Doc no: F036-3D Doc title: PMS activities report 3D Bond - English Version: 10
Dear customer,
Augma Biomaterials is committed to ensure the highest level of quality for all its products and services. In order to reevaluate our products and our striving for improvement, we kindly ask your feedback. This questionnaire aims to enable us an evaluation of safety, effectiveness, convenience, quality and clinical success of our products. Augma Biomaterials appreciate your time and your cooperation.
User Details
Name
Title:
Dentist
Assistant
Other
(if other, elaborate):
Company/Clinic name:
Phone number:
Address
Email
Date:
Professional background
Overall dental experience:
more than 20 years
10-20 years
less than 10 years
Special Degree
No
Yes
(if yes, elaborate):
Experience with dental bone grafts:
more than 20 years
10-20 years
less than 10 years
Frequency of augmentation procedure:
<1 per month
2-10 per month
10-20 per month
>20 per month
Clinical Questionnaire – 3D Bond™
Instruction for use
Have you read the instruction for use before using?
Yes
No
Instructions were easy to understand (5 = high score, 1 = low score)
5
4
3
2
1
Material handling was as described
5
4
3
2
1
Guidance
Have you passed training prior to use?
Yes
No
Have you used a DEMO prior to use?
Yes
No
How did you learn to use the material?
hands-on guidance
instruction for use
colleagues
conferences
website
other
(if other, elaborate):
Is there more information you would like Augma to provide?
No
Yes
(if yes, elaborate):
Strengths and weaknesses
(5 = high score, 1 = low score)
Quality and safety
5
4
3
2
1
Handling end ease of use
5
4
3
2
1
Clinical performance
5
4
3
2
1
Innovation
5
4
3
2
1
Price
5
4
3
2
1
Clinical performance
3D Bond™ was easy to use during the procedure
5
4
3
2
1
Using 3D Bond™ reduced procedure time
5
4
3
2
1
3D Bond™ remains pliable after mixing, which allowing handling time to complete the bone reconstruction procedure
5
4
3
2
1
Setting time
too long
appropriate
too short
Would you rather use 3D Bond as:
composite graft
mixed with other grains
standalone
both
3D Bond™ by itself (not as a composite graft)
Have you used 3D Bond™ by itself in the following clinical cases?
As a barrier or a membrane
Yes
No
Socket preservation
Yes
No
Other:
Overall clinical success
5
4
3
2
1
3D Bond™ as a composite graft (used with others granules)
Did you use an Autograft granules?
No
Yes
What product?
Did you use an Allograft granules?
No
Yes
What product?
Did you use a Xenograft granules?
No
Yes
What product?
Did you use some other granules?
No
Yes
What product?
What is the volume ratio between 3D bond™ powder and the granules you used?
4: 1 (3D Bond™ : Granules)
2:1
1:1
other
Other - Specify
Have you used 3D Bond™ as a composite in the following clinical cases?
Vertical augmentation
No
Yes
Horizontal augmentation
No
Yes
Vertical augmentation
No
Yes
Sinus augmentation
No
Yes
Defects higher than 10 mm with less than 3 bony walls
No
Yes
Augmentation around implant with immediate implant placement
No
Yes
Other
Overall clinical success
5
4
3
2
1
Follow up
Was follow up performed post augmentation procedure?
No
Yes
If yes, after ______ months post augmentation
Are you satisfied from bone quality at the implantation site during follow up?
No
Yes
How long post bone augmentation procedure had you implanted the implant?
less than 3 months
3 months
6 months
The overall augmentation procedure was successful
No
Yes
Summary
Will you consider using 3D Bond™ in the future?
No
Yes
Will you recommend 3D Bond™ to others?
No
Yes
Open questions
Have you encountered risks or safety issues relating to device usage?
Have you encountered any major usability issues?
Have there been any un-anticipated adverse events during your use of the product (related to patients, handling, safety or other)?
Comments
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