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

Bone Substitutes
Membranes
- Geistlich Bio-Gide^®
- RPM™
Matrices
- Geistlich Fibro-Gide^®
- Geistlich Mucograft^®
Bone Harvesting
- Instruments
3D Titanium Scaffold
- Yxoss CBR^®
Membrane Fixation
- MC Bio Supertack
Growth Factors
- GEM 21S^®
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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(27)
- Major Bone Augmentation(35)
- Minor Bone Augmentation(21)
- Peri-Implantitis(5)
- Periodontal Regeneration(9)
- Sinus-Floor Elevation(5)
- Soft-Tissue Regeneration(56)
Products
- Geistlich Bio-Gide Compressed®(2)
- Geistlich Bio-Gide®(26)
- Geistlich Bio-Oss Collagen®(4)
- Geistlich Bio-Oss Pen®(1)
- Geistlich Bio-Oss®(32)
- Geistlich Fibro-Gide®(3)
- Geistlich Mucograft®(5)
- RPM™(1)
- Safescraper Twist(3)
- vallomix™(1)
- vallos®(2)
- Yxoss CBR®(13)

Found 35 Results

Dr. Gian Maria Ragucci
Prof. Federico Hernández-Alfaro

BIOBRIEF, Download, Video

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

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Preview

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

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 - 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 - 3D reconstruction from CBCT images showing horizontal maxillary atrophy at the two-teeth gap.

2 - Intraoperative view of the atrophied anterior maxillary site. Tenting screws are placed to support the collagen membrane.

3 - Application of a mixture (1:1) of autologous bone chips from the retromolar area and Geistlich Bio-Oss®.

4 - Coverage with a double layer of collagen membrane Geistlich Bio-Gide®.

5 - Tension-free, primary wound closure by mattress and single interrupted sutures.

6 - Situation at re-opening after 6 months showing vital bone and reconstructed ridge contour.

7 - Guided implant placement in regenerated bone with stent (additional implant placement at position 22).

8 - Final prosthetic restoration.

Pre-operative situation showing the horizontal ridge deficiency (left). Buccal bone concavity evident after full thickness flap elevation (middle). There is insufficient bone to place implants in an ideal restorative position (right).

It is important to locate the mental foramen. Intramarrow penetrations were done to allow for improved blood supply to the bone graft.

The clinical cocktail used for guided bone regeneration: 1) 50/50 mixture of autogenous bone chips, collected with Geistlich SafeScraper TWIST, and Geistlich Bio-Oss®, and 2) Geistlich Bio-Gide® Compressed 20 x 30 mm and 13 x 25 mm.

“Sticky bone”, created by combining PRF with the bone graft, adapted well to the site of the defect. Periosteal biting sutures were used for stabilization of the multiple layers of Geistlich Bio-Gide® Compressed and underlying bone graft.

Geistlich Bio-Gide® Compressed was carefully trimmed to be mindful of the mental nerve.

Tension-free primary closure achieved with horizontal mattress sutures and simple interrupted sutures.

Re-entry and CBCT scan at 8 months showing a significant increase in horizonal bone dimension.

Sufficient regenerated bone to allow for implant therapy (left). Implants #19 and #20 placed. Vital bone from guided bone regeneration as evidenced by the bleeding bone (middle). Tension-free primary closure achieved using 5-0 glycolon sutures.

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