clarify the things . working with those type of cements prevent the need for a membrane ,when using a membrane you actualy block the periosteum and inhibit the healing in addition when you are using the conventional grafts and technique you must use a membrane and have large and aggressive dissection in order to gain tension free and primary closure ,if not you might end up with exposure and probably with graft failure . on contrary with the cements the flap dissection is as minimal as possible you don't want that the flap will be influenced by the mussels movements.the flap should be reposition directly on the cement with tension to gain more accurate to say maximal closure and not necessarily complete primary closure. which mean 1-3 mm exposure is fine however not more than it .exposure of the cement will not lead to contamination due to the nature of the calcium sulphate ,over exposure might lead to volume lose instead .thats why in case of up to 3 mm exposure soft tissue will migrate rapidly above the cement and bridge the gap .this tension provide a perfect stability of the soft tissue on the cement and only on this type of cements the protocol is with tension. all other grafts you should have tension free as we were trained .when having that tension on the cement also simple suture are sufficient because the elasticity of the flap can not be even compared to the mussels traction which is much more powerful .you can check it after suture that when you will move with your finger on the vestibule and try to pull the flap , nothing will move even if you have just 3 simple suture in place . so we must remember here it is completely deferent concept that should be treated differently. Therfore it is much less invasive , less chance for complications ,more predictable ,with better outcome due to the transformation into the patient out bone himself . regeneration is when you don't have integration of the graft .is when you can see osteocyte within you graft particles , unless you don't see those osteocytes this is not regeneration bone ,this is a repair by integration of sterile sequestrum that might integrate very well it looks like bone but is not real bone . you don't need to mix those cements with nothing to enhance the healing and to improve the outcome .calcium sulphate is the only material that transform simultaneously into the patient own bone .its the only material that has identical outcome as autogenous bone graft .thousands of article were published on it . the biphasice calcium sulphate has the same chemical structure as the old calcium sulphate with the ability to set and harden instantly in presence of blood ,this material most of it is already after setting with the ability to behave as a cement . the Bond Apatite is intended to be used also in large and complex defect therefore we provide it i 1 cc for socket grafting you can use our 3D bond 0.5 cc so you will not need to spend unused material . but remember 3D bond by itself is only for sockets .if you will use it in larger defect it will resorb to fast . as we any surgery you must use only sterile gauze to compact the cement . for horizontal you can gain 5-6 mm very easily as long as your flap is with tension above and maximal close .

Joon Kim554 - (11/4/2017 10:35 AM)

There are some confusions that need to be clarified. - Primary closure with moderate tension. Is it even possible to achieve primary closure when tension exists? The reason we always wanted tension free closure is so that we don't end up destabilizing the graft and membrane. Do we not need to worry about destabilizing the bond cement? And why do all videos show #15 blade releasing periosteum if we want tension? - regeneration/repair: I thought allograft fully resorbs and causes regeneration whereas xenograft lasts much longer and causes repair. - Can it be mixed w/ biologic material such as Gem21 for better result? - Why is there only 1 CC version of bond apatite? 1 tooth horizontal augmentation probably needs 0.5CC and I feel like I am wasting half of the material. - What's the working time once I push the syringe and reach the blue line? - Can we use any unsterilized 2x2 gauge to push for 3 sec? - What was the maximum horizontal gain during lateral augmentation? Does it have to be in the bony housing? Thank you.

John Baik - (10/26/2017 8:24 PM)

Thank you for this wonderful and very interesting presentation. Is it necessary to decorticate bone when performing a lateral ridge augmentation using the BCS/HA material?

dr Amos yahav - (10/26/2017 6:25 AM)

Prgf/prp are not really needed when using biphasic calcium sulfate product , although those are not contraindicated . Due to the virtues and characteristics of the bioactivity of BCS to encourage vascularization ,and to transform simultaneously during its replacement into the patient own bone ,a true regeneration take place with minimal disturbance to the healing. Opposite to the other solution in which integration take place

Barry Rimmer - (10/25/2017 5:27 PM)

Hi you have mentioned adding prgf/prp products-when and how?

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