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Clinical Case Study - July 2019

Right maxillary fractured molar and replacement by an implant after GBR with biphasic calcium sulfate and vertical sinus lift.

Surgery by Stephane Berg, DDS

52 years old female presented with fractured right maxillary first molar in September 2018.
It was decided to proceed with extraction and GBR with biphasic calcium sulfate cement (Bond Apatite®, Augma Biomaterials Ltd) in order to avoid the resorption of the alveolar bone and to maintain the crestal width. The exposed graft was covered by collagen sponge secured in place.
On March 2019, the regenerated bone allows the placement of an implant in conjunction with a crestal sinus lift and sinus filling by biphasic calcium sulfate cement (Bond Apatite®).

Periapical radiographic image before extraction

Clinical appearance before extraction

Clinical appearance after extraction

Bond Apatite syringe Sterile gauze and collagen sponge ready to use Prior to augmentation

Bond Apatite® Injected tin to place 

Bond Apatite® Bone graft cement In place

The graft  is well compacted In place by placing a sterile gauze above and applying firm pressure for 3 seconds 

The exposed graft is covered by Collagen sponge secured in place by suturing

Clinical appearance with collagen sponge secured in place

Radiographic appearance day one After graft placement

CBCT after the first healing stage, before crestal sinus elevation approach

Mid crestal incision, site exposure and osteotomy preparation  for crestal sinus elevation 

Bond Apatite is ejected  into a sterile dish and left To harden for 3 minutes 

After 3 minutes Bond apatite® semi hard block Is crushed into small particles and reloaded into bone carrier syringe

The graft is injected into the osteotomy and pushed by osteotome to elevate the Sinus membrane 

Implant was placed after elevation of the sinus membrane 

Do you have questions about Dr. Berg surgery that you would like to direct him? 
email him:
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