maxgraft® bonebuilder2022-09-14T15:00:42+02:00

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 revascularization, rapid formation of new bone tissue and bone remodeling.7 Simultaneously the biological regeneration capability of maxgraft® is supported by good flexibility on the basis of natural collagen content, which will facilitate screw fixation.

The processing sequence meets high quality standards with regard to biomechanical properties and safety. maxgraft® is storable at room temperature (5-30°C) for 5 years. However, the block should be used as soon as possible after delivery to provide a precise fit, enabling rapid revascularization and fast graft incorporation.

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INDICATIONS

Implantology, Oral and CMF Surgery

Horizontal and vertical augmentation

 Extensive bone defects

Product properties and specifications

maxgraft® bonebuilder

+ 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

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.

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 surrounding soft tissue, fat and cartilage; donor tissue is brought into its final shape
  • Defatting by ultrasonication
  • Complex chemical treatment – alternating durations of diethyl ether and ethanol
  • Oxidative treatment with hydrogen peroxide
  • Freeze-drying
  • Sterilization method: Gamma-irradiation
  • 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 blocks
  • The process takes 4-6 weeks
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maxgraft® bonebuilder should be rehydrated briefly before fixation with sterile saline solution (e.g. by creating a vacuum in a disposable syringe -recommended by Dr. Blume). maxgraft® bonebuilder consists of a mineralized collagen matrix with a residual moisture content of <10%, 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 can be filled with particulate grafting material (e.g. 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

Support/Contact

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

Ms. Gina Grosser +49 30 20 60 73 98 68

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. et al. (2011). Cancellous bone block allografts for the augmentation of the anterior atrophic maxilla. Clin. Implant Dent. Relat. Res. 13, 104–11.
4 Jacotti, M. et al.(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. et al. (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 Kloss FR, et al. (2020). Customized allogeneic bone grafts for maxillary horizontal augmentation: A 5-year follow-up radiographic and histologic evaluation. Clin Case Rep. 2020;00:1–8

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