**4. Clinical Cases**

After reviewing the topic, six clinical cases used Bond Apatite® as bone graft material in different procedures. The characteristics of the patients and surgeries are summarized in Table 2.

**Table 2.** Description of the cases. I.M.: Intraoperative management; I.C.: Intraoperative complications; G: Good; M: Moderate.


Without exception, informed consent was obtained from all subjects involved in the study.

In all cases, both after the extractions and after the placement of the implants, postsurgical recommendations were provided and explained, as well as Amoxicillin 750 mg every 8 h × 7 days, Dexketoprofen 25 mg every 8 h × 3–4 days alternated with Paracetamol 1g every 8 h if there was pain, in addition to rinses with Chlorhexidine 0.12% (Bexident® Post topical gel, Isdin, Barcelona Spain) every 8 h × 7 days beginning 24 h after surgery.

Periodic follow-ups were carried out after a week, after the first month, and three months after the intervention with their corresponding X-ray. In all cases except one (Patient No. 1), after 4 months and before implant placement, a biopsy of the regenerated area was performed using a histopathological study (Trefina Komet, 032, Barcelona Spain, 032, diameter 3, 2 external, and 2.6 mm internal).

#### *4.1. Patient No. 1*

A 63-year-old woman with no known allergies or medical history of interest, a smoker of two cigarettes a day, came to the clinic to rehabilitate an edentulous area at levels 45 and 47. She presented with 46 with a metal-ceramic crown and cantilever towards the mesial (Figure 2A). It was decided to cut the cantilever, keep the crown at 46 temporarily, place implants at 45 and 47 and subsequently rehabilitate with three individual metalceramic crowns. At the 45 level, there was a horizontal bone defect (Figure 2B), so it was decided to perform a lateral ridge augmentation with Bond Apatite® on the same day as implant placement. Surgery was performed following the manufacturer's protocol, incision, detachment of the mucoperiosteal flap, micro-perforations in the cortex, placement of a Bond Apatite® syringe, compression with dry and sterile gauze, placement of Microdent® Genius 3.5 × 12 mm implants at the level of 45 and 4.5 × 12 mm at the level of 47, following the milling of the commercial house, repositioning the flap and tension suture (Figure 3). The recommendations and postoperative pharmacological guidelines were delivered. No intra- or postoperative complications occurred. The stitches were removed a week after surgery (Figure 4A) and regular monthly check-ups were performed (Figure 4B,C). After three months, a new CBCT was requested to assess the bone gain achieved (Figure 2D). Prosthodontic rehabilitation was carried out 4 months after surgery.

**Figure 2.** (**A**) Preoperative intraoral periapical radiograph (IOPA); (**B**) Initial CBCT; (**C**) Intraoperative IOPA; (**D**) CBCT after 4 months.

**Figure 3.** (**A**) Preoperative occlusal view; (**B**) Incision; (**C**) flap detachment; (**D**) Drilling according to protocol, check the position with the pin; (**E**) Implant placement at level 45; (**F**) Micro perforations in the vestibular; (**G**) Placement of Bond Apatite®; (**H**) Tension suture and implant placement in 47.

**Figure 4.** (**A**) Follow-up and removal of the suture after 7 days; (**B**) 1 month follow-up; (**C**) 2 months follow-up; (**D**) 3 months follow-up and healing abutments' placement.
