Bone Bond

24
News No.24 July 2010

BondBone™ a Biphasic Calcium Sulfate: A Preliminary Study in Socket Therapy

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News 24, July 2010

BondBone™ a Biphasic Calcium Sulfate: A preliminary study in socket therapy
Ziv Mazor, DMD1; Michael D. Rohrer, DDS, MS2; Hari S. Prasad, BS, MDT3; Nick Tovar, PhD4; Robert A. Horowitz, DDS5.

Introduction
Clinical studies have shownsignificant bone resorption and volume loss in the first 6 months after tooth extraction (1). Socket augmentation has been advocated to eliminate the need for a secondary reconstructive procedure (2). Several types of graft material have been used to prevent bone resorption and volume loss, including FDBA (1), ABBM (3), DFDBA

(4,5), alloplastic materials (6), and mixtures of allograft materialswith calcium sulfate (7-9), as well as only dense PTFE barriers to protect a blood clot in the extraction socket. This enables vital bone formation in the site (10-12). The purpose of this study was to evaluate an innovative, biphasic calcium sulfate (BCS), BondBone™ (MIS, Israel), to be used as a graft material at the time of tooth extraction.

The ability of BondBone™ to preserve and augmentsocket volume and resorb in the desired time period between extraction and implant placement was evaluated clinically and histologically.

1 Private Practice Periodontics and Implant Dentistry, Ra’anana, Israel. 2Professor and Director, Division of Oral and Maxillofacial Pathology, Director Hard Tissue Research Lab, University of Minnesota, School of Dentistry, Minneapolis, Minnesota. 3SeniorResearcher, Department of Hard Tissue Research, University of Minnesota, Minneapolis, Minnesota. 4Senior Researcher, NYU College of Dentistry, Department of Biomaterials and Biomimetics, New York, NY. 5Private Practice Periodontics and Implant Dentistry, Scarsdale, NY and NYU College of Dentistry, Departments of Periodontics and Implant Dentistry, Oral Surgery, New York, NY.

Fig. 1 Clinical view ofmandibular right first molar after PFM crown removal.

Fig. 3 Intact socket after tooth extraction.

Fig. 2 Periapical radiograph taken after tooth extraction.

Fig. 4 Socket grafted with BondBone™.

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News 24, July 2010

Case Description
A 39-year-old woman presented with a failing mandibular right first molar under a fixed PFM prosthesis. The patient was in good health and had nomedical contra-indications that would prevent routine dento-alveolar surgery. Pre-operative photographs and periapical radiographs were taken of the site. After bridge removal, the tooth was deemed hopeless. It was sectioned and extracted in an atraumatic manner using periotomes and luxators (Figs. 1-3). The site was thoroughly debrided by mechanical means to remove granulated tissue. BCS,packaged in a sterile syringe, was grafted to the level of the gingival margin, and the BCS powder was whetted with sterile saline before placing in the socket. Excess liquid was expressed into sterile gauze and the BCS injected into the site. After the site filled to ideal contour, dry gauze was

applied and lightly compressed on top of the BCS. Working time was approximately 2 minutes (Fig. 4). Thesite was covered with a collagen fleece (Fig. 5). Over a 3-month period, the patient was monitored for soft tissue healing and radiographic evidence of graft resorption and bone formation. A radiograph was taken which revealed a defect fill (Fig. 6). A full thickness mucoperiosteal flap was elevated and a trephine was used as the first bur for osteotomy preparation in the mandibular right firstmolar site (Figs. 7,8). A dental implant was inserted in dense bone which was fully stable at the time of placement. Histologic evaluation showed vital bone in the site (Fig. 9), which was allowed to heal for 3 months before uncovering (Fig. 10), prosthetic loading, and restoration.

Histological Preparation and Histomorphometry
At the time of implant placement, bone core was harvested from the...