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Treatment Solutions
- 2-Stage Implant Placement(16)
- Gain of Keratinized Tissue(5)
- GBR Procedure(8)
- Peri-Implantitis Therapy(1)
- Recession Coverage(9)
- Ridge Preservation(5)
- Soft Tissue Thickening(16)
- Surgical Periodontal Treatment(22)
Products
- Geistlich Bio-Gide®(19)
- Geistlich Bio-Gide® Compressed(1)
- Geistlich Bio-Gide® Forte(5)
- Geistlich Bio-Oss Collagen®(7)
- Geistlich Bio-Oss®(22)
- Geistlich Fibro-Gide®(18)
- Geistlich Mucograft®(11)
- Geistlich Mucograft® Seal(2)
- Geistlich Panorama®(1)
- GEM 21S®(4)
- RPM™(2)
- vallos®(5)
- vallos®f(2)
- Yxoss CBR®(7)

Found 54 Results

Initial clinical presentation showing the reduced ridge width.

Decortication was performed and the flap was mobilized.

Geistlich Bio‑Gide® Forte was fixed on the lingual aspect, and the defect was filled with Geistlich Bio‑Oss® and vallos® mineralized cortical‑cancellous granules.

The densely packed Geistlich Bio‑Gide® Forte membrane was secured with pins on the buccal aspect.

Primary wound closure was achieved with single interrupted sutures.

Six‑month follow‑up showing successful bone regeneration.

Andrea Ravidà, DDS, MS, PhD (Periodontist)
Jasper Wu, DDS, MS (Periodontist)

2-Stage Implant Placement in the Posterior Mandible using the Sausage Technique

Preview

Initial clinical presentation showing the reduced ridge width.

Decortication is performed and the flap is mobilized.

Fixation of Geistlich Bio‑Gide® Forte using the Sausage Technique™ was initiated on the lingual aspect.

The space beneath the membrane is filled with a 50:50 mixture of Geistlich Bio-Oss® and autologous bone.

The densely packed membrane is secured with pins on the buccal aspect (Sausage Technique™).

3-month follow-up shows visible horizontal bone gain and favorable soft-tissue conditions.

Five month CBCT cross sections showing consistent horizontal ridge augmentation and implant ready bone.

Six‑month re‑entry showing a stable, well‑integrated graft ready for implant placement, with a Geistlich Panorama retractor used to enhance visibility and access.

Six-month occlusal view showing implant placement following successful graft maturation.

Initial situation, patient presented with radiographic and clinically traditional signs of peri-implantitis, including bleeding on probing, suppuration, radiographic progressive bone loss and clinical pathologic probing depths.

Mechanical debridement was achieved using titanium scalers, an ultrasonic device with an implant protective cap and titanium brushes to remove all of the visible contaminants of the implant surface. Citric acid was then placed on shreds of a non-woven gauze and applied to the surface for approx. 1min. Copious irrigation was done using saline solution and the surface was ablated using the Er:YAG laser at 20pps/50mj.

After the surface was prepped and no signs of residual granulation tissue was noted, the defect was grafted with Geistlich Bio-Oss®. Attention was given towards not augmenting beyond the bony envelope.

A protective Geistlich Bio-Gide® membrane was placed over Geistlich Bio-Oss®.

Geistlich Fibro-Gide® was placed over Geistlich Bio-Gide® to enhance soft-tissue volume and quality. Geistlich Fibro-Gide® was trimmed and adapted to the defect site ensuring a tension free closure.

Geistlich Fibro-Gide® was place on the top of the bone graft to enhance soft-tissue thickness. Geistlich Fibro-Gide® is porous. We can observe the rapid penetration of blood through the matrix.

Closure with a tension-free flap was achieved by releasing incisions and secured using 4-0 chromic gut sutures.

1.5 year post-operative photo and radiograph show the healing of the soft-tissues with no signs of peri-implantitis and adequate tissue thickening. Radiographic bone levels have maintained stable over the course of the year.

1 – Pre-operative radiograph showing the severe bone defect around the tooth.

2 - Six weeks after tooth extraction, uneventful soft-tissue healing in the post-operative phase is visible.

3 - After flap preparation, an implant was placed in a site with a severe bone defect.

4 - In order to fill up the defect and provide volume stability Geistlich Bio-Oss Collagen® was applied.

5 - After augmentation with Geistlich Bio-Oss Collagen®, the site was covered with a collagen fleece.

6 - Final crown restoration after 6 months post-operative.

7 - The radiograph after 25 years shows a stable bone situation.

8 - The clinical picture after 25 years follow-up presents a very nice and stable bone and soft-tissue situation.

1 - Clinical situation in the posterior maxilla depicting a large buccal defect in the edentulous area.

2 - Fixation of the autologous block from the symphysis.

3 - Contouring of the grafted site with Geistlich Bio-Oss®.

4 - The augmented area is covered with the collagen membrane Geistlich Bio-Gide®.

5 - Primary wound closure is accomplished with single interrupted sutures.

6 - Clinical aspect of the augmented ridge with no signs of block resorption.

7 - Implant placement 3 months post augmentation.

8 - Long-term follow-up showing stable peri-implant bone level 3 years after implant placement.

1 - Thin mucosal tissue over implant #7 creating an unesthetic appearance.

2 - Occlusal view of #7 reveals buccal soft-tissue defects.

3 - Augmentation of the soft-tissue on two implant sites, #7 and #10, using a conventional full thickness flap with vertical releasing incisions on site #7 and an envelope flap on site #10.

4 - Geistlich Fibro-Gide® is split into two 3mm thick matrices to be used in both sites, hydrated with sterile saline and trimmed to the defect dimensions.

5 - Geistlich Fibro-Gide® is secured to the periosteum apically and the interproximal papillae with 5-0 chromic gut sutures.

6 - Passive closure of the flap achieved with 6-0 vicryl sutures.

7 - 1 week post-surgery reveals uneventful healing with maintenance of tissue volume.

8 - Buccal view at 8 weeks reveals uneventful healing with maintenance of tissue volume.

9 - Occlusal view at 8 weeks post-surgery.

1 - Large horizontal and vertical bone defect in region 5-12; deficit emerging from many years of wearing mucosa-supported dentures.

2 - 3-D design including 3-D model, grafting volume, Yxoss CBR® and implants.

3 - 3-D Design including 3-D model and Yxoss CBR®.

4 - Initial clinical situation before opening of the soft tissue.

5 - Presentation of bony situs with a full-thickness flap (ridge incision).

6 - Titanium scaffold filled with 100% Geistlich Bio-Oss® and placed onto bone defect. Fixation performed with 4 mini-screws in the buccal area.

7 - Soft tissue situation after 6 months of healing.

8 – Careful separation of Yxoss CBR® into two parts at predetermined breaking points (Easy Removal Design®). Pilot drill performed through built-in holes according to backward planning principle.

9 - 4 implants placed in positions 5, 7, 10 and 12 to support the prosthesis. Bleeding out of the bone shows a good vascularization.

10 - Panoramic X-ray 6 months after the augmentation. In the meantime, 4 additional implants have been placed in the lower jaw.

1 - Preoperative radiograph depicting the severe bony atrophy in the posterior mandible.

2 - Fixation of the pre-formed osteosynthesis plate with miniscrews.

3 - Augmentation with autologous bone harvested from the angular region of the mandible and mixed with Geistlich Bio-Oss®.

4 - The grafted site including the osteosynthesis plate is covered with Geistlich Bio-Gide® and the tensile collagen membrane is pinned down. Thus, the augmented site is accurately covered and stabilized.

5 - In order to obtain primary wound closure, a double-layered suturing technique is used by combining a horizontal internal mattress and a coronal single stitch technique.

6 - Implants are inserted 6 months after augmentation and the healing abutments are connected to the implants.

7 - Lateral view of the final prosthetic restoration 6 months after implant placement.

8 - Intraoral radiograph 15 months after augmentation procedure showing a stable bony situation.

1 - This case shows a shallow vestibule and almost no keratinized tissue on the lower crestal part. The horizontal incision has to be made within the keratinized tissue (see depicted line).

2 - Ensure the incision is within the keratinized tissue: an apically fixed split flap is used here. Remove the muscles, scar fibers and ligaments before application of Geistlich Mucograft®.

3 - Measure the defect carefully with a periodontal probe and cut Geistlich Mucograft® in a dry state. In the case of a large vestibuloplasty, several pieces of Geistlich Mucograft® can be sutured side by side.

4 - Geistlich Mucograft® is sutured directly onto the periosteum with 5.0 resorbable sutures and left exposed for open healing (healed by secondary intention).

5 - 10 days post-operative: favorable healing where granulation tissue and new soft tissues have formed.

6 - 1 month post-operative: excellent wound healing with complete integration and epithelialization of Geistlich Mucograft® as well as keratinization of the crestal aspect could be observed.

7 - 3 months post-operative: excellent esthetic outcome with full integration and epithelialization of Geistlich Mucograft® to the surrounding tissue and keratinization of the crestal aspect.

8 - 1 year post-operative: the formed keratinized tissue fulfills its functionality and shows an esthetically pleasing result matching the structure and color of the surrounding tissues. The mean width of the peri-implant keratinized mucosa was 4.0 mm, and a low shrinkage was assessed at 38%.

9 - 5 years post-operative: the mucogingival appearance remains stable. The resulting keratinized tissue fulfills its functionality and shows an esthetically pleasing result.

1 - Gingival recessions #23 and #22

3 - 10 week post op healing. Root coverage achieved. Patient reports no problems and is pleased with the results. More follow ups to come.

2 - Sites at the day of the procedure after sutures placed. Tunnel between #23,24 and partial thickness flap raised between #23,22.

Pre-operative view of recession defects that ranges from 2-5 mm. There is minimal keratinized tissue on #14. Pocket depths are within limits with no loss of interproximal tissue.

A 15c blade is used to make sulcular incisions with scooping incisions at the level of the CEJ. A combination flap consisting of full-thickness coronally followed by a partial-thickness dissection apically is reflected.

The papillary tissue is de-epithelialized with a football diamond bur on a rotary hand piece. This exposes a vascular bed for the graft and intended coronal positioning of the flap.

Side-view of the recession defects. It is clearly visible how deep the recession defects are.

Geistlich Mucograft® is trimmed and positioned to extend beyond the root surfaces. A combination of simple interrupted sutures at its coronal edge and mattress sutures extending over the entire graft are used to adapt the graft to the recipient site.

The flap is then advanced and coronally positioned with horizontal mattress sutures to release tension and simple interrupted sutures to approximate the flap edges to the de-epithelialized papillas.

Follow-up after 1 week: note that the flap margins appear stable. Erythema and edema evident with maturation of the tissue beginning.

Follow-up after 3 months: maturation of the tissue evident with complete root coverage. An increase in the zone of keratinized tissue by #14 is also visible.

Follow-up after 1 year: stability of the graft is evident, complete coverage and a healthy and maintainable gingival situation have been achieved.

1 - Baseline frontal view: missing central incisor.

2 - Baseline occlusal view: The facial contour is flattened by physiological dimensional ridge alterations post-extraction.

3 - Full-thickness flap using one releasing incision in the distal aspect of the canine. Simultaneous contour augmentation using GBR was performed with autogenous bone chips to cover the exposed implant combined with a layer of Geistlich Bio-Oss®and Geistlich Bio-Gide®.

4 - Application of Geistlich Fibro-Gide® on top of the augmented area. A tension-free primary wound closure was obtained by a periosteal releasing incision.

5 - Suture removal 14 days post-surgery. Uneventful wound healing and an increase in soft-tissue volume.

6 - Frontal view 4 weeks post-surgery.

7 - 2 months follow-up combined with abutment connection.

8 - Occlusal view of final restoration 2 years post-surgery.

9 - Final restoration 2 years post-surgery shows pleasing esthetics.

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