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