KEY INDICATIONS

The very slow resorption kinetics of cerabone® make the material the ideal choice
in situations where long-term stability is of utmost importance.

OVERVIEW
INDICATIONS

cerabone® is recommended for implantology, oral surgery, periodontology and craniomaxillofacial surgery (CMF):

– Sinus floor elevation
– Horizontal and vertical augmentation
– Ridge preservation
– Intraosseous defects
– Peri-implant defects
– Socket preservation
– Furcation defects


BONE AUGMENTATION IN THE AESTHETIC ZONE1,2

In the anterior region where the bony support of the soft tissue is essential to achieve optimal aesthetic results, the long-term stability of cerabone® supports long-term aesthetic outcomes. For the treatment of an implant dehiscence, cerabone® can be applied using the sandwich technique, i.e. covering autologous bone chips previously applied on the implant surface.


SOCKET AND RIDGE PRESERVATION3

cerabone® is the ideal biomaterial for preservation of the ridge shape. If implantation is not foreseen within one to two years following tooth extraction, but a bridge restoration is planned, then cerabone® would be the biomaterial of choice since it remains within the augmentation area and permits to preserve the shape of the ridge.


RESORPTION PROTECTION4,5

Due to its only superficial degradation, cerabone® can be used for protecting auto- or allografts from resorption. It can be applied covering bone blocks and bone rings, or can be mixed with particulate autologous or allogeneic bone grafting materials.

cerabone® is the leading bovine bone grafting material made in Germany,
as demonstrated by its clinical and scientific success.

INDICATION TABLE

The following chart provides a decision aid for the choice of the particle size and amount of cerabone® granules required for a certain clinical indication.
For each recommendation advises for the application are given.
cerabone®
small granules

(0.5 – 1 mm)
cerabone®
large granules

(1 – 2 mm)
Recommendations for application6,7
Immediate implantation
(gap augmentation around placed implants)
Volume needed ~0.5 – 1 ml
Ref 1510, 1511
– Overfilling should be avoided
– Covering of the granules by the flap is sufficient in this indication, no membrane is needed, alternatively a collagen fleece can be applied to cover the particles
Horizontal/vertical augmentationVolume needed ~0.5 – 5 ml
Ref 1510, 1511, 1512, 1515
Volume needed ~0.5 – 5 ml
Ref 1520, 1521, 1522, 1525
– Can be used alone for smaller defects
– For bigger defects mixing with auto-/allograft (maxgraft®8) in the ratio of 50:50 is recommended
– Mixing with auto-/allograft (maxgraft®8) reduces time for re-entry (four to five months post-surgery)
– If used alone, re-entry at six to nine months post-surgery
Sinus floor augmentationVolume needed ~0.5 – 5 ml
Ref 1520, 1521, 1522, 1525
Re-entry at six to 12 months post-surgery depending on the dimensions and anatomy of the sinus cavity, and augmented volume
Implant dehiscence
(buccal bone missing)
Volume needed ~0.5 – 1 ml
Ref 1510, 1511
Sandwich technique recommended: first layer autologous/allogenic (maxgraft®8) bone, second layer cerabone®
Socket/Ridge preservationVolume needed ~0.5 – 2 ml
Ref 1510, 1511, 1512
Volume needed ~0.5 – 2 ml
Ref 1520, 1521, 1522
– Can be used alone or in combination with auto-/allograft (maxgraft®8)
– Mixing with auto-/allograft (maxgraft®8) in the ratio of 50:50 reduces time for re-entry (four to five months post-surgery)
– If cerabone® is used alone, re-entry earliest at six months post-surgery
Periodontal bone defectsVolume needed ~0.5 – 1 ml
Ref 1510, 1511
Can be used either in conjunction with a barrier membrane or enamel matrix derivative (Emdogain®)

6 for all indications rehydration of cerabone® granules with sterile saline or patients’ blood is recommended
7 gentle compression of the granules should be minded
8 if available, maxgraft® processed human allograft

cerabone® PRODUCT LINE

cerabone® is available as granules or block.
The cerabone® granules come in eight different volumes of small (0.5 – 1.0 mm) and large (1.0 – 2.0 mm)  granule sizes.
The cerabone® block is available in a standardized size of 20 x 20 x 10 mm.

SMALL PARTICLES
Small cerabone® particles are particularly advantageous for contouring, e.g. for augmentation in the aesthetic region or to fill remaining gaps when a block grafting is performed. Small particles are also preferably used for the regeneration of smaller defects and intraosseous defects.
LARGE PARTICLES
Large cerabone® particles are favorable, if large volume defects (e.g. sinus floor elevation) are filled. In addition to the higher volume, there is more space between the large particles, which enables a better revascularization of bigger defects.

cerabone® SMALL granules

Art.-No.Particle SizeContent
15100.5 – 1.0 mm1 x 0.5 ml
15110.5 – 1.0 mm1 x 1.0 ml
15120.5 – 1.0 mm1 x 2.0 ml
15150.5 – 1.0 mm1 x 5.0 ml

cerabone® LARGE granules

Art.-No.Particle SizeContent
15201.0 – 2.0 mm1 x 0.5 ml
15211.0 – 2.0 mm1 x 1.0 ml
15221.0 – 2.0 mm1 x 2.0 ml
15251.0 – 2.0 mm1 x 5.0 ml

cerabone® block

Art.-No.Dimension Content
172020 x 20 x 10 mm1 x block

REFERENCES

1 Pelekanos S, Pozidi G. Immediate One-Time Low-Profile Abutment to Enhance Peri-implant Soft and Hard Tissue Stability in the Esthetic Zone. Int J Periodontics Restorative Dent. 2017 Sep/Oct;37(5):729-735.

2 Cristache CM. Presurgical Cone Beam Computed Tomography Bone Quality Evaluation for Predictable Immediate Implant Placement and Restoration in Esthetic Zone. Case Rep Dent. 2017;2017:1096365.

3 Kollati P, Koneru S, Dwarakanath CD, Gottumukkala SNVS.Effectiveness of naturally derived bovine hydroxyapatite (Cerabone™) combined with platelet-rich fibrin matrix in socket preservation: A randomized controlled clinical trial. J Indian Soc Periodontol. 2019 Mar-Apr;23(2):145-151.

4 Wen SC, Huang WX, Wang HL. Regeneration of Peri-implantitis Infrabony Defects: Report on Three Cases.Int J Periodontics Restorative Dent. 2019 Sep/Oct;39(5):615-621.

5 Khojasteh A, Nazeman P, Tolstunov L.Tuberosity-alveolar block as a donor site for localised augmentation of the maxilla: a retrospective clinical study. Br J Oral Maxillofac Surg. 2016 Oct;54(8):950-955.