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GEM 21S^®, the first recombinant growth factor product for use in oral regenerative surgery. Learn More

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- Geistlich Mucograft^®
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Clinical Resources

Use the search and filter form below to find informative clinical content by format, therapeutic areas, or product.

FEATURED RESOURCE

Therapeutic Areas
- Extraction Socket Management(2)
- Major Bone Augmentation(8)
- Minor Bone Augmentation(7)
- Peri-Implantitis(1)
- Periodontal Regeneration(3)
- Soft-Tissue Regeneration(14)
Products
- Geistlich Bio-Gide Compressed®(1)
- Geistlich Bio-Gide Shape®(1)
- Geistlich Bio-Gide®(13)
- Geistlich Bio-Oss Collagen®(5)
- Geistlich Bio-Oss Pen®(1)
- Geistlich Bio-Oss®(16)
- Geistlich Fibro-Gide®(8)
- Geistlich Mucograft®(6)
- Micross(1)
- Safescraper Twist(3)
- vallomix™(1)
- vallos®(4)
- vallos®f(1)
- Yxoss CBR®(3)

Found 27 Results

Initial Situation: a failing mandibular molar with a vertical sub-osseous fracture.

A pre-operative radiograph and CBCT showing the cross-section of the involved tooth.

An implant site was developed by placing a pilot drill down the mesial root space, then uprighting it. This was continued up through the drill sequence. The mesial radicular septum is moved in the process.

A Camlog® 5.0 x 11 mm implant was placed with the platform set just down below the bone height of the socket walls.

After placing a 4.0 mm height cylindrical gingiva former in the implant, 250 mg of Geistlich Bio-Oss Collagen® was packed down in the socket around the implant.

Geistlich Mucograft® was adapted to the region then tucked down under the gingival margin.

The gingival margins were adapted and closed together with 4.0 teflon sutures (Cytoplast™, Osteogenics). The region was then covered with Glustich - PeriAcryl®90 Oral Tissue Adhesive.

After 3 months of healing, the top of the gingiva former is exposed and the situation is ready for Emergence Profile Development. This is quite standard.

4 months later following Emergence Profile Development.

An occlusal view of the final one-piece, screw-retained zirconia crown restoration based on a Camlog® Titanium Base Abutment.

CT scan showing insufficient bone width for implant placement < 4mm.

Initial incisions on the midcrest of the ridge were performed for full-thickness flap preparation.

Four mucoperiosteal flaps were done with vertical releasing incisions and interosseous holes created to stimulate bone formation (RAP phenomenon).

Harvesting of the autologous cortical bone from the lateral surface of the ramus, utilizing the Geistlich Micross.

Geistlich Bio-Oss® granules mixed with harvested autologous bone chips.

Geistlich Bio-Oss® and autologous bone mixture was placed and covered with Geistlich Bio-Gide®. Pins and screws were utilized for fixation to provide primary stability.

Re-entry 8 months post-grafting: sufficient bone has been regenerated to place implants in the desired positions.

Follow-up at the time of implant uncovering and placement of the healing abutments, (4 months post- implant placement). All implants were successfully reverse torqued at 20ncm.

At re-entry eight months post-grafting, the width of the bone had increased significantly and measured 7.46mm at position #21.

Alveolar ridge split with Geistlich Bio-Oss® graft in place (subsequently applied Geistlich Mucograft®).

6 months post grafting with Geistlich Bio-Oss® and Geistlich Mucograft®.

Implant osteotomies with adequate alveolar width.

Implants in tooth positions 29, 30 and 31.

Pre-op mandibular ridge after the extraction of teeth #17 and #20. Note the significant horizontal ridge deficiency.

Yxoss CBR® Protect Customized Bone Regeneration Titanium Mesh in place, secured with two Stryker screws, 1.2 mm in diameter and 6 mm in length.

Note the excellent adaptation of the Yxoss CBR® Protect and that the edges are apical to the adjacent bony sockets.

Geistlich Bio-Gide® (resorbable collagen membrane) draped over the Yxoss CBR® Protect to separate osteoblasts from fibroblasts.

Implants restored with single-unit crowns.

Guide pins in place for implants #19, #20, and #21, with adequate ridge height and width.

Screw-retained final implant crowns with healthy keratinized tissue on the facial side.

Initial clinical and radiographic presentation shows buccal soft tissue enlargement and bone loss #21-22 area.

Clinical facial view showing full thickness flap reflection with complete enucleation of cystic lesion (excisional biopsy).

Clinical view showing hydration of vallos®f and Geistlich Bio-Oss® as two separate grafts.

Clinical facial view showing placement of vallos®f internally for maximum osteogenic/osteoinductive potential and Geistlich Bio-Oss® externally for space maintenance.

Clinical facial view showing placement of Geistlich Bio-Gide® covering the defect and extending one tooth mesillay and distally.

Clinical facial view showing primary closure using 6-0 prolene sutures.

CBCT immediately post-surgery showing radiolucent allograft internally for osseoinduction and radiopaque xenograft externally for space maintenance.

After flap elevation at 4 months showing, the new buccal bone plate together with a completely filled alveolus.

Clinical facial views showing healing at 2 and 4 weeks with proper soft tissue healing.

6 months post-surgery radiographic presentation showing stable periodontium and proper bone fill #21-22 area.

Comparison of pre- and post-surgical CBCT views showing good bone formation.

Comparison of pre- and post-surgical clinical views showing stable periodontium.

Pre-operative assessment demonstrates minimal zone and thickness of buccal keratinized gingiva, with a medium periodontal phenotype.

Pre-operative CBCT with virtually planned implant placement. A thin buccal plate (<1mm) is measured. Good apical bone is noted for the placement of a Straumann® 12mmx4.1mm bone level tapered implant.

Minimally invasive removal of #12 using only a buccal approach mini-flap showing an intact buccal plate with immediate placement of the implant (1 mm below the intact buccal wall) in a screw-retained position. A 3mm buccal gap is measured and a 1.5mm palatal gap.

Both the buccal and palatal gaps have been packed with Geistlich Bio-Oss Collagen® hydrated with Gem 21S. It’s my preference to squeeze Geistlich Fbro-Gide® between thumb and forefinger, prior to placement. A dry-carved piece of Geistlich Fibro-Gide® is in position thinned approximately 2mm with beveling laterally and coronally with a new #15 blade.

Geistlich Fibro-Gide® in place facial to the intact buccal wall under a full thickness buccal approach mini-flap. Immediate contour management was completed using an Anatotemp® for a maxillary bicuspid tooth.

Suturing completed using 4-0PTFE and 5 -0 polypropylene non-resorbable sutures. Anticipated short-term 25% post-operative swelling is discussed with the patient.

3 months post-operative appointment showing a well-developed subgingival transition zone created with immediate contour management. A reverse torque test was completed, and the case proceeded to completion.

9 month post-operative view with final screw-retained crown in place. Good interproximal papilla healing is noted with thickening of the buccal periodontal phenotype compared with Fig. #1. (Restorative Therapy: Drew Shulman DMD, MAGD; Philadelphia, PA)

Baseline full-mouth intra-oral view: the residual maxillary teeth were preliminarily reconstructed with a composite mock-up. The horizontal atrophy of the posterior areas of the maxilla is clearly visible.

The cone beam, realized with a radio-opaque diagnostic template, shows inadequate bone volume for implant placement in all the analyzed sites.

The use of the diagnostic template during the augmentation procedure helps to highlight the presence of bone defects in relationship to the restorative plan and future position of implants.

Large Geistlich Bio-Oss® particles are directly applied inside the sinus with Geistlich Bio-Oss Pen®.

The Geistlich Bio-Gide®, fixed with titanium pins is used to protect and stabilize the augmented site. As the surgical template shows, the bone augmentation is based on the future restorative project following the principle of PGR.

The same surgical procedure is performed on the left posterior side of the maxilla.

Cone-beam 6 months after surgery and prior to implant placement. The relationship between the template used for diagnosis and the bone crest reveals adequate bone volume to place implants in the correct prosthetically driven position.

Implant placement was guided by the same template utilized for diagnosis and bone augmentation.

Final view of the prosthetic reconstruction demonstrates bio-mimetic integration of implant-supported prostheses and ceramic veneers bonded to residual natural teeth.

The panoramic radiograph shows adequate integration of the implants and absence of peri-implant bone resorption.

A flap has been raised and reveals a significant facial and palatal defect at congenitally missing site #10.

Harvested ramal graft. Slightly over-sized to allow for mitering and harvest of particulate autograft with a bone trap on the suction.

Onlay graft now secured with two fixation screws (Stryker) with a lag screw technique. Geistlich Bio-Oss Collagen® has been placed on the palatal aspect of site #10

Combination of a fixated onlay graft with Geistlich Bio-Oss®/autograft particulate graft at the periphery and over the facial plate of the adjacent dentition

Geistlich Mucograft® matrix placed over facial augmentation of the adjacent dentition and ridge crest of the augmented site

Closure following ramal grafting and Geistlich Mucograft®matrix application

Implant placement with static guide and dental implant hand driver

Implant placement with slight subcrestal placement of the platform just prior to osteoplasty by the periodontist.

Baseline: endodontic/prosthetic failure on the maxillary left lateral incisor.

The cone beam image shows the missing bony buccal plate.

Clinical situation following a minimally invasive, flapless extraction approach.

Geistlich Bio-Gide® Shape is inserted into the socket, with the long wing in contact with the buccal surface in order to recreate the cortical bone.

The socket is carefully grafted with Geistlich Bio-Oss Collagen®.

The three remaining wings of Geistlich Bio-Gide® Shape are folded over the bone graft and gently secured inside the gingival sulcus. The membrane is then sutured to the surrounding soft-tissue with six single-interrupted sutures.

Implant placement can be planned 4 months after the ridge augmentation procedure.

4 weeks post-operative view with an open-healing approach, showing a positive soft-tissue response.

After flap elevation at 4 months, the new buccal bone plate can be detected, together with a completely filled alveolus. An implant can now be easily inserted into a fully healed ridge.

Clinical image of the final ceramic crown. An esthetic improvement can be noted when compared with the baseline image. The free gingival margin has been shifted in a coronal direction.

Pre-operative condition: Note that the gingival recession of 3-4 mm is evident as is the cervical root abrasions. The interdental papillae completely fills the embrasure space.

Incision design showing the sulcular incisions with horizontal incisions across the interdental regions ending with a remote oblique vertical releasing incision distal to the first bicuspid tooth.

The interdental papillae were de-epithelialized and Geistlich Fibro-Gide®was placed over the exposed roots extending onto the bone. Geistlich Fibro-Gide® was not secured with sutures.

Internal periosteal releasing incision was made to allow tension-free coronal advancement of the buccal flap to completely cover Geistlich Fibro-Gide®.The flap was secured with 5-0 Monocryl® sutures.

1-week post-operative visit: the healing looks good and sutures are intact. There was a small soft-tissue dehiscence at the buccal margin of the canine tooth.

Healing progressed well at 2 months post-operatively and the dehiscence defect seen at 1 week appears to be healing. Soft-tissue thickness is also evident at this stage.

At 6 months, 100% root coverage has been achieved. Note the increase in keratinized gingiva at the canine tooth where there was previously delayed healing. The patient is happy with the esthetic and functional outcome.

At 1 year, we can see root coverage has been sustained. Complete root coverage is not seen for the upper left bicuspid, not surprising given the tooth had an older restoration which was removed prior to grafting and the CEJ on the proximal surface is visible. Partial coverage was achieved however and is much more pleasing to the patient.

At 1.5 years, the tissue looks stable, healthy and esthetic. The patient is very happy with results thus far both from esthetic and functional standpoints. She is still free of sensitivity.

Full thickness flap elevation exposing the complex clinical situation.

Alveolar socket after the tooth removal exposing the loss of bone on the distal of tooth #11, prior to the debridement of the granulation tissue and root preparation.

Adaptation on the buccal defect prior to placement of bone grafting with vallos® mineralized cortical cancellous mix granules (bottom) followed Geistlich Bio-Oss® (top).

Post adaptation with Geistlich Bio-Gide® for alveolar ridge preservation and guided tissue regeneration, followed by final suturing of the site using ePTFE material.

Radiographic overview of the clinical procedure: initial presentation with the bony defect impacting distal of #11 and #12 – mesial and inter-radicular, site after the tooth #12 was extracted, radiographic bone fill of the defect post-operative.

Post-operative healing of the site, 4 weeks after the procedure was completed.

A young male patient was referred to the clinic with a missing central incisor, #9 following trauma.

Preparation of a split-thickness flap (buccal pouch).

Due to releasing incisions within the periosteum, the tissues can be advanced more coronally.

The dimension and shape of Geistlich Fibro-Gide® with a maximal thickness (5mm) at the transition between the buccal and occlusal aspect.

Geistlich Fibro-Gide® inserted and immobilized with a horizontal cross-suture to the palatal flap.

A provisional reconstruction is inserted; blanching of the tissues can be observed.

Final emergence profile established with a provisional reconstruction.

8 weeks healing: Abutment connection is performed

The clinical situation at 1-year follow-up.

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Geistlich Pharma North America Inc.
400 Alexander Park Drive, Suite 302
Princeton, NJ 08540

Customer Care Toll-free 855-799-5500
[email protected]

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Clinical Resources

FEATURED RESOURCE

Alveolar Ridge Preservation with vallos® Mineralized Cortico-Cancellous Allograft

Immediate Mandibular Molar Transition

Lateral Ridge Augmentation in the Posterior Mandible

Mandibular Alveolar Ridge Split with Delayed Implant Placement

Mandibular Ridge Augmentation Using Customized Titanium Mesh

Odontogenic Keratocyst Management

Phenotype Conversion Using Geistlich Fibro-Gide® for Immediate Implants in the Esthetic Zone

Prosthetically Guided Regeneration (PGR) in the Posterior Maxilla

Ramal Bone Graft for Congenitally Missing Maxillary Lateral Incisor

Ridge Augmentation and Delayed Implant Placement on an Upper Lateral Incisor

Root Coverage for Multiple Adjacent Teeth in the Maxilla with Geistlich Fibro-Gide® 1.5-Year Follow-Up

Selecting Biomaterials for Combined Complex Defects

Soft-Tissue Augmentation in the Esthetic Zone