logo-augmaSpecializes in the development and manufacturing of bone graft cements, and is the pioneer in two innovative bone graft cements for the use in dentistry; 3D Bond and Bond Apatite. Both are patented, CE approved and FDA cleared.

Compared to the existing traditional granules and putty bone graft solutions, working with Augma’s cements drastically simplifies augmentation procedures.  Augma’s cement shortens the length of surgery by an impressive 90%, while perfectly recreating the patient’s own bone in half of the time. The need for membrane coverage is no longer needed, significantly reducing excess costs.

Bond Apetite

CE approved and FDA cleared

Proven and Safe: Well-documented research on the synthetic technology with optimal graft and safety biocompatibility

Better Application and Reduced Chair-Side Time: Cement that can easily be molded for facilitated and precise augmentation. Entire graft placement and stabilization can be done in less than one minute, as opposed to 15-20 with existing methods of bone grafts

Improved Outcome and Faster Regeneration: Optimal graft characteristics for fast and complete bone formation, shortening healing time from 6 months to 3 months

Cost Effective: Reduces procedural costs by 50% (membrane coverage is no longer required)

Frequently Asked Questions

  • What is Bond Apatite®?
    • Bond Apatite® is a Bone Graft Cement composed of pure biphasic calcium sulfate mineral and high density synthetic hydroxyapatite particles as well as a sterile saline solution for activation of the cement.
  • What is the ratio between the biphasic calcium sulfate and the HA?
    • Bond Apatite is a composite graft composed of 2/3 biphasic calcium sulfate cement matrix’s and 1/3 hydroxyapatite granules in different sizes and shapes.   
  • What is biphasic calcium sulfate and why is it different from the old known calcium sulfate?
    • Biphasic calcium sulfate is a patented formulation of calcium sulfate. This is the only formulation of calcium sulfate that has the ability to behave as cement in the oral cavity. Additionally, the BCS is moldable and can set and harden instantly in the presence of blood and saliva. The old calcium sulfate could not set and harden when it got it contact with blood or saliva; therefore, it could not be easily used as a suitable cement in the maxillofacial field.
  • Is there are any additives, accelerators, or polymer within the biphasic calcium sulfate matrix of the Bond Apatite® ?
    • No, the cement matrix within Bond Apatite ® is made of a pure calcium sulfate as a biphasic formulation. We did not add any additives, polymers or other chemicals, so the chemical structure of calcium sulfate was not changed at all. Its ability to be moldable and to harden instantly in the presence of blood or saliva of the biphasic formulation is due to the fact that the particles within the cement are partially crystalized and still maintain the ability to adhere and to set and harden. In that way, the cement is much more stable and has a predictable resorption behavior.
  • What is the resorption time for Bond Apatite®?
    • Bond Apatite® is a composite graft made of Biphasic Calcium Sulfate and HA granules (granule size 90-1000μm) in a specific particle size distribution and in a variety of forms. The ratio of BCS/HA is 2/1. This combination takes advantage of each part of its components. Calcium sulfate acts a short-range space maintainer scaffold. It completely degrades in strict relation to the bone formation rate (4-10 weeks), while the HA acts as a longer term space maintainer. The HA particles within the graft is relatively in a small proportion (33.3%) and is intended only to slow down the overall resorption of the graft. The bioactivity and the graft transformation into vital bone are due to the biphasic calcium sulfate, which is 66.6% of the graft.
  • What is the porosity percentage of the material?
    • The overall structure of Bond Apatite® has micro porous (1-10μm) and macro porous (50-500μm). The initial surface porosity percentage is about 40 percent; however, since Calcium Sulfate completely degrades over time, it creates more space for the new bone to be formed.
  • Should I mix the material with blood?
    • No. After placing the cement in place and pressing above for setting and hardening, you should not. The graft porosity and its hygroscopic ability will seep inside of the blood immediately.
  • How long does it take for the material to harden?
    • The setting time is approximately 3-5 minutes.
  • Can I place an additional layer of Bond Apatite®  if the material is already hard ?
    • Yes, you can. You can place consecutive layers in addition even if the first layer of Bond Apatite® in the grafted site has already set.
  • Does the material remain hard during the healing period as a block?
    • No, the material does not remain hard. The degradation process starts immediately after its placement while new bone formation simultaneously takes place.
  • What is the working time with the material?
    • The working time with the material starts when the powder is mixed with saline. At this time, the material is moldable and pliable for about 3 minutes (Working time). Thus, it is important to have the lesion fully prepared prior to the activation of the material. As soon as the material is placed in the defect, it should be compressed with a dry gauze pad for 3-5 seconds and then the material will harden in-situ immediately. At this point, you should proceed with primary soft tissue closure.Keep in mind – your augmentation procedure should be done by 3 consecutive simple steps – place –press –closeAnd you should keep it simple as it sounds. In less than a minute, your graft placement and stabilization can also be done in the most challenging cases.Place the material into the grafted site. Press above it with dry gauze for 3 seconds. The cement will harden instantly and will be stable and then close the flap.
  • Is it necessary to use a membrane?
    • Due to the cement properties, using a membrane is not needed in most of the clinical cases as long as primary soft tissue closure is achieved.Using a membrane might be recommended in large size defects in which soft tissue stabilization cannot be ensured or in socket preservation procedure when a flap was not reflected and the material is completely exposed to the oral environment. In such cases, a protection barrier is required above the graft to prevent volume loss. (It can be a collagen sponge or a membrane that can be left exposed above the graft.)
  • Can I leave the material exposed to the oral cavity?
    • NO – It is not recommended to leave the material exposed. Leaving the material exposed without a protection of a physical barrier can lead to material volume loss.Nevertheless, leaving the material exposed with a gap of 1-3 mm is not an issue as soft tissue will migrate rapidly over it and will close the gap in a few days.
  • What are the indications for using Bond Apatite®?
    • Bond Apatite® can be used in a wide diversity of osseous defects, including medium and large size defects such as dehiscence, fenestration cases, lateral augmentations (horizontal crest widening), small or medium sizes of sinus cavities, or as lateral bone window closure in some very large sinus cavities, periodontal bone defects, filling of bony defects pre-implant placement, or simultaneously with implant placement, filling a cavity post cyst removal, ridge augmentations, bone splits, etc.
  • Should I over augment?
    • Yes, you should over augment to compensate for the material shrinkage during the healing prosess and the replacement into the patient’s own bone. You might lose about 10-15% of volume; hence, you sould overfill the grafted site to compensate for this shrinkage.
  • What is the recommended protocol for using Bond Apatite® in socket preservation procedures?
    • In socket grafting procedure, eject the material from its syringe into the socket, place a dry gauze above the material, and with your finger (or a spatula if there is not enough space for your finger), press firmly for 3 seconds then remove the gauze and close the flap in cases when you did not reflect a flap. In order to prevent volume loss, you must protect the exposed graft by physical barrier such as with an inexpensive collagen sponge or a membrane. Those can be left exposed, however; any such physical barrier must be well stabilized and sutured to the proximity soft tissue until the proliferation of the soft tissue above the graft will take place.*When 4 bony walls exist, do not use any tool to push the cement into the bottom of the socket as you are used to with granules.  Doing so might cause pain to the patient due to the cement expansion.
  • Can I augment and place my implant in the same procedure?
    • Yes, you can as long as you have good primary stability. Your primary stability shoud come from the bone and not from the graft. First place your implant, verify that it has a good primary stability and then you can augment with the Bond Apatite®.
  • How long do I need to wait until I can place or load my implant?
    • In most of your cases, 3 months are sufficient healing time until you can place your implant. In cases when your implant was placed simultaneously with the augmentation procedure, you can load the implant as well after 3 months.Cases in which you should wait longer (4-6 months) include sinus lift or very large augmented defects with minimum bony walls support.
  • How Can Bond Apatite® be used for a sinus lift?
    • In small to medium size sinus cavities, Bond Apatite® can be used by itself. Small or medium sized sinus cavities are cases when one or two syringes of Bond Apatite® can be sufficient for the entire procedure. In such cases, eject the material from its syringe through the crest direction into the sinus cavity and then   place dry gauze above the material, place your finger above the gauze and press for 3 seconds, and then remove the gauze and close the flap. There is no need for membrane coverage. Additionally, in large sinus cavities when more than 2 cc (2 syringes) are required, it is less comfortable to work just with Bond Apatite® because you will need to work by increment; therefore, we recommend you to fill 2/3 of the sinus cavity with your preferable granular augmentation material and the final 1/3 with Bond Apatite®. It will enrich the grafted site with calcium ions and will also close the sinus window. No additional need for membrane is required.
  • How should I use the Bond Apatite® in lateral augmentation?
    • It is very simple. Reflect the flap and prepare the site, with decortication or without, prepare and release the soft tissue for final coverage. Then, after graft activation, eject it into the augmented site, place a dry gauze pad above and press for 3 seconds and close the flap. There is no need for membrane as long as your soft tissue is primary closed and well sutured.
  • Can Bond Apatite® be used for vertical augmentation?
    • Bond Apatite® can be used for vertical augmentation only if you are already familiar with the material and experienced with vertical augmentation techniques. In such cases, a well-stabilized rigid protection barrier is always required.
  • Can I use Bond apatite® in Periimplantitis case ?
    • Periimplantitis cases are most challenging and unpredicteable with any types of graft even when autogeneous bone graft is used. The same goes for Bond Apatite®.
  • Should I expect a different radiographic appearance than I am used to?
    • Due to the graft nature, the biphasic calcium sulfate matrix within the graft is simultaneously replaced by the patient’s own bone; therefore, the radiographic appearance is completely different compared to other grafts which always appears radiopaque due to their constant presence in the grafted site.In contrary, the radiographic appearance with Bond Apatite® is as follows:During day one after graft placement –it appears radiopaque.Gradually, radiolucency appearance takes place (reflecting the graft transformation into the new formed osteoid before its calcification).2-4 weeks after graft placement, the majority of the grafted site will appear radiolucent while few radiopaque spots remain, reflecting the presence of the HA particles. Within 12 weeks, radiopacity takes place with the appearance of the native trabecular form. That is the time when the new osteoid has already calcified.