Easy-graft : F.A.Q

 

Frequenty Asked Questions

  material properties

  What raw materials are used to manufacture GUIDOR easy-graft and GUIDOR calc-i-ossproducts?

GUIDOR easy-graft products are alloplastic materials manufactured from mineral raw materials. They do not contain any substances of animal or human origin.

  What is the difference between easy-graft CLASSIC and easy-graft CRYSTAL?

easy-graft CLASSIC contains phase pure ß-tricalciumphosphate (ß-TCP) and is resorbed over a period of 5–15 months. easy-graft CRYSTAL contains biphasic calcium phosphate (60 % hydroxyapatite, 40 % ß-TCP). It is partially resorbable, the hydroxyapatite remains embedded in the new bone.

  easy-graft CLASSIC and easy-graft CRYSTAL –How do I decide which material is suitable in a specific case?

Both materials are approved for identical indications. The topic of material selection is a matter of clinician and surgical planning preference. See timing/staging of dental implant.

  easy-graft CRYSTAL: Are there two types of granules (HA and ß-TCP) in easy-graft CRYSTAL?

No. Every single granule consists of a compound of 60 % hydroxyapatite and 40 % ß-TCP.

  Do GUIDOR easy-graft products have bacteriostatic properties?

A test on bacterial nutrient medium confirmed reduced bacterial growth around GUIDOR easy-graft samples. This effect was attributed to the BioLinker. In the body, the BioLinkeris extracted from the GUIDOR easy graft materials after just a few hours, therefore, the clinical relevance of the bacteriostatic properties observed in vitro is not confirmed.

 

  application

  Can GUIDOR easy-graft products be used without mixing them with BioLinker?

Yes, in this case the material properties are comparable with those of traditional particulate bone graft substitutes such as GUIDOR calc-i-oss.

  Can GUIDOR easy-graft products be dispensed?

GUIDOR easy-graft products can be dispensed after mixing on a dry, sterile surface with dry, sterile tools. Under these conditions the material remains mouldable, because it does not harden until it comes into contact with aqueous liquids such as blood.

  How can a flexible, porous layer be formed with GUIDOR easy-graft products?

Thin, flexible layers (e.g. as resorption protection for autogenousbone) can be mouldedbetween two sterile, smooth and dry surfaces (glass, metal, no plastics) or with dry, sterile gloves with the addition of a few drops of sterile water or sterile saline solution. After contact with the material, the gloves should be changed.

  Should defects be overfilled?

No, the material swells after application. Therefore, overfilling is not recommended.

  Should the material in the defect be condensed?

GUIDOR easy-graft products should be well condensed in the defect before the material hardens. The round granules withstand compression, therefore, fragments from fractured granules will not form.

  How should GUIDOR easy-graft material be condensed?

Experienced GUIDOR easy-graft users use various aids such as flattened stoppers or the plunger of the GUIDOR easy-graft applicator syringe. Over larger areas the material can be evenly condensed by pressing down a piece of gauze (moistened with physiological saline solution) with the finger for 10–30 seconds.

  Can GUIDOR easy-graft products be used in combination with dental membranes?

Yes, an ideal alloplastic option would be GUIDOR matrix-barrier

  When would the use of a membrane be recommended?

GUIDOR easy-graft products are stable and do not require a membrane for containment in 3 or 4 walled defects. Flat (non-concave defects with limited walls) and defects of a critical size may require the additional support of a barrier membrane. Sites where a full thickness periosteal relieving flap is created may also benefit from a barrier membrane for exclusion of soft tissue ingress. The decision to use a membrane is part of therapy planning and is the responsibility of the practitioner.

  Can GUIDOR easy-graft products be mixed with autogenousbone or bone graft substitutes in the application syringe?

No, mixing GUIDOR easy-graft products with autogenousbone chips or foreign materials will cause the material to harden prematurely in the syringe, or will prevent the material from hardening in the defect. This means that GUIDOR easy-graft products will lose their unique handling advantage. GUIDOR calc-i-ossproducts are ideal to mix with autogenousbone or other bone graft substitutes.

  Can GUIDOR easy-graft products be used in combination with autogenousbone?

Yes. For example, GUIDOR easy-graft products can be used as resorption protection for autogenousbone grafts. However, bone chips should not be mixed with the material in the syringe .

  Can GUIDOR easy-graft products be used with preparations such as BMP-2 and Enamel matrix proteins?

Mixing with protein preparations may result in premature hardening. The combination of GUIDOR easy-graft with active biological factors in the defect has not been clinically tested. GUIDOR calc-i-ossproducts are ideal to mix with BMP-2 and Enamel matrix proteins.

  Can GUIDOR easy-graft be used in combination with antibiotics?

The use of antibiotics is the responsibility of the practitioner. Any interaction between systemically administered antibiotics and GUIDOR easy-graft products is not known and not to be expected.

  Does GUIDOR easy-graft adhere to the bone surface?

No. GUIDOR easy-graft products do not adhere to tissue and do not contain adhesives. The granules adhere to one another and form a mouldablemass because of the coating of the granules with PLGA (“sticky granules”).

  Can GUIDOR easy-graft products be ground down after hardening?

Grinding down is not recommend-ed. The effect of the rotary forces may cause the graft to loosen in the defect, which may endanger the bone regeneration. Excess material should be removed before hardening (e.g. with a curette).

 

  INDICATIONS

  Can GUIDOR easy-graft products be used for closure of oroantralcommunications?

Yes, but it is important to ensure that material is not pressed into the sinus cavity.

  Is it necessary to cover the material with soft tissue after socket grafting?

No, the material will also heal in place without a soft-tissue cover. The material surface should be well condensed during socket preservation. The application of retention may be useful depending on the shape of the extraction socket. A temporary restoration serves to protect the graft surface from the tongue and foodstuffs. For examples of applications see the SunstarGUIDOR guidebook for ridge preservation.

  When can an implant be placed after using easy-graft products to fill the extraction sockets?

easy-graft products are osteoconductivebone graft substitutes. The time of implant placement can be selected in accordance with experience with comparable materials (e.g. ß-TCP granules, bone replacement materials of bovine origin). A definite answer to this common question cannot be given, because the regeneration of bone depends on the anatomical and physiological conditions at the extraction site and the time of implant placement depends on the treatment philosophy.

  Can an implant be placed immediately after filling a defect with easy-graft?

Yes, periimplantgaps and bone deficiencies around implants with primary stability can be filled with easy-graft products (See pages 10). However, implant placement immediately after filling a defect is not recommended.

  Can easy-graft products be used for fixing implants without primary stability?

No. Implants must be anchored in local bone with primary stability. easy-graft products are suitable for filling bone deficits around implants anchored in pristine bone.

  To what degree can an atrophied alveolar ridge be restored with easy-graft materials?

The alveolar ridge should only be grafted with appropriate techniques (bone spreading, distraction, suitable methods for onlaygrafting). The possible degree of horizontal and vertical grafting depends primarily on the selected method. Simple placement of bone graft substitutes on cortical bone surfaces is not a suitable method for establishing sufficient bone volume for implant placement.

  Are easy-graft materials radio opaque?

Yes, easy-graft and easy-graft CRYSTAL are both opaque to x-rays.

  How long do easy-graft products remain stable in the body?

The adherence of the granules is determined by the PLGA coating. It is resorbed over a period of 3–6 weeks. During this period the strength of the material gradually decreases.

  Does the volume of easy-graft products change during the healing process?

easy-graft materials increase in volume in the first few days after application by water absorption, the material swells.

  After a defect has been filled with an easy-graft product, some granules are expelled from the healing soft tissue during the first few days. What does this mean?

The post-operative exfoliation of individual easy-graft granules through the soft tissue has been observed and is not necessarily a sign of suboptimal healing. However, exfoliation may also occur as the result of an infection, therefore the patient should be thoroughly examined