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Treatment Solutions
- 2-Stage Implant Placement(7)
- Gain of Keratinized Tissue(3)
- GBR Procedure(9)
- Peri-Implantitis Therapy(3)
- Ridge Preservation(6)
- Sinus Floor Elevation(1)
- Soft Tissue Thickening(13)
- Surgical Periodontal Treatment(7)
Products
- 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®(8)
- GEM 21S®(1)
- Micross(1)
- Safescraper Twist(3)
- vallomix™(1)
- vallos®(4)
- vallos®f(1)
- Yxoss CBR®(4)

Found 33 Results

Matteo Chiapasco, D.D.S., M.D.
Grazia Tommasato, D.D.S., M.S.C.

3D Bone Augmentation Using Customized Titanium Mesh in Conjunction with Autogenous Bone and Bovine Bone Material Granules

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Panoramic radiograph of initial situation showing the atrophic mandibular areas.

The final Yxoss CBR® ready for use.

The customized Ti-mesh is filled with the autologous bone chips mixed with Geistlich Bio-Oss® granules in a 50:50 ratio.

Intra-operative view at the end of the reconstruction showing the bone augmentation: the customized mesh was stabilized with 2 fixation screws.

A Geistlich Bio-Gide® membrane is used to cover the customized mesh in order to increase the barrier effect.

Intra-operative view after primary closure of the surgical wound.

Panoramic radiograph after surgery.

Clinical control 3 months later showing favorable healing of the soft tissue and correction of the defect.

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.

Hanae Saito, DDS, MS, CCRC
Andrew Tong, DDS

Alveolar Ridge Preservation with vallos® Mineralized Cortico-Cancellous Allograft

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Preoperative radiograph of #31 with guarded prognosis due to potential root fracture and infection.

Atraumatic extraction was performed and intact furcation bone is noted.

vallos® mineralized cortico-cancellous bone allograft was placed.

A collagen plug was used to cover the bone allograft

Immediate post alveolar ridge preservation radiograph.

Healing at 2 weeks prior to implant placement.

Healing at 4 months prior to implant placement.

Implant was placed with 32 Ncm. Post implant placement radiograph.

6 months after the implant placement, the final restoration was delivered.

6 months following horizontal ridge augmentation, using Dr. Urban’s sausage technique, we re-entered the site for implant placement using a full thickness flap with no vertical incisions, to not disrupt collateral blood supply. There is excellent bone volume, but a very thin vertical soft tissue volume over the crest of the implant site.

Straumann implants are placed in sites #4 and #5 to a 25Ncm torque value with no issues and the cover screws were placed.

Geistlich Fibro-Gide® is placed crestally over the implants and draped to the buccal and slightly towards the lingual. Geistlich Fibro-Gide® was trimmed slightly to minimize the thickness of the material.

The flap was released so that we can achieve tension-free primary closure over the implant and the Geistlich Fibro-Gide® soft tissue augmentation site.

Following an 8 week healing period, we make a crestal incision and lay a conservative full-thickness flap to uncover the implants. We observe a 3-4 mm increase in verticle soft tissue thickness over the implant site.

We allow 3 weeks following the initial uncovering and can now see beautiful soft tissue architecture surrounding the implants.

Prior to the restorative process we see the pre-restorative radiograph with the healing abutments in place and we can also observe excellent crestal bone levels around the implants.

1 year follow-up. The restorative dentist opted to splint the crowns together. The patient did not want implants posterior to this area and he did not want any sinus augmentation as he had a history of sinus issues.

The patient presented to the clinic with a discolored tooth #8, with mobility and a history of trauma. The tooth has a horizontal fracture in the apical third of the root and has recurrent infection after the root canal treatment.

The tooth has had root canal treatment, has a horizontal root fracture in the apical third and exhibits with a periapical lesion.

The tooth is carefully extracted and the socket is left to heal through unassisted healing.

After 6 weeks a full thickness flap is elevated with a distal releasing vertical incision. A bone level implant is placed according to the prosthetic plan through a surgical guide. Notice the buccal dehiscence.

Geistlich Bio-Oss Collagen® is trimmed to an “L-Shape” and is placed on the buccal-occlusal side of the implant. Additional Geistlich Bio-Oss® granules are placed around the remaining gaps.

To stabilize the grafted area the bone augmentation is covered with Geistlich Bio-Gide®, which is fixated apically with two resorbable pins.

The flap is sutured with horizontal mattress and single interrupted sutures and primary closure is achieved.

Four months after implant placement, a limited access “U”-flap was created and an implant impression was taken. The tissue was rolled to the buccal side and the abutment connection was performed.

The definitive layered zirconia crown was fabricated and placed. The clinical situation 5 months after implant placement, shows harmonious soft tissue and a well-integrated implant crown. The patient is satisfied with the esthetic result.

The periapical radiograph taken at the one-year follow-up shows stable marginal bone levels.

Waldemar D. Polido, DDS, MMS, PhD
Wel-Shao Lin, DDS, FACP, PhD, MBA

Bone Grafting and Immediate Implant Placement in the Maxillary First Molar Region

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Pre-operative occlusal view showing the involved tooth’s condition.

Pre-operative periapical radiograph capturing the cross-section of the involved tooth.

Comprehensive Digital Planning for Implant Placement – A multi-view CBCT and 3D reconstruction showcasing precise anatomical assessment and guided surgical approach.

Geistlich Bio-Oss Collagen® placement, demonstrating the material packed around the implant within the socket.

Immediate provisional crown, occlusal view showcasing restoration alignment technique.

Immediate crown periapical view, reflecting the initial stability of the implant and prosthesis.

Final crown occlusal view, illustrating the restoration’s integration and final crown periapical view, emphasizing implant stability post-restoration.

Occlusal view at the 3-year post-implant placement, highlighting tissue health and crown durability. Periapical CBCT view at the 3-year post-implant placement, providing insight into bone stability over time.

Dr. Alberto Ortiz-Vigón
Dr. Erik Regidor Correa

Clinical Efficacy of Geistlich Mucograft® in Regeneration of Oral Mucosa Combined with the Surgical Treatment of Peri-implantitis in Implants with Lack of Keratinized Tissue

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Pathological peri-implant pocket depth combined with bleeding on probing.

Partial thickness flap in order to create a periosteal bed free of any muscle attachment and apically positioned.

Implantoplasty of the exposed rough implant surface using burs and silicon carbide polishers.

Xenogeneic collagen matrix structure (Geistlich Mucograft®).

Future position of the xenogeneic collagen matrix facilitated by prosthodontic abutment.

Suture of xenogeneic collagen matrix around the abutment and over the recipient bed.

Buccal view of xenogeneic collagen matrix and apically positioned flap.

Occlusal view of xenogeneic collagen matrix and apically positioned flap.

Lateral view of xenogeneic collagen matrix and apically positioned flap.

Peri-implant tissue health and maintenance of keratinized tissue after one year of surgical treatment.

Periimplant tissue health and maintenance of keratinized tissue after 2 years

Dr. Gian Maria Ragucci
Prof. Federico Hernández-Alfaro

Combined Horizontal and Vertical Regeneration Using a CAD-CAM Titanium Scaffold

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Panoramic radiographic view of the defect

Horizontal and vertical augmentation step by step

Baseline situation (left) and 9-month follow-up (right)

Scaffold removal and implant placement step by step

Soft-tissue management with free gingival graft

Final restoration

Periapical radiographs of implants and prosthesis

Final restoration at 16 months

A mid-facial incision was made, with the intent to preserve the minimal keratinized tissue that was available, as well as vertical incisions along the line angles of the canines to reflect a partial thickness flap.

Platelet-rich fibrin clots were formed by centrifugation. The leukocyte-PRF (L-PRF) was extracted, and the L-PRF was used to hydrate Geistlich Mucograft®

Geistlich Mucograft® and PRF stabilized via glycolon sutures.

Clinical situation at three-week follow-up.

Occlusal view at twelve-month follow-up.

Frontal view at twelve-month follow-up.

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.

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.

Initial clinical and radiographic presentation showing vertical bone loss #9-10 area

Initial CBCT presentation showing bone loss between #9-10 wrapping palatally

Occlusal clinical views showing sulcular incision with paracrestal incision #9-10

Facial and occlusal clinical views showing full thickness flap reflection with wide 1-2 bony wall defect measuring ~7mm vertical bone loss

Facial clinical views showing full thickness flap reflection and GTR procedure using Geistlich vallomix™ bone graft (allograft as an internal first layer and xenograft as an outside second layer) and collagen membrane

Facial and occlusal clinical views showing primary closure using 6-0 prolene sutures with immediate post-surgical bone addition

Facial and occlusal clinical views showing healing at 10 days with tissue granulating in

Facial and occlusal clinical views showing healing at 6 weeks

Pre-operative vs post-surgical clinical and radiographic views showing adequate bone fill and reduction in probing depths

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