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Treatment Solutions
- 2-Stage Implant Placement(36)
- Gain of Keratinized Tissue(14)
- GBR Procedure(37)
- Peri-Implantitis Therapy(7)
- Recession Coverage(19)
- Ridge Preservation(33)
- Sinus Floor Elevation(9)
- Soft Tissue Thickening(47)
- Surgical Periodontal Treatment(47)
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- Geistlich Bio-Gide®(66)
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- Geistlich Bio-Oss Pen®(1)
- Geistlich Bio-Oss®(76)
- Geistlich Fibro-Gide®(42)
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- Geistlich Mucograft® Seal(4)
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- GEM 21S®(24)
- Micross(1)
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- Safescraper Twist(4)
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- vallos®(20)
- vallos®f(10)
- Yxoss CBR®(17)

Found 166 Results

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.

Primary wound closure.

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.

1 - The basis for planning implant therapy is clinical and radiological diagnosis with a CBCT scan.

2 - A precise 3-D planning model will be created based on CBCT data. Adaptations of the exact shape are possible, depending on the surgeon’s preference and feedback.

3 - The usual oral surgery and implantology hygiene provisions apply for the use of Yxoss CBR® intraoperatively. The same applies to patient medication.

4 - The opening incision should be designed in accordance with the extent, location and with respect to the anatomical structures of the region to be augmented.

5 - Subsequent steps are the preparation of a mucoperiosteal flap, debridement of scar tissue and the exposure of the defect. Sufficient blood supply of the flap is favored by a flap with a wide base.

6 - Autologous bone can be harvested from the usual intraoral donor sites and can be mixed with bone substitutes (e.g. Geistlich Bio-Oss®).

7 - The Yxoss CBR® is initially filled with autologous bone and bone substitute material (e.g. Geistlich Bio-Oss®).

8 - Yxoss CBR® is fixed on the existing residual bone with an osteosynthesis screw. The titanium screw can generally be introduced, depending on the intended position, through any opening of the titanium grid. The edges of Yxoss CBR® rest on the underlying bone tissue.

9 - A resorbable membrane (e.g. Geistlich Bio-Gide®) should be placed over the Yxoss CBR® to prevent ingrowth of soft-tissue and to support soft-tissue regeneration over the titanium frame.

10 - The wound should be closed completely whenever possible. The mucoperiosteal flap is positioned tightly but tension-free over Yxoss CBR® with single interrupted and deep mattress sutures. Pressure on the augmented crest has to be avoided. Dentures are not to be applied.

11 - Before reopening, clinical and radiological diagnosis are to be taken into consideration.

12 - Reopening of the augmented site approx. 4 to 6 months post surgery and depend on the defect geometry, at latest 9 months after initial surgery.

13 - After removing the fixation screws, Yxoss CBR® can be easily removed using preset breaking points

14 - Newly formed vital bone is regenerated up to the contour defined by the shape of the Yxoss CBR®.

15 - Insertion of implants into the augmented alveolar ridge according to the prosthetic position.

16 - Prosthetic restoration is carried out in accordance with the usual precautions.

17 - Follow-up and radiological evaluation should be performed according to the standardized recommendations of the respective dental societies.

18 - Clinical and radiological imaging of long-term outcome in this case at 5-year follow-up.

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.

Page 12 of 14

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