EthOss® is recommended to be used with the following published protocol: Protocol for Bone Augmentation With Simultaneous Early Implant Placement: A Retrospective Multi-Centre Clinical Study. — International Journal of Dentistry, 2015, Article ID 589135. Email firstname.lastname@example.org if you would like a hard copy.
Tooth extraction should be performed atraumatically to preserve host bone.
Leave the site to heal for 3 - 4 weeks post-extraction. This should allow sufficient time for soft tissue healing over the extraction site.
Raise a papillae-preserving flap to allow sight of the defect/proposed implant site.
Allow any excess bleeding to subside before grafting. If the flap will require releasing to obtain tension free primary closure then perform the releasing incisions at this stage, allowing bleeding to subside before graft placement.
Thoroughly remove all granulation tissue ensuring the graft will be in direct contact with healthy host bone. EthOss® Degranulation Burs are recommended.
Place the implant ensuring primary stability. Alternatively, if it is preferred, the site can be grafted and the implant placed at a later date (12 weeks is usually suitable).
Draw back the plunger to the 1cc mark for 0.5cc syringes, or 2cc mark for 1cc syringes.
Holding the syringe horizontally, gently tap it to loosen any compacted EthOss®.
Hold the syringe vertically and remove the end cap.
Fill to the top of the syringe with sterile saline, replace the cap and tap or shake the syringe for 10 seconds until the powder is wet through.
Remove the end cap. Place a sterile gauze over the end of the syringe and express the excess fluid. Firm pressure is needed.
Your EthOss® is now ready to use.
Ensure any excess bleeding in the site has subsided before grafting.
Place the EthOss® with the syringe and shape as required.
Do not use suction on the site once grafted – this may disturb the material.
Do not overfill the site with graft material – this may cause bone to grow over the implant.
Apply a sterile gauze to the graft for 3-5 minutes. This will accelerate the setting reaction of the Calcium Sulphate cell occlusive barrier. A separate collagen membrane should not be used.
Once EthOss® becomes firm and you feel resistance from the graft, begin suturing. EthOss® does not need to “set” like bone cement before suturing.
Full and passive soft tissue closure is required. It is recommended that the first sutures should be at the papillae to ensure passive closure which does not disturb the graft.
EthOss® has no special post-surgical requirements that would not be followed with any other graft material. We recommend the use of Blue®m implant care products post-surgery.
The implant can usually be restored after a 12 week healing phase subject to appropriate ISQ readings.