BONDBONE TM F.A.Q.
(Frequently Asked Questions)
© MIS Corporation. All Rights Reserved.
What is BondBone™?
BondBone™ (patent pending) is a novel synthetic bone graft material
considered to be a breakthrough in the field of dental bone grafting.
It is composed of biphasic calcium sulfate, which has documented
biocompatible, osteoconductive, and bioresorbable properties. The
biphasic calcium sulfate is fast setting and its physical properties are
not affected by the presence of blood or saliva. Indications for use:
BondBone™ can be used in three different ways:
1. In conjunction with other granular augmentation materials.
2. Alone, in defects of less than 10mm.
3. As a barrier over other grafting materials.
What are the main advantages
of BondBone™?
BondBone™ has unique advantages when used with additional bone
graft materials and as a stand-alone product. Advantages when mixed
with another bone graft:
■ BondBone™ has excellent handling properties: The initial pliable
paste hardens in approximately three minutes ■ Osteoconductive:
BondBone™ decreases the regeneration time of new bone, compared
to slowly resorbed granular materials ■ Cost-effective: BondBone™ will
act as a binder between the granules of other bone graft materials.
This enables additional volume to be maintained.
Advantages when used as a stand-alone product:* ■ BondBone™
significantly reduces procedure time and time to dental implant placement
■ In most cases it does not require membrane coverage ■ BondBone™
has excellent handling properties when used by itself: The initial pliable
paste hardens in approximately three minutes ■ Osteoconductive: Its
unique porous structure allows infiltration of growth factors through its
micropores and angiogenesis, as well as cell proliferation through its
macropores ■ Safe: BondBone™ is purely synthetic. It does not contain
any components other than calcium sulfate.
* When used alone, it is ideal for defects less than 10mm in diameter that have at least
three-wall bony support.
What is the resorption rate
of BondBone™?
BondBone™ has a resorption rate that is comparable to rate of natural
bone growth, without interfering with the healing process.
Does it contain any additives other
than calcium sulfate?
BondBone™ offers high performance with absolutely no elements other
than pure calcium sulfate; the well-known advantages of calcium sulfate
are maximized for optimal healing. Other bone graft materials based
on calcium sulfate may contain additives to improve their bone grafting
capabilities. For example, some calcium sulfate bone graft materials
contain polymers in order to reinforce the material. Others may use
accelerating agents for fast setting. Because of the biphasic structure
of BondBone™, the advantages of both hemihydrate and dihydrate
calcium sulfate are realized, without the need for additives.
2.
What is the setting time
of BondBone™?
The setting time of approximately three minutes allows for outstanding
handling properties. In addition, it is the only bone graft material that
can set in an aqueous environment and in the presence of blood and
saliva. The reaction temperature is lower than 30ºC (85ºF) and it has a
neutral PH, thus reducing the patient’s discomfort during surgery.
Can BondBone™ act as a
binding material?
Yes, it can serve as a binder with granular augmentation materials such
as autografts, xenografts, allografts, and alloplasts.
Is BondBone™ stable post-setting?
Yes. The initial strength is obtained right after setting and is reduced
over time as the bone rebuilds. This occurs at a rate that is comparable
to that of bone regeneration.
How does the unique microstructure of
BondBone™ affect bone regeneration?
Its unique porous structure allows infiltration of growth factors through
its micropores and angiogenesis, as well as cell proliferation through
its macropores.
Can BondBone™ function
as a membrane?
BondBone™ can function as a moldable membrane over other
augmentation materials. Calcium sulfate allows soft tissue to grow
over it, even when exposed.
Is BondBone™ fully resorbable?
Yes, it is composed solely of calcium sulfate and is fully resorbed,
leaving behind a normal bone morphology.
Can BondBone™ be mixed with
antibiotics and growth factors?
Yes. BondBone™ is composed of pure calcium sulfate, which can be
combined with antibiotics and growth factors.
Taking into consideration the
resorption time of BondBone™,
when can we place an implant?
BondBone™ does not interfere with the healing process and is totally
resorbed and replaced by bone at a rate equivalent to that of bone
formation. Therefore, after three months the bone is ready for implantation.
The stability of BondBone™, which is achieved directly after it sets, is
not adequate to support immediate implant placement.
Do all synthetic bone products
provide the same results?
No, synthetic materials are divided into resorbable synthetics, such as
calcium sulfate, and nonresorbable or partially resorbable materials.
The clinician should choose the material according to the indication
and the desired outcome.
How can we increase patient
acceptance of the material?
Patients often feel a reluctance to have materials that are derived from
animal or human origins placed in their bodies, because of either
psychological issues or fear of contamination. Because BondBone™ is
a synthetic bone graft, it may be more acceptable to the patient.
3.
Why is BondBone™ better than or different
from other synthetic products?
BondBone™ is a novel biphasic calcium sulfate and is the only calcium
sulfate that can set within the presence of blood and saliva. Moreover,
due to its composition and form, it has the ability to serve as an excellent
binder for composite grafts.
How should I use it? Should I compact
the graft to get more bone? I am afraid to
lose volume with a synthetic material.
You can use BondBone™ in two ways: by itself or as a composite graft. By
itself, if the defect is not larger than 10 mm and has at least three-wall bony
support, BondBone™ can be used for regeneration. BondBone™ can also
be used as a composite graft in more complex cases. The setting takes
place when it reacts with saline. Approximately 15% of volume is lost during
the healing phase, so you should overfill during the initial surgery.
What is recommended as a clinician’s
first surgery using BondBone™?
When a clinician is using BondBone™ by itself for the first time, the
manufacturer suggests a surgery such as socket preservation.
Does BondBone™ provide better
stability than xenografts do?
Xenografts or other augmentation materials based on granules do
not provide initial stability of the implanted bone graft. In order to
stabilize these grafts in the defect and to prevent particle migration,
the practitioner often uses a membrane. The next generation in bone
regeneration techniques is using cements such as BondBone™ as a
bonding material.
Should we use BondBone™ in cases
similar to those where xenografts
are used?
Xenografts and other types of granular materials that are either
nonresorbable or are slowly resorbed (> six months) are used in cases
where a longer period of time or space maintaining is required (such
as lateral augmentation, vertical sinus lift, or any defect that is larger
than 10 mm with less than three-wall bony support). The outcome is
bone repair rather than bone regeneration. However, in order to obtain
optimal and complete bone regeneration, it is necessary to use a space
maintainer with a resorption pattern that matches the bone formation
rate, such as BondBone™. You can use BondBone™ alone in those
defects that do not need a longer period of space maintaining.
I already use a synthetic grafting
material and it does not work as
well as xenografts.
Xenografts are good bone graft materials, and you shouldn’t replace
them if you are happy with their results. However, you can combine
xenografts with BondBone™ to obtain an excellent composite graft.
This will facilitate the handling and improve the outcomes, resulting in
reduced procedure time.
MC-BBFAQ Rev.1