maxgraft® bonebuilder2019-08-28T12:18:26+01:00

maxgraft® bonebuilder:
Customized allogenic bone block

maxgraft® bonebuilder is a customized allogenic bone block for two-stage alveolar ridge augmentation. Based on CT/CBCT scans of the patient, the bone block is virtually designed using the latest 3D-CAD/CAM (computer-aided design/computer-aided manufacturing) technology. The final product is then milled from processed cancellous bone blocks originating from living human donors (explantation of femoral heads during hip endoprosthesis surgery).

In clinical practice, the application of allogenic blocks has been established as a reliable alternative to autogenous bone blocks for alveolar ridge augmentation to avoid donor site morbidity1,2,3 and limitations in material quantity4.

maxgraft® bonebuilder offers greater precision and accuracy of fit compared to classical block augmentation. Manual adjustment of the block during the operation is seldom required and maxgraft® bonebuilder may be applied directly onto the defect, reducing surgery time as well as risk of infection.5,6 The individual design provides a precise fit between local bone and the allogenic bone block, enabling rapid revascularization and fast graft incorporation.7

Achieve a safe, reliable and predictable clinical outcome

Due to the stable trabecular structure of the cancellous bone, maxgraft® bonebuilder provides an ideal matrix for predictable and highly effective revascularization, rapid formation of new bone tissue and complete bone remodeling. Simultaneously the excellent biological regeneration capability of maxgraft® is supported by exceptionally good flexibility on the basis of natural collagen content, which will facilitate screw fixation.

The processing sequence meets highest quality standards with regard to biomechanical properties and safety, prohibiting infect transmission or antigenic effects. It is storable at room temperature for 5 years.
However, it should be used as soon as possible after delivery to provide a precise fit, enabling rapid revascularization and fast graft incorporation.

FURTHER VIDEO

INDICATIONS

Implantology, Oral and CMF Surgery

Horizontal and vertical augmentation

 Extensive bone defects

Product properties and specifications

maxgraft® bonebuilder

+ Patient-customized, processed allograft (from selected living donors)
+ Mineralized human collagen for excellent biocompatibility and flexibility
+ Stable trabecular structure of the cancellous bone enables rapid revascularization
+ Osteoconductive properties support natural and controlled bone remodeling
+ Max. dimensions 23 x 13 x 13 mm
+ In cases with multiple or larger defects, several blocks can be designed and used.

Art.-No. Content
PMIa Individual planning and production of a bone block max. dimensions 23 x 13 x 13 mm
PMIa 2 maxgraft® bonebuilder, additional block(s) for this patient

bonebuilder dummy

An individual 3D-model of the patient’s defect, including the planned maxgraft® bonebuilder block(s) printed in synthetic filament, can be ordered together with the maxgraft® bonebuilder and delivered beforehand. The user-friendly demo material helps to inform the patient and supports preoperative planning (e.g., orientation and positioning of the block, placement of screws).

Art.-No. Content
32100 Individual 3D-printed model of the patient’s defect and the planned maxgraft® bonebuilder for demonstration purposes made of plastic

SPECIFIC FACTS

  • Removal of soft tissue, fat and cartilage; grinding/cutting into final shape
  • Defatting by ultrasonication
  • Complex chemical treatment different steps of diethylether and ethanol
  • Oxidative treatment with hydrogen peroxide
  • Lyophilization
  • Sterilization method: Gamma-sterilization
  • CT/CBCT scan by responsible surgeon/radiologist
  • Transfer of DICOM-data to botiss biomaterials
  • Planning of the individual maxgraft® bonebuilder by botiss product specialists located in Berlin and final confirmation by responsible surgeon
  • Transfer of the milling file to tissue bank (C+TBA, Austria)
  • Milling of the block from cancellous bone blanks
  • The process takes 4-6 weeks

maxgraft® bonebuilder should be rehydrated briefly before fixation by creating a vacuum in a disposable syringe filled with sterile saline solution. If possible, mix the saline solution with the exudate serum obtained from preparing autologous platelet-rich fibrin (PRF) matrices. maxgraft® bonebuilder consists of a mineralized collagen matrix with a residual moisture content of <5%, rehydration may be useful especially for blocks of bigger and complex dimensions to enhance the adaptability of the material to the specific defect site.

Courtesy of Dr. Anke Isser, Frankfurt, Germany

Additional void volume should be filled with particulate grafting material (maxgraft® or cerabone®) to improve the aesthetic outcome and to protect the soft tissue.

For guided bone regeneration, the augmented site needs to be covered entirely with a barrier membrane, preventing the ingrowth of soft tissue into the bone block (e.g. Jason® membrane).

Courtesy of Dr. Viktor Kalenchuk, Chernivtsi, Ukraine

  • maxgraft® bonebuilder should be covered by a resorbable barrier forming collagen membrane (e.g. Jason® membrane) for GBR
  • This prevents resorption and ingrowth of soft tissue into the bone graft

Courtesy of Dr. Anke Isser, Frankfurt, Germany

  • Depending on the defect size, the graft will be stably incorporated within 5-6 months
  • Product will be degraded when not loaded after healing period
  • Due to the thorough tissue donor testing and the validated processing of maxgraft®, complications that are directly caused by the material itself are highly unlikely
  • Non-collagenic proteins are removed or denatured
  • Most problems appear as a result from allergic reactions against antibiotics or caused by contact of the maxgraft® with saliva prior to implantation
  • Complaints of our customers will be registered
  • Reference samples of maxgraft® products are stored for 1 years to enable proper investigation in case of an incident

Support/Contact

Mr. Goran Nikoloski +49 30 20 60 73 98 35

Ms. Kristina Domann +49 30 20 60 73 98 26

E: bonebuilder@botiss.com

We offer the printing of individual 3D models.

For an individual offer or support, contact us.

References

1 Monje, A. et al. (2014). On the feasibility of utilizing allogeneic bone blocks for atrophic maxillary augmentation. Biomed Res. Int. 2014, 814578.
2 Novell, J. et al. (2012). Five-year results of implants inserted into freeze-dried block allografts. Implant Dent. 21, 129–35.
3 Nissan, J., Mardinger, O., Calderon, S., Romanos, G. E. & Chaushu, G. (2011). Cancellous bone block allografts for the augmentation of the anterior atrophic maxilla. Clin. Implant Dent. Relat. Res. 13, 104–11.
4 Jacotti, M., Wang, H.-L., Fu, J.-H., Zamboni, G. & Bernardello, F. (2012). Ridge augmentation with mineralized block allografts: clinical and histological evaluation of 8 cases treated with the 3-dimensional block technique. Implant Dent. 21, 444–8.
5 Jacotti, M., Barausse, C. & Felice, P. (2014). Posterior atrophic mandible rehabilitation with onlay allograft created with CAD-CAM procedure: a case report. Implant Dent. 23, 22–8.
6 Blume, O. et al. (2017). Treatment of Severely Resorbed Maxilla Due to Peri-Implantitis by Guided Bone Regeneration Using a Customized Allogenic Bone Block: A Case Report. Materials 10(10): 1213.
7 McAllister, B.S. (2007). Bone augmentation techniques. Journal of Periodontology 2007:78:377-396.