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PRODUCT INFORMATION

Ideal Matrix for Volume Stability

Geistlich Fibro-Gide® is a volume-stable collagen matrix specifically designed for palate free soft tissue regeneration.

  • Made of Collagen – a porcine, porous, resorbable, and volume-stable collagen matrix1
  • Volume Stability – the reconstituted collagen undergoes smart cross-linking for volume stability of the matrix1
  • Supports Soft Tissue Integration – the porous network supports angiogenesis, formation of new connective tissue, and stability of the collagen network in submerged healing situations2,3
  • Soft Tissue Formation – animal models have shown good product integration into the surrounding soft tissue while maintaining stability4

UNIQUE BENEFITS

Turning Up the Volume on Patient and Practice Satisfaction

Provides stable augmented soft tissue in terms of both quality and quantity, while eliminating the donor site, shortening surgical time, and lowering patient pain perception.2-3, 5-7

  • Fewer Surgical Procedures – Eliminates the need to harvest an autologous graft
  • Patient Morbility – No palate required significantly reduces post-operative pain and chair time5, 8-10
  • Complication Free Healing – No increase in post-surgical complications were observed with Geistlich Fibro-Gide® vs. a Connective Tissue Graft2
  • Patient Preferred – 66.7% of patients prefer Geistlich Fibro-Gide® over connective tissue graft treatment11

Handling at a Glance

As with any new product, initially, you will experience some differences in the handling properties and performance of the matrix. The instructions below are intended to provide insights for the successful use and application of Geistlich Fibro-Gide®.

Careful Case Selection

When using Geistlich Fibro-Gide®, it is important to carefully consider the patient and desired outcome to determine the appropriate surgical technique.

Flap Design

Geistlich Fibro-Gide® can be used in both open flap and flapless procedures. A generous release of the flap is the key to successful healing by complete coverage of the matrix (submerged healing).

Trimming and Cutting

Geistlich Fibro-Gide® can be adjusted in size and thickness, in both a wet or dry state. The use of a scalpel is recommended when the matrix is in a dry state and scissors when in a wet state.

Volume Changes

Swelling of the matrix upon wetting must be taken into account when determining final dimensions, as the matrix will gain approximately 25% in volume.

Thickness

When treating recession defects (Miller Class I/III)*, Geistlich Fibro-Gide® 3 mm thickness is recommended to achieve tension-free wound closure.

*Clinical evidence is continuously being collected for this indication.

Application

Geistlich Fibro-Gide® can be applied in either a dry or wet state upon individual preference. Pre-wetting can be done with the patient’s own blood, you may also dampen with sterile saline solution, but do not fully hydrate the matrix.

Fixation

When hydrated the matrix will adhere rapidly. Suturing the matrix can be performed, however is not always necessary.

Tension-Free Wound Closure

This is key for complication-free healing. It is recommended to bevel the edges of the matrix to accomplish this.

Healing

Primary closure is recommended to ensure maximum soft-tissue thickness gain. In case of exposure Geistlich Fibro-Gide® is forgiving and can heal without additional treatment. Clinical experience shows low incidence of wound healing complications.1,5-8

Post-Operative Instructions

Following the application of Geistlich Fibro-Gide® and during healing, there may be a slight change in the color of the soft-tissue and an increase in volume at the surgical site. Both color matching and a reduction in tissue volume to varying degrees, should be expected over time. It is recommended that this is expressed to the patient, as part of their post-operative instructions, to ensure appropriate expectations, during healing.

Guidance above is based on pre-clinical and clinical evidence gained in Europe and North America during the pre-launch and launch phase of Geistlich Fibro-Gide®.

Handling Geistlich Fibro-Gide®

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Geistlich Fibro-Gide®

The Alternative Soft-Tissue Graft

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“Avoiding a second surgical site reduces patient morbidity, as well as my surgical time.”

– Prof. Dr. Daniel Thoma | Zurich, Switzerland

“Geistlich palate free products have provided me with an endless source of soft tissue material, which is beneficial specifically in multiple teeth defects. There are many factors that I take into consideration when going to sources other than autogenous tissue, such as a patient’s concern, a shallow palate and presented with a multiple tooth defect.”

– Dr. Thaer Alqadoumi | Loma Linda, California, USA

“Geistlich Fibro-Gide® has enabled my practice to offer a long-lasting esthetic outcome for my patients. It is a predictable and less traumatic alternative for several soft tissue augmentation procedures.”

– Dr. Erik Sahl | Palm Springs, California, USA

“Always looking for ways to make my patient experience better, Geistlich Fibro-Gide® has quickly become a regular part of my practice. In many clinical scenarios, it allows me to avoid harvesting tissue from the palate while achieving a long-lasting esthetic result.”

– Dr. Israel Puterman | Chevy Chase, Maryland, USA

“Geistlich Fibro-Gide® has been added to my tool belt to provide my patients with a palate free option to optimize implant esthetics all while avoiding a second donor site.”

– Dr. Yvette Carrillo | San Diego, California, USA

“Geistlich Fibro-Gide® has been a real game changer for my practice! It has allowed me to offer a predictable Palate Free alternative to autogenous tissue for root coverage procedures especially for those patients of mine who are anxious, have had a previous negative experience with palatal harvest, or just don’t have the palatal real estate for sufficient graft harvest!”

– Dr. Vinay Bhide | Aurora, Ontario, Canada

“In my practice I am always open to new products and procedures to optimize patient care. It is also important that it is backed by long-term predictable outcomes. In my experience over the last several years, Geistlich Fibro-Gide® has the capacity to enhance the soft tissue during guided bone regeneration. It is an alternative approach I use clinically every day.”

– Dr. Hector Sarmiento | New York, New York, USA

“When I evaluate products that I am considering to use in clinical procedures I am always looking at the evidence. With Geistlich products you can be sure that the scientific evidence is well documented and is published in animal and human clinical trials. This has been my clinical experience for over 25 years with the use of Geistlich Bio-Gide®, Geistlich Bio-Oss® and Geistlich Bio-Oss Collagen® for GBR procedures. It continues to be very positive with my use for over a decade with Geistlich Mucograft® and more recently with Geistlich Fibro-Gide®, in providing a ‘Palate Free’ mucogingival solution for my patients. In addition and just as important, my patient reported outcome measures (PROMS) are very positive with their use and this is shared with the prospective patient in helping them to make their decision.”

– Dr. Robert Levine | Philadelphia, Pennsylvania, USA

Frequently Asked Questions

What are the indications for Geistlich Fibro-Gide®?

Geistlich Fibro-Gide® is intended for soft-tissue augmentation. It is indicated for localized gingival augmentation to increase keratinized tissue (KT) around teeth and implants, alveolar ridge reconstruction for prosthetic treatment, and recession defects for root coverage.1

  1. Instructions for Use. Geistlich Fibro-Gide®. Geistlich Pharma AG, Wolhusen, Switzerland.

What is Geistlich Fibro-Gide® made of?

Geistlich Fibro-Gide® is a porous, resorbable and volume-stable porcine collagen matrix specifically designed for soft tissue regeneration.1 The matrix is made of reconstituted collagen and undergoes smart chemical cross-linking to improve volume stability of the device while maintaining its excellent biocompatibility.1-3

  1. Instructions for Use. Geistlich Fibro-Gide®. Geistlich Pharma AG, Wolhusen, Switzerland.
  2. Thoma DS et al. J Clin Periodontol. 2016 Oct; 43(10): 874–85.
  3. Thoma DS et al. Clin Oral Implants Res. 2015 Mar; 26(3): 263–70.

Is Geistlich Fibro-Gide® resorbable?

Animal models show gradual resorption and integration of Geistlich Fibro-Gide® into host tissue while maintaining volume stability.1

  1. Thoma DS. et al. Clin Oral Implants Res. 2012.

Is Geistlich Fibro-Gide® an alternative to free gingival graft (FGG) or to connective tissue grafts (CTG)?

Geistlich Fibro-Gide® is an alternative to autologous connective tissue grafts (CTG) for soft tissue volume augmentation around dental implants and natural teeth.1,2Geistlich Fibro-Gide® obviously has the advantage of reducing patient morbidity since there is no additional harvest site. Furthermore, there is minimal risk of necrosis when using Geistlich Fibro-Gide® compared to CTG.3

  1. Thoma DS et al. J Clin Periodontol 2016.
  2. Zeltner M et al. J Clin Periodontol 2017.
  3. Data on file. Geistlich Pharma AG, Wolhusen, Switzerland.

Does Geistlich Fibro-Gide® need pre-treatment?

Geistlich Fibro-Gide® is ready to be applied in a dry or wet state to the defect and does not need pretreatment or conditioning before application. Geistlich Fibro-Gide®possesses excellent hydrophilic characteristics that lead to a rapid hydration of the collagen matrix (patient’s own blood and/or sterile saline).1 When applied dry to the defect site, the matrix will hydrate easily by soaking up the patient’s own blood and/or sterile saline if applied to the matrix, very quickly.1

  1. Data on file. Geistlich Pharma AG, Wolhusen, Switzerland.

Is it easier to apply/handle Geistlich Fibro-Gide® in a dry or wet state?

Geistlich Fibro-Gide® can be applied either in a dry or wet state subject to individual preference: pre-wetting can be done with blood and/or sterile saline.1,2 Geistlich Fibro-Gide® can be cut and trimmed both in a dry or wet state, using scissors and/or a scalpel.1,2 The scalpel is recommended for dry handling.1,2 Using a scalpel will help to obtain smooth edges and tapers for improved wound adaptation and precise fit of the matrix.1,2

  1. Instructions for Use. Geistlich Pharma AG, Wolhusen, Switzerland.
  2. Data on file. Geistlich Pharma AG, Wolhusen, Switzerland.

Does Geistlich Fibro-Gide® increase its volume after hydration?

The device will gain approximately 25% in volume once wet. This increase in volume has to be taken into account when deciding to trim the matrix and determining its dimension prior to implatation.1 A generous flap design is the key to full submersion of the matrix.

  1. Data on file. Geistlich Pharma AG, Wolhusen, Switzerland.

Which flap design is recommended when using Geistlich Fibro-Gide®?

Use your preferred flap design. A generous preparation of the flap and ensuring adequate blood supply is key to promoting successful healing by complete coverage of Geistlich Fibro-Gide® (submerged healing). Different surgical techniques, such as tunneling and/or envelope techniques are currently being clinically tested.

What suture technique should be used with Geistlich Fibro-Gide®?

Clinical experience has shown that tension-free wound closure is a key factor in preventing dehiscence. In open flap procedures for augmentation at the alveolar ridge a horizontal mattress suture is recommended to stabilize the matrix (5.0-6.0).1 In recession coverage, single sutures (7.0) have been used for stabilization.1

  1. Data on file. Geistlich Pharma AG, Wolhusen, Switzerland.

How should the flap be closed with Geistlich Fibro-Gide®underneath?

A tension-free closure of the flap is key to a successful and complication-free healing and avoidance of any dehiscences during the healing phase.

Are antibiotics needed after treatment with Geistlich Fibro-Gide®?

After surgical treatment with Geistlich Fibro-Gide®, post-surgical management that typically follows procedures involving connective tissue grafts has been reported to be effective. Please use your clinical judgment based on the individual profile of the patient and the details of the surgery.

What is the difference between Geistlich Mucograft® and Geistlich Fibro-Gide®?

Geistlich Mucograft® = Compact and spongy layer
Geistlich Fibro-Gide® = Porous layer

Geistlich Mucograft® = Reconstituted collagen: No cross-linking
Geistlich Fibro-Gide® = Reconstituted collagen: Smart cross-linking

Geistlich Mucograft® = Reduced volume stability
Geistlich Fibro-Gide® = Good volume stability 

Geistlich Mucograft® = Open-healing & submerged healing
Geistlich Fibro-Gide® = Submerged healing only 

Geistlich Mucograft® Treatment Option:

  • Gain of keratinized tissue
  • Socket Seal
  • Vestibuloplasty
  • Recession Coverage

Geistlich Fibro-Gide® Treatment Option:

  • Soft tissue volume augmentation around dental implants and natural teeth, and under pontics
  • Recession Coverage

How much thickness of Geistlich Fibro-Gide® is required in order to obtain a thickening of the soft-tissue comparable to when connective tissue graft (CTG) is used?

Clinical studies have shown a physiological increase in thickness when using CTG as the gold standard of 0.35 to 3.2 mm.1-3 Clinical studies have shown that treatment with Geistlich Fibro-Gide® results in an increase of 1-2 mm of thickness4,5 which is equivalent to results obtained with CTG4. Geistlich Fibro-Gide® is provided with a thickness of 6 mm which gives freedom to the surgeon to trim it to the desired size and to use the collagen matrix for thickening of tissues under pontics where more volume might be required. For lateral soft tissue augmentation, it is recommended to reduce the thickness of Geistlich Fibro-Gide® in order to achieve a tension-free, primary wound closure.

  1. Eghbali A et al. Clin Implant Dent Relat Res. 2016.
  2. Thoma DS et al. Periodontol 2000. 2014.
  3. De Bruyckere T et al. J Clin Periodontol. 2015.
  4. Thoma DS et al. J Clin Periodontol 2016.
  5. Chappuis V et al. Manuscript in preparation.

How does Geistlich Fibro-Gide® perform if exposed in the oral cavity?

Geistlich Fibro-Gide® was designed for and performs best with primary wound closure. Clinical observation suggests that under circumstances where the wound dehiscence led to limited exposure of Geistlich Fibro-Gide®, uneventful healing and successful outcomes were nonetheless achieved.

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Geistlich Fibro-Gide® Clinical Study
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Which Geistlich Matrix is the Right Choice?
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Geistlich Fibro-Gide®: Before You Begin
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Geistlich Fibro-Gide® Technical Guidelines
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  1. Instructions for Use. Geistlich Fibro-Gide®.Geistlich Pharma AG, Wolhusen, Switzerland.
  2. Thoma DS. et al. J Clin Periodontol. 2016 Oct; 43(10): 874–85 (clinical).
  3. Thoma DS. et al. Clin Oral Implants Res. 2012 Dec; 23(12): 1333–9 (pre-clinical).
  4. Thoma DS. et al. Clin Oral Implants Res. 2015 Mar; 26(3): 263–70 (pre-clinical)
  5. Zeltner M. et al. J Clin Periodontol. 2017 Apr; 44(4): 446–453 (clinical).
  6. Huber S et al. J Clin Periodontol. 2018 Apr;45(4):504-512 (clinical).
  7. Chappuis V et al. Int J Periodontics Restorative Dent. 2018 Jul/Aug;38:575-582 (clinical).
  8. Maiorana C. et al. (2016). Open Dent J. 22(10): 395-410.
  9. McGuire MK, Scheyer ET. (2016). J Periodontol. 87(3): 221-227.
  10. Sanz, M. et al. (2009). J Clin Periodontol. 36(10): 868-76.
  11. McGuire, M. et al. (2022). JPeriodontol. 93(3): 333-342.