Powerbone CORTICAL PLATE graft – Synthetic alternative for Khoury(8) technique.   

SAFETY

The first synthetic alternative to autogenous or allograft bone plate/lamella graft free from animal or human tissue. 

FORMULATION

• 30% Silicate substituted βeta-Tricalcium Phosphate synthetic graft granules (0.05-0.1mm) embedded in a resorbable Polylactide matrix.

• 25 x 10 x 1mm thick plate.

RESORPTION

• Silicate resorption occurs first inducing angiogenesis and appetite formation (1,2,5) in a process biomechanical and histologically equivalent to autograft (1).

• Beta-TCP provides an osteoconductive scaffold for new bone, resorbing in line with bone healing.

• Resorption of the polylactide matrix begins at 3 months and is complete at 12 to 18 months.

INDICATIONS – THE SHELL TECHNIQUE

Powerbone Cortical plate is used to create a biological container which is filled with bone graft.* Numerous studies highlight the hard tissue gains possible with this type of technique. (8) 

TECHNIQUE

• Host bone is perforated to create a bleeding site. We recommend Bionnovation Decortication drill. 

• Pre-drill Powerbone Cortical plate. 

• Fix Powerbone Cortical plate using Bionnovation Bone Screws or equivalent. Use at least 2 screws to ensure stability. 

• Soften any edges of Powerbone Cortical Plate with a burr.

• Fill the space between the plate and the defect with graft material*.  

• Cover with a barrier membrane and ensure tension-free soft tissue closure.

*BONE GRAFT FILL OPTIONS

• Autogenous bone can be collected with Powerbone Bone Scraper or Bionnovation Bone Collection Device  and used alone or with the addition of:

  • Powerbone Silicate Substitutedβeta-Tricalcium Phosphate granules. (Fully resorbing graft)

  • Powerbone Biphasic granules (Slow resorbing graft).

  • Powerbone Silicate Substitutedβeta-TCP Dental Putty (Fully resorbing graft. Form Stable Graft Putty).

1. Iimori Y, Kameshima Y, Yasumori A, Okada K. Effect of solid/solution ratio on apatite formation from CaSiO3 ceramics in simulated body fluid. J Mater Sci Mater Med 2004;15:1247–1253. 
2. Xu S, Lin K, Wang Z, Chang J, Wang L, Lu J, Ning C. Reconstruction of calvarial defect of rabbits using porous calcium silicate bioactive ceramics. Biomaterials 2008;29:2588–2596. 
3. Hing KA, Wilson LF, Buckland T. Comparative performance of three ceramic bone graft substitutes. Spine J. 2007; 7(4):475-490 
5.Dashnyam, K.; El-Fiqi, A.; Buitrago, J.O.; Perez, R.A.; Knowles, J.C.; Kim, H.-W. A mini-review focused on the proangiogenic role of silicate ions released from silicon-containing biomaterials. J. Tissue Eng. 20 17, 8, 1–13. 
7. Licina et al, Comparison of (SiCAP) with (Infuse) in Posterolateral Instrumented Lumbar Fusion Global Spine J 2015;5:471–478.
8. Khoury F. (2017) Augmentation of severe bony defects with intraoral bone grafts: biological approach and long-term results. http://dx.doi.org/10.1016/j.ijom.2017.02.099