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Treatment Solutions
- 2-Stage Implant Placement(7)
- Gain of Keratinized Tissue(2)
- GBR Procedure(9)
- Peri-Implantitis Therapy(3)
- Ridge Preservation(6)
- Sinus Floor Elevation(1)
- Soft Tissue Thickening(13)
- Surgical Periodontal Treatment(6)
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- Geistlich Bio-Gide Compressed®(1)
- Geistlich Bio-Gide Shape®(1)
- Geistlich Bio-Gide®(14)
- Geistlich Bio-Oss Collagen®(8)
- Geistlich Bio-Oss Pen®(1)
- Geistlich Bio-Oss®(16)
- Geistlich Fibro-Gide®(10)
- Geistlich Mucograft®(7)
- GEM 21S®(1)
- Micross(1)
- Safescraper Twist(3)
- vallomix™(1)
- vallos®(4)
- vallos®f(1)
- Yxoss CBR®(4)

Found 32 Results

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.

Frontal view revealed adequate contours of soft-tissue especially in gingival height and presence of interdental papilla which needed to be preserved.

Bilateral papilla-sparing incisions were used to preserve the existing papilla and the osteotomies were prepared to allow implant trajectories for cement retained restorations.

An apical fenestration was noted in the osteotomies. After placement of a narrow diameter implant at patient’s right lateral incisor, the site was grafted with a mixture of autologous bone chips and Geistlich Bio-Oss®.

Geistlich Bio-Gide® is trimmed to match the trapezoidal flap design and placed over the graft material.

Healing Abutments 3.5 mm were placed at time of surgery for single-stage healing

After a 3-month healing period, the implants were osseointegrated and then screw-retained provisional crowns were fabricated over both implants. The soft-tissues showed an excellent response to the bone graft materials.

The soft tissues around the implants show excellent maturation and support especially in the interdental papilla region which was preserved during surgery.

Occlusal view shows adequate restoration of the facial contour around the implant restorations indicating excellent outcome from the contour augmentation procedure.

Frontal close-up view of the implant restorations shows pleasing dental and gingival esthetics.

The clinical picture is showing a fistula buccal to #21 as well as leakage on old composite restorations. A thin biotype is evident.

The sagittal cuts are reporting chronic peri-apical lesions on both central incisors and a thin buccal plate with minor vertical bone loss but fenestration apical to #21.

The intrasurgical picture is showing the bony defect, the buccal fenestration and the thin buccal plate.

After allowing the tissue to heal for 4 months a first “Buccal Pedicle Flap” was performed during the uncovery of the dental implant. Simultaneously, Geistlich Fibro-Gide® was inserted into the envelope created by the flap design.

Geistlich Fibro-Gide® is reduced to a thickness of 4 mm at its borders so that it is easier to get adapted to the recipient site.

The Fibro-Gide® is trimmed so that its borders don’t approach the vertical incisions of the Buccal Pedicle Flap.

Polypropylene 6.0 sutures are used to compressed the Fibro-Gide® underneath the flap thus creating the “wrinkles” on the mucosa.

The wrinkles are visible also on the occlusal view. The mucogingival line is repositioned at its original level.

Four months after immediate implant placement and GBR in area #11 a second Buccal Pedicle Flap is performed to reduce the buccal concavity, boost the peri-implant mucosa and increase the thickness as well as the band of the keratinezed mucosa.

As in the previous surgery the Fibro-Gide® is inserted underneath the Buccal Pedicle Flap and stabilized with e-PTFE 6.0 sutures.

8 weeks post surgery, the occlusal view is showing a biomimetic countouring of the peri-implant mucosa.

The final esthetic result is emphasizing an excellent blending of “white” and “pink” esthetics.

Pre-surgical, occlusal view, demonstrating buccal ridge concavities at edentulous sites, #7 and #10.

Geistlich Fibro-Gide® collagen matrix is cut and shaped prior to placement into surgical sites.

Immediate post-surgical occlusal view following placement of implants and Geistlich Fibro-Gide® on facial aspects. Implant #7 was provisionalized immediately, however implant #10 did not achieve sufficient stability and a healing abutment was placed.

Immediate post-surgical facial view. One can note the buccal prominences being developed by the presence of Geistlich Fibro-Gide®.

2-month post-surgical view, following provisionalization of implant #10. Buccal convexities at the implant sites are still evident.

8 month view of implant sites at time of torque test, following maturation of gingival emergence. Of note is thick, convex buccal tissue free of any sign of inflammation.

Occlusal view following final restoration, (Dr. Paul Krainson). Natural-appearing buccal gingival convexities remain 1.5 years post-surgery.

Frontal view of final restoration of implants. The tissue health with stippling and root-like gingival prominences are noted.

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Clinical Resources

FEATURED RESOURCE

Alveolar Ridge Preservation with vallos® Mineralized Cortico-Cancellous Allograft

On-Demand Webinars

Learn on your own Time and Earn CE

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

Successful Implant Placement and Horizontal Augmentation for Bilateral Congenitally Missing Maxillary Incisors

The Buccal Pedicle Flap for Peri-Implant Soft Tissue Volume

Use of Geistlich Fibro-Gide® for Correction of Maxillary Anterior Soft Tissue Peri-implant Ridge Deficiencies