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Bone Substitutes
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- Geistlich Fibro-Gide®
- Geistlich Mucograft®
Bone Harvesting
- Geistlich Safescraper
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3D Titanium Scaffold
- Yxoss CBR®
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- Meisinger® Fixation System
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- GEM 21S^®
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Treatment Solutions
- 2-Stage Implant Placement(37)
- Gain of Keratinized Tissue(14)
- GBR Procedure(37)
- Peri-Implantitis Therapy(7)
- Recession Coverage(20)
- Ridge Preservation(34)
- Sinus Floor Elevation(10)
- Soft Tissue Thickening(48)
- Surgical Periodontal Treatment(49)
Products
- Geistlich Bio-Gide®(67)
- Geistlich Bio-Gide® Compressed(2)
- Geistlich Bio-Gide® Forte(5)
- Geistlich Bio-Gide® Shape(1)
- Geistlich Bio-Oss Collagen®(31)
- Geistlich Bio-Oss Pen®(1)
- Geistlich Bio-Oss®(78)
- Geistlich Fibro-Gide®(43)
- Geistlich Mucograft®(27)
- Geistlich Mucograft® Seal(4)
- Geistlich Panorama®(1)
- GEM 21S®(26)
- Micross(1)
- RPM™(2)
- Safescraper Twist(4)
- vallomix™(1)
- vallos®(22)
- vallos®f(11)
- Yxoss CBR®(17)

Found 170 Results

1 - Baseline: recession defect Miller Class I on tooth #11.

2 - Trapezoidal flap design: split-full-split flap elevation flap.

3 - Positioning of Geistlich Fibro-Gide® and fixation with single sutures (PGA 7.0 Sutures) at the base of the de-epithelialized anatomic papillae and in the apical mesial and distal angles.

4 - Tension-free wound closure with two sling sutures (PGA 6.0 Sutures).

5 - Suture removal 14 days post-surgery.

6 - Buccal view 3 months post-surgery.

7 - Buccal view 6 months post-surgery.

8 - Follow-up after 1 year: complete root coverage with Geistlich Fibro-Gide® is achieved.

9 - 3 year post-surgery: stable results with Geistlich Fibro-Gide®.

1 - Pre-operative view. A small band of keratinized gingiva is present

2 - The band of keratinized gingiva is split and a split-thickness flap is elevated exposing connective tissue and periosteum.

3 - Geistlich Mucograft®is sutured to the recipient bed and left exposed.

4 - Follow-up after 1 week: the area appears to granulate underneath the fibrin clot.

5 - Follow-up after 4 weeks: excellent wound healing.

6 - Follow-up situation after 2 months.

7 - Follow-up after 3 months.

8 - Follow-up after 6 months: Lugol’s iodine staining indicates delineating keratinized tissue.

9 - Follow-up after 6 months: mucogingival appearance with 4 mm of keratinized tissue.

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.

Pre‑operative occlusal photograph of the maxillary arch showing a pronounced Seibert Class III ridge deformity, with simultaneous horizontal and vertical soft and hard tissue loss in the edentulous area.

Intraoperative view following reflection of full‑thickness flaps, revealing a pronounced combined horizontal and vertical ridge deficiency.

Upper left view showing the mixture of large-particle vallos® allograft, demineralized cortical granules, and large-particle Geistlich Bio-Oss® xenograft, combined with rhPDGF-BB, a component of GEM 21S®.

Upper right view showing the mixture of large-particle vallos® allograft, demineralized cortical granules, and large-particle Geistlich Bio-Oss® xenograft, combined with rhPDGF-BB, a component of GEM21S®.

Closure of the maxilla was achieved using a PTFE barrier membrane and 4‑0 PTFE sutures. Horizontal mattress sutures were placed to provide initial tension relief and flap stabilization, while simple interrupted sutures were used for precise approximation of the wound margins.

Six‑month postoperative CBCT images with virtual implant planning reveal sites #5, 7, 10, and 12, exhibiting 5–7 mm of horizontal ridge augmentation and 3–4 mm of vertical ridge augmentation.

Intraoperative view demonstrating vertical and horizontal ridge augmentation at 7 months following the initial augmentation procedure.

A 4.3 × 8 mm tapered implant with crestal sinus elevation was placed at site #5, and a 4.3 × 10 mm tapered implant was placed at site #7.

(Left) A 4.3 × 10 mm implant was inserted at the site. (Right) Placement of a 4.3 × 10 mm implant in conjunction with a crestal sinus elevation.

1 - Pre-operative photograph showing the horizontal bone defect at sites #18 and #19

2 - Cone-Beam Computed Tomography (CBCT) showing the horizontal and vertical bone defects at sites #18 and #19

3 - Full-thickness flap reflection and buccal flap release to achieve tension-free primary closure

4 - Harvested autograft and vallos™ fibers hydrated with platelet-rich plasma and placed in the Yxoss CBR®mesh

5 - The titanium mesh was covered with a Geistlich Bio-Gide® Compressed membrane and platelet-rich fibrin (PRF) membranes

6 - week post-operative healing of surgical site shows increase in tissue width and no membrane exposure

Preoperative view showing the anterior maxillary defect with loss of #6 and #7; #5 and #8 are planned to be extracted because of severe mobility and advanced bone loss.

Full-thickness mucoperiosteal flap elevation revealing a vertically and horizontally deficient ridge in the #5–8 region, prepared for augmentation.

Adaptation and fixation of two allogenic cortical bone plates to the native ridge using micro screws to create a “box” configuration for vertical bone augmentation. The box between and around the plates is packed with vallos® mineralized cortico-cancellous granules mixed with rhPDGF-BB component of GEM 21S®, completing the three-dimensional reconstruction of the defect.

Immediate closure with PTFE sutures providing tension-free primary closure over the augmented site.

Site at five months post-op.

Re-entry after healing demonstrating well integrated cortical plates and a vertically augmented ridge suitable for implant placement.

Occlusal view showing well integrated particulate bone at relatively early stage.

Placement of two implants into the regenerat ed ridge, with a regular diameter implant anteriorly and a wide diameter implant posteriorly.

Geistlich Mucograft® is layed on top of the implants before flap closure to improve the tissue phenotype.

Flap closure

Occlusal view after the second stage for implant uncovery with Geistlich Fibro-Gide® left between the flap intentionally slightly exposed. Due to volume stability of Geistlich Fibro-Gide®, it aids in maintaining tissue verticality during healing.

Occlusal view after 2 weeks of the second stage showing excellent healing of Geistlich Fibro-Gide® with secondary intention with traces of keratinzed tissue forming between wound edges. Both healing abutments were replaced with bigger sizes to aid with tissue contouring before final restoration.

1 - The preoperative radiograph displays the vertical bone defect in the left mandible and thus, insufficient vertical bone volume to allow implant placement.

2 - Yxoss CBR® is planned based on the preoperative CBCT data.

3 - Opening the defect site using the ridge incision technique. The titanium scaffold fits the bone defect precisely during the augmentation procedure.

4 - The titanium scaffold is filled with 50% autologous bone and 50% Geistlich Bio-Oss®. Fixation is performed with one titanium screw in vestibulolingual direction.

5 - A collagen membrane (Geistlich Bio-Gide®) is used to provide an additional barrier for bone regeneration.

6 - Stable soft tissue situation after 6 months with no complications during the healing period. After reopening, bone is regenerated to the contour defined by the titanium scaffold.

7 - The bone is completely regenerated in the correct three-dimensional orientation. This is also visible in the respective CBCT. Implant placement is now possible.

8 - Two implants were placed with good primary stability. The vertical bone regeneration is also visible in the CBCT data.

9 - Postoperative panoramic radiograph after implant placement.

10 - Clinical situation 3 months post implant insertion.

11 - Final prosthetic reconstruction 6 months post implant insertion and 16 months post regenerative surgery.

12 - Final prosthetic reconstruction 16 months post regenerative surgery.

1 - Radiographic image showing the vertical bone deficit in the left mandible.

2 - Clinical situation before opening the area.

3 - Incision for the creation of a poncho flap.

4 - Starting in the retromolar area the incision is directed toward the distal region of tooth 23.

5 - Cortical bone is removed with the trephine, crushed and mixed with Geistlich Bio-Oss® (50:50).

6 - Successive application of Geistlich Bio-Gide®.

7 - Dehiscence after 1.5 months. The soft tissue was de-epithelialized and a free gingival graft was sutured to protect the exposition. Dehiscence may occur but usually heals spontaneously after appropriate cleaning.

8 - After 6 months, the ridge incision is applied to access the 3-D titanium scaffold.

9 - Buccal view of the regenerated bone. Even though there was dehiscence, the bone was regenerated satisfactorily.

10 - Four implants are inserted and the soft tissue is healed showing the contour provided by the good adaptation of the provisional prosthesis.

11 - Clinical situation after the final prosthesis and the soft tissue frenum removal.

12 - Radiographic situation.

Muhammad Saleh, BDS, MSD, PhD (Periodontist)
Karim Ghishan, BDS, MS (Periodontist)

Vertical Ridge Augmentation in the Anterior Maxilla

Preview

Six-week healing at the site of tooth 7* following implant removal.

Site condition prior to vertical ridge augmentation. The 8 mm defect (from bony peaks) indicates the need for vertical augmentation.

Ridge augmentation was performed using vallos® mineralized cortical-cancellous granules and RPM Reinforced PTFE Mesh to support bone regeneration.

Adaptation and stabilization of Geistlich Bio-Gide® Forte over the augmented site.

Five-month follow-up evaluation. Favorable hard- and soft-tissue healing is observed at the regenerated site.

Five-month radiographic evaluation of the regenerated site. Restored ridge volume is evident, supporting readiness for implant placement.

1 - Pre-operative assessment demonstrating significant bone loss, prior to vertical ridge augmentation.

2 - Labial view of the posterior mandibular defect site. Cortical bone was perforated to increase the blood supply.

3 - RPM™ was secured on the lingual side prior to applying a 1:1 mixture of autogenous bone and Geistlich Bio-Oss®.

4 - RPM™ was secured over the bone graft with titanium pins and screws.

5 - Geistlich Bio-Gide® is placed on top of RPM™ to prevent early soft tissue ingrowth while allowing for graft vascularization.

6 - Labial view of the soft tissue 9 months after the vertical bone augmentation.

7 - RPM™ exposed at 9 months, following flap elevation.

8 - Labial view of the regenerated surgical site at 9 months demonstrates well vascularized bone.

9 - Occlusal view of the regenerated surgical site at 9 months demonstrates well vascularized bone.

10 - Implant placement in the newly regenerated bone.

Geistlich Fibro-Gide® (15x20x6mm) was placed on top of two implants, to increase soft tissue thickness.

12 - Periapical x-ray 1 year post-operatively, demonstrates implant stability and mature bone formation following vertical bone augmentation and soft tissue thickening.

1 - Baseline: recession defects on teeth #19 to #22 in the lower left quadrant. Exposed root surfaces of these teeth were thoroughly scaled and root planed before surgery.

2 - A full thickness muco-gingival tunnel was prepared through a minimally-invasive vestibular access incision apical to the teeth with gingival recessions.

3 - Geistlich Fibro-Gide® was cut into small pieces in a dry state using a scalpel.

4 - Insertion of Geistlich Fibro-Gide® into the subperiosteal tunnel.

5 - Geistlich Fibro-Gide® in situ: the gingival margin had been coronally advanced and stabilized after pieces of Geistlich Fibro-Gide® were placed.

6 - 1 week post-surgery: anchoring sutures were left in place for 1-2 weeks.

7 - 2 weeks post-surgery: anchoring sutures in place.

8 - 2 weeks post-surgery: removal of anchoring sutures.

9 - 7 months post-surgery: complete recession coverage.

Page 14 of 15

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