Guidance for the Clinical Application of EthOss Synthetic Biomaterial

EthOss Surgical Guidelines

The goal of grafting is to regenerate sufficient bone to support the dental implant in the long term. The following guidelines have been used successfully by Professor Dr Peter Fairbairn, London, UK for over 13years.

Pre-Surgery:

  1. Tooth extraction should be performed atraumatically to preserve host bone.
  2. By leaving the site for 3weeks, the soft tissue is given sufficient time to heal.

Site preparation:

  1. A papillae preserving flap should be raised so that all of the proposed defect/implant site can be seen.
  2. Great care should be taken to remove all granulation tissue. This is a very important step since it ensures that the graft is in contact with bone.
  3. At this stage, the implant can be placed, ensuring primary stability. Alternatively, if it is preferred, the site can be grafted and the implant placed at a later date (12weeks is normally suitable)

Preparing EthOss:

  1. As per the instruction for use, draw back the plunger to the 1cc mark for 0.5cc packs or 2cc mark for 1cc packs. Before removing the end cap, hold the syringe horizontal and tap it to remove any compaction that might have occurred in transit or storage.
  2. Hold the syringe vertically and remove the end cap.
  3. Fill with sterile saline, replace the cap and tap or shake the syringe for 10seconds until the fluid has soaked into the powder.
  4. Remove the end cap, place a dry gauze over the end of the syringe and express any excess fluid.
  5. Your EthOss is now ready to use.

Applying EthOss:

  1. EthOss can either be syringed directly into the site or into a bowl and applied using a sterile instrument of your choice.
  2. The material will start to set after 1minute so it should be placed into the site quickly.
  3. Once in the site the EthOss can be shaped as required using either a damp gauze and finger pressure or an instrument of your choice.
  4. Do not overfill the site.
  5. EthOss is hydrophilic so will readily settle into the defect even in a bloody site.
  6. An important step is to apply a dry gauze to the graft for 3 to 5 minutes. Patience at this stage produces a consistent result.
  7. EthOss has a built in membrane (Calcium Sulphate) so no further membrane is necessary.
  8. Once you feel resistance from the graft you are clear to begin suturing.
  9. Full and, importantly, passive soft tissue closure is required. Monofilament sutures are preferred.

Post-Surgery:

  1. When using EthOss, there are no special post-surgical requirements that would not be followed with any other graft material. Our preference is to instruct the patient to use BlueM products post-surgery in order to reduce the likelihood of infection and ensure good tissue healing.
  2. Implant can be placed or restored after a 12 weeks healing phase.

Sound clinical judgement should be used at all times.