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Most certainly.
Due to the cement's properties, using a membrane, between the flap and the cement, is not needed. Tissue closure is accomplished by stretching the flap on top of the cement. Please see the protocols.
Using a membrane is not recommend. Perform augmentation, close the flap and suture. If the graft is exposed more than 3mm, secure a collagen sponge on top as shown in the protocols.
No membrane is required with Augma bond cement. However, extra caution is needed to minimize removable prosthesis impingment on the grafted area. Contact on to the graft with the removable appliance will significantly reduce bone volume. Consider over building graft, and minimizing flage/prosthesis contact
The use of membranes inhibits soft tissue proliferation above the bone cement. It blocks the periosteum and impairs its osteoprogenerativity. In addition, if membranes are used, traditional bone augmentation rules such as tension-free flaps, and primary closure must be followed.
With Augma bone graft cement, there is no need for membranes. The cement can set and harden in situ. As such, it acts as a graft and a barrier at the same time. The exceptional biocompatibility and bacteriostatic nature of calcium sulfate provide a synergic matrix for soft tissue to proliferate safely and rapidly. Hence, invasive surgery is not needed to gain a tension-free flap, nor for primary closure, which is not mandatory. Placing a membrane above the material delays the healing and forces traditional invasive surgical protocols to be performed, and thus, also exposes the patient to all known traditional complications.
I used bond apatite today for the first time and it didn’t harden at all at the surgical site, and kept almost flowable about 20 minutes.
How could that be?
In order for the material to harden properly it should be used as follows:
During activation the shaft of the syringe should be advanced until the first piston reaches the blue line. Then the cap is removed, and the material should be injected into the site. Immediately place on it a dry gauze, not too folded, simply in two layers. Then press strongly with a finger on top of the gauze for 3 seconds, and again with a periosteal elevator for an additional 3 seconds. That’s all you need to do and the material will set instantly. It will never be hard like a stone, but it is definitely stable. During suturing, if the material breaks, place a dry gauze on it and press for one second before continuing to suture.
If the material didn’t harden, it’s probably because the pressure with the gauze was not done immediately. As such, the crystals are soaked with blood and it will not set properly, and will be flowable.
Please see our online course for more instructions on proper use.