Dear Anne, usually you fill from the bottom to the top for simply practical reasons; once a hole is plugged, it is not possible to fill the defect up. The details, of course, always depend on the indication. E.g. in case of juvenile cysts a fairly homogenous filling will be sufficient, because the bone itself has the capacity to regenerate. A little bit of stuffing, preferably with sensitive fingers, is also allowed. Hagen.

it´s a hard to aswer question.

but usually it depends on the sistem the cement comes.

if it´s in a syringe with a long and thin applicator, we may use from the deep, if it comes in our hands, we need to put from outside -in in a more homogenous way, leaving some bubles inside...

so.. you decide the way you gonna send it...

dear Ann,

after 15 years experience I can say:

It depends the product:  bone apatite or brushite cement it's surely better from bottm up; for nanogel it's equal

CS

It is better to fill from the inner most part to the outer

From the deeper parts, like filling holes in the wall