Simple, Fast, Economical, Effective
Stimulates Rapid Bone Growth without Incisions or Primary Closure
Dental Implants in 6 to 8 weeks
Proven Immediate Implant Integration
FDA Approved
- Provides faster patient turnaround
- Dramatically lowers material costs
- Differentiates your practice
- Increases patient comfort and loyalty
- Reduces post extraction complications
SOCKET GRAFT™ is designed to treat the extraction socket to retain alveolar bone quickly and economically,
and stimulate bone formation in the osseous defect without flap surgery.
 TISSUE ENGINEERING TO DIRECT REGENERATION AND STIMULATE BONE GROWTH
SOCKET GRAFT is the only bone graft approved by the FDA for placement without tissue closure. SOCKET GRAFT’s unique technology provides an effective and efficient method for tissue regeneration, and specifically, for the stimulation of bone growth.
Steiner laboratories is a leader in tissue engineering. Tissue engineering is the practice of replacing lost tissue or organs by introducing biologically active products to stimulate regeneration in a synthetic matrix designed to organize tissue growth. The goal of tissue engineering is to control the healing process in order to produce a normal tissue or organ.
The tissue engineering of bone requires the biologic stimulation of host cells. Due to the short half life of growth factors when placed in the graft site and the inability of a single growth factor to orchestrate the complex temporal and spatial molecular reactions needed to produce tissue, the use of single growth factors for the biologic stimulation of host cells produces only limited bone growth. For these reasons, Socket Graft does not use growth factors, but instead contains SL Factor which stimulates the cell to increase the production of growth factors and other signaling molecules. SL Factor is time released as Socket Graft is degraded. SL Factor enters the osteoblast and stimulates the osteoblast to produce the required signaling molecules and growth factors for bone production. SL Factor is transported across the cell membrane and into the nucleus, where it has been shown to modify the activity of over 300 genes and to produce an up-regulation in genes known to stimulate bone formation and a down-regulation in genes that facilitate bone loss. SL Factor stimulates mesenchymal stem cells to differentiate into osteoblasts and increases the production of alkaline phosphatase. SL Factor creates a two-fold increase in BMP2 and Runx2 production and reduces osteoclast formation by inhibiting the production of RANK ligand. In addition, SL Factor is stored in the osteoblast and continues to stimulate bone growth after the synthetic matrix has been resorbed.
The tissue engineering matrix of Socket Graft is designed to provide timed release of SL Factor as the matrix is resorbed. The matrix is a dual phase calcium phosphate biocement. The first phase sets quickly to provide body for the graft material. The second phase of the matrix sets over the following days as the first phase washes out - resulting in a porous matrix. The matrix is then resorbed as cells populate the matrix and provides calcium and phosphate compounds for the mineralization process. The matrix is non-ceramic, and therefore, does not inhibit bone formation. The matrix is completely resorbed in approximately 2 months.
Socket Graft modifies the healing process through tissue engineering and skips the normal healing process. Bone is the only tissue formed in Socket Graft and this results in integration of bone to the implant surface as Socket Graft is resorbed. This makes Socket Graft the only graft material to be proven to integrate to immediate implant surfaces. Please see clinical cases below.
PRICING
SOCKET GRAFT UNIDOSE 1CC SYRINGES RECOMMENDED FOR ANTERIOR AND BICUSPID REGIONS $50.00/syringe.
SOCKET GRAFT UNIDOSE 2CC SYRINGES RECOMMENDED FOR THE POSTERIOR MOLAR REGION $60.00/syringe.
To order online click here or call (808) 689-1710
IMPROVES PATIENT OUTCOMES
Requiring only 15 minutes and no surgery, SOCKET GRAFT™ causes no trauma to the patient and reduces postoperative
complications. The patient is less stressed and more comfortable. Also, the use of the ovate pontic for
retention imparts an esthetically pleasing smile– maintaining gingival esthetics and helping to keep the patient
self-confident and assured during the regeneration period.
IMPLANT PLACEMENT IN 6 TO 8 WEEKS
SOCKET GRAFT™ is quickly and completely resorbed to facilitate the placement of dental implants. Implant
placement is advised at 6 weeks for incisors and bicuspids, and 8 weeks for molars. During this 6- to 8-week
period, the socket will contain approximately 50% mineralized tissue but still contain islands of bone graft
material which are continuing to stimulate osteogenesis. Placing the implant in an actively mineralizing
environment is advised for optimum osseous integration.
The graft material is fully resorbed in 8 to 12 weeks – leaving the socket filled with cortical bone.
RESORPTION OF THE GRAFT MATERIAL
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| 6 WEEKS. The photomicrograph on the right shows
the molar extraction site six weeks after extraction
and grafting with SOCKET GRAFT™. The lower half of
the photomicrograph shows the apical portion of
the core sample, which has filled with cortical bone.
With a significant number of osteoblasts in the soft
tissue, the remaining graft particles are attached to
newly formed bone. |
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| 6 WEEKS. Magnified to 400 power, the graft particle
is nearly encapsulated in bone. Voids are found
throughout the graft particle which are designed
to facilitate in growth of nutrient canals. A nutrient
canal can be seen entering the top of the graft
particle where it courses through the center of the
particle and bifurcates before exiting the bottom
of the graft particle. SOCKET GRAFT™ is quickly
converted from inorganic graft material into bone.
SOCKET GRAFT™ is both biocompatible and capable
of stimulating bone growth. |
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| 8 WEEKS. In this molar extraction site SOCKET
GRAFT™ has produced active octeogenesis ideal for
implant integration. |
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| 8 – 12 WEEKS. When resorption of the graft material
is complete, the extraction socket is filled with
cortical bone. |
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| PREPARATION FOR USE IS QUICK & EASY |
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SOCKET GRAFT UNIDOSE 1CC SYRINGES ARE RECOMMENDED FOR BICUSPID AND ANTERIOR EXTRACTIONS AND GRAFTING AROUND IMMEDIATE IMPLANTS |
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SOCKET GRAFT UNIDOSE 2CC SYRINGES ARE RECOMMENDED FOR MOLARS |
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| Instructions for Unidose Syringe |
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| Open blue valve, push liquid into powder, mix back and forth until reaching a paste consistency and finish with graft material in one syringe. Allow mixed graft material to set for 3 minutes. After 3 minutes express the air out of the syringe. Remove the blue valve and place the dispensing tip on the syringe. Inject the graft material into the socket beginning at the apex filling to the gingival margin. |
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Integration of immediate implants with bone regeneration and implant integration at the crest.
To achieve integration at the crest after immediate implant placement, the graft material must prevent the fibrin clot, granulation tissue and collagen formation found in the normal healing process. If collagen fibers attach to the implant prior to bone arriving, the implant will be encased in a fibrous layer and integration will be prevented. Socket Graft skips the normal healing process and the graft material is replaced by bone. Socket Graft bonds to the implant surface and as the graft material resorbs osteoblasts form osteoid on the implant surface which mineralizes resulting in implant integration at the graft site. |
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Proven Immediate Implant Integration |
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Failed implant #19 and failed #20 in a type one diabetic patient. |
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#20 was removed a-traumatically. However, the failed implant presented with only granulation tissue between the apex of the implant and the mandibular nerve. |
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Due to the size of the defect in the area of the previous implant, no bone was available to contact the new implant. The site was grafted with Socket Graft and the implant was floated in graft material. The adjacent radiografts were taken the day of implant placement. Due to the initial poor alignment of the molar implant, it was uprighted with a probe in the cover screw to aid restoration. |
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Three months after placement, the implants were uncovered and healing abutments were placed. |
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The implants were shortly restored showing greater bone density in the area of the graft site around #19 implant than in the surrounding host bone. |
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Restoration of the immediate implants with the molar implant floated in Socket Graft proves that Socket Graft achieves implant integration in humans. |
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On more routine cases Socket Graft provides implant integration in the graft site without osseous defects at alveolar crest. |
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Cut the provided socket seal to fit the extraction site orifice. Place a suture through the lingual gingival margin, fold the suture seal in half and place suture through the middle. |
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Place Socket Seal into orifice, place suture through buccal gingival margin then tie without cutting suture ends. |
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After the first knot is tied, continue to overlap with the suture as needed. |
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After the extraction, suture the papilla and any lacerated tissue then fill with Socket Graft. |
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Socket Seal securely in place after tooth extraction. |
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Socket Seal at 4 day post- op. |
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4 day post-op with seal removed. |
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Socket Graft is also available in six, sterile, single-use packets ready for use in the sterile surgical field (Hydrase, the wetting agent is needed for this order). |
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Socket Graft is constituted with HYDRASE™ bone graft wetting agent. HYDRASE is an ideal bone graft wetting agent for all bone graft materials and for implant wetting prior to insertion. HYDRASE meets USP standards for water for irrigation and is specifically formulated to provide the optimum pH, ion conductivity, and ion content for osteoblastic activity. |
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| BEFORE. #14 has been extracted and the socket has been curetted to remove any granulation tissue or remaining endodontic material. |
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| AFTER one week of healing, the packing is removed showing the graft covered by connective tissue with the epithelial border moving over the connective tissue. |
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| SOCKET GRAFT™ has been designed to be used without incisions or flaps. However, SOCKET GRAFT™ can be used equally as well if it is covered with a membrane or closed with primary closure. |
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FOR EXTRACTIONS IN THE AESTHETIC ZONE
An Ovate Pontic Stayplate Offers an Aesthetic Solution for Graft Retention and maintanence of the gingival margin and papillae. |
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| After tooth removal and bleeding has subsided, the site is grafted with SOCKET GRAFT™. |
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| Instructions for the lab is to carry the pontic straight into the socket 3 mm apical to the buccal gingival margin and then round the apex of the pontic into an ovate shape. The resulting ovate pontic sits approximately 4.5 mm apical to the buccal gingival margin. |
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| The stayplate needs two clasps for stability and should be completely out of occlusion. If the stayplate is in occlusion pumping action may pump out the graft material before it sets. |
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| With the socket filled with SOCKET GRAFT™ the pontic will express any excess graft material when the stayplate is seated. |
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| Wipe off the excess graft material and instruct the patient to keep the stayplate in for 2 days without removal. During this time, the patient can gently brush and rinse with mouthwash avoiding the extraction site. After 2 days, the stayplate can be removed for brushing and flossing only. The stayplate should be worn continually in order to maintain the gingival margins and papilla until the tooth is permanently replaced. |
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| The socket is filled with dense bone. Bone is also formed around the ovate pontic with approximately one millimeter of soft tissue between the pontic and bone. |
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A preoperative photograph of a maxillary bicuspid prior to extraction. |
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| This photo shows the ovate pontic. Your lab will need guidance on the proper preparation of the pontic. Most labs do not understand the fabrication of an ovate pontic. In this case, in spite of proper instructions, the lab prepared a ridge lap pontic that needed to have acrylic added to create the proper ovate pontic with the desired depth. |
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| After extraction and grafting with SOCKET GRAFT™ the stayplate is seated and then taken out of occlusion to prevent any pumping action by the pontic. |
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| Tooth number 7 was extracted and grafted with SOCKET GRAFT™ This photo was taken two weeks after extraction. |
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At the two week post operative appointment, the ovate ridge is covered with epithelium. |
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 Click here to print laboratory instructions. |
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To read our publication on Extraction Socket Healing and Socket Regeneration as published in the Compendium March 2008 click here.
To order online click here or call (808) 689-1710
Click here for information on HYDRASE.
Click here for a photo essay
on when to use SOCKET GRAFT
for socket regeneration and when to use a hard bone graft and membrane for
ridge augmentation. |
