No. If Geistlich Bio-Oss® is autoclaved, moisture can collect in the particles due to the high porosity of the product, which can change the hydrophilic properties. Moreover, Geistlich Bio-Oss® is not approved for re-sterilization. Re-sterilization under any circumstances is not recommended.
Depending on the size of the defect, between 1.5 to 4 cc of Geistlich Bio-Oss® granules are needed, 3cc on average. This is equivalent to two 1.5cc Geistlich Bio-Oss Pen® with large granules or three 1cc Geistlich Bio-Oss Pen® with small granules.
A membrane should be used in conjunction with Geistlich Bio-Oss® as a barrier against the ingrowth of soft tissue1. Native collagen membranes such as Geistlich Bio-Gide® also promote wound healing and increase therapeutic safety in the event of a postoperative wound dehiscence2,3. Physicians should read the package insert prior to use.
References:
Gielkens PF, et al.: Clin Oral Implants Res 2008; 19: 516-21.
Tal H, et al.: Clin Oral Implants Res 2008; 19: 295-302.
Becker J, et al.: Clin Oral Implants Res 2009; 20(7): 742-49.
Fundamentally, the use of small particles is recommended for small defects (up to 2 dental alveoli) and for augmenting autogenous grafts. The large particles are recommended for large defects (> 2 dental alveoli, sinus lifts), however, preferences can vary from dentist to dentist.
Geistlich Bio-Gide® is a membrane with a unique bilayer structure. It combines optimal bone formation with complication–free wound healing and predictable outcomes. A significant number of scientific publications and proven long-term clinical success support the safety and efficacy of Geistlich Bio-Gide®.
Geistlich Bio-Oss Collagen® and Geistlich Bio-Gide® are made of collagen, therefore allergic and inflammatory tissue reactions cannot be excluded. However, this is extremely rare.
Geistlich Combi-Kit Collagen is packed in a double blister. After the outer blister has been opened sterility can no longer be guaranteed. The product Geistlich Combi-Kit Collagen is registered for one time use only. It is not recommended to use the products separately.
Geistlich Combi-Kit Collagen is recommended for the reconstruction of the alveolar ridge, extraction socket management and augmentation of bone dehiscences.
Geistlich Bio-Gide® Perio and Geistlich Bio-Oss® Collagen are made of collagen, therefore allergic and inflammatory tissue reactions cannot be excluded. However, this is extremely rare.
The collagen in Geistlich Bio-Oss® Collagen does not function as a membrane. In guided bone regeneration (GBR) procedures, a membrane is indicated to obtain optimal results.1
References:
Perelman-Karmon M, et al.: Int J Periodontics Restorative Dent 2013, 32(4): 459-65.
Perio-System Combi-Pack is packed in a double blister. After the outer blister has been opened, product sterility can no longer be guaranteed. The product Perio-System Combi-Pack is approved for single use only.
As Geistlich Bio-Gide® Perio adheres very well to the defect, it is normally not necessary to utilize fixation screws or pins. However, fixation is possible if required.
No. Autoclaving or hot-air sterilization irreversibly destroys the collagen structure. The physical properties of the membrane are changed and the consistency of the product becomes like parchment paper. In addition the product is not approved for re-sterilization and therefore may not be used.
The bilayer structure of Geistlich BioGide® Perio has a compact and porous surface. The compact layer of Geistlich Bio-Gide® Perio exhibits higher cell occlusiveness than the rough, porous layer, preventing the downgrowth of epithelial cells. If the membrane is applied with the porous surface placed toward the soft tissue, integration of the bone cells may take place more slowly. However, it is not necessary to remove the membrane.
Inflammation is a possible complication, which may occur with any surgery. However, the biocompatibility of Geistlich Bio-Gide® Perio has been verified in clinical studies and the incidence of complications is low.
The surface of Geistlich Bio-Gide® Perio has been made firmer when dry to facilitate periodontal applications. Second, the outer blister pack of Geistlich Bio-Gide® Perio includes four sterile water repellent templates. These can be placed repeatedly in the region of the defect to allow customization of the template before trimming the membrane to the precise shape.
After treatment with Geistlich Mucograft®, please follow the same postsurgical management that is usually applied with connective tissue grafts or free gingival grafts.
It depends on the indication: 1. Gain of Keratinized Tissue: Open healing is recommended when Geistlich Mucograft® is used to increase the width of keratinized tissue. The innovative design of Geistlich Mucograft® allows excellent healing in open healing situations1. 2. Recession Coverage: Geistlich Mucograft® should remain completely submerged under the flap to avoid premature resorption of the collagen.2-4 Direct blood supply is important.
References:
Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.
It depends on the indication: 1. Gain of keratinized tissue: Geistlich Mucograft® should be applied on a periosteal bed1,2 as direct blood supply is important. In open healing, the blood is supplied through the edges of the device from the surrounding tissue and from the periosteum. 2. Recession Coverage: Geistlich Mucograft® can be used partially or completely over bone.3-5 Blood is supplied through the edges of the device from the surrounding tissue and from the flap completely covering the matrix. References:
Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.
Lorenzo R, et al.: Clin Oral Impl Res 2012; 23(3): 316-24.
In the majority of the clinical cases reported and in all the studies performed with Geistlich Mucograft®, one matrix layer was used. Presently, clinical data is not available to prove that several layers of the device outperform a single layer of Geistlich Mucograft®.
The compact structure should face,away from underlying bone, with the spongeous structure facing the bone or soft-tissue wound bed. No clinical or comparative data is available regarding the performance of Geistlich Mucograft® when placed with the compact structure facing the bone or soft-tissue wound bed.
Published data shows different suturing techniques with Geistlich Mucograft®: non-resorbable1,2 and resorbable3, 0-51,2 and 0-64. There is no clinical evidence showing a benefit of one type of suture over another one when suturing Geistlich Mucograft®.
References:
Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.
Geistlich Mucograft® is ready to be applied directly to the defect and does not need treatment or hydration prior to application. Due to its excellent hydrophilicity, the matrix will hydrate quickly with the patient’s blood after placement in the defect.
Geistlich Mucograft® can be used as an alternative to both a free gingival graft or a connective tissue graft (CTG) for increasing keratinized tissue1-3. Geistlich Mucograft® is also an alternative to CTG for use in recession coverage procedures4-6.
References:
Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.
Lorenzo R, et al.: Clin. Oral Impl. Res 2012; 23(3): 316-24.
Nevins M, et al.: Int J Periodontics Restorative Dent 2011; 31(4): 367-73.
The collagen in Geistlich Mucograft® is methodically replaced by newly formed soft tissue. The matrix is rapidly vascularized and colonized by soft-tissue cells. This leads to a good integration of the matrix without any signs of foreign body reaction1,2.
References:
Rocchietta I, et al.: Int J Periodontics Restorative Dent 2012; 32(1): e34-40.
Ghanaati S, et al.: Biomed Mater 2011; 6(1): 015010.
Geistlich Mucograft® consists of porcine collagen and is specifically designed for soft-tissue regeneration. The matrix is comprised of a compact structure that provides stability while allowing open healing, paired with a spongy structure that supports blood clot stabilization and ingrowth of soft-tissue cells.
Geistlich Mucograft® is a unique 3D-collagen matrix designed specifically for soft-tissue regeneration as an alternative to autogenous soft-tissue grafts.
Geistlich Mucograft® Seal should be sutured using non-resorbable sutures, not glued1. The close adaptation of the device to tissue borders can be accomplished by single interrupted sutures, double interrupted sutures, cross sutures, or sling sutures1. The finest possible suture material comfortably used by the surgeon should be selected: for single interrupted sutures, the 6.0 or 5.0 suture size is recommended; for cross-suturing, a 5.0 suture size is appropriate1.
References:
Geistlich Mucograft Seal Advisory Board Meeting Report, 2013. Data on file Geistlich Pharma AG, Wolhusen, Switzerland.
The compact structure should face outward, away from underlying bone, with the spongeous structure facing the bone or soft-tissue wound bed. Geistlich Mucograft® Seal spongeous structure is striped for easier differentiation of the two sides. The striped spongeous structure should face the bone.
Geistlich Mucograft® Seal is ready to be applied to seal the socket and does not need pretreatment or moisture before application. Due to its excellent hydrophilicity, the matrix will hydrate quickly after implantation in the defect by soaking rapidly the patient’s blood.
The collagen of Geistlich Mucograft® will be replaced by newly formed soft tissue. The matrix is rapidly vascularised and colonised by soft-tissue cells1,2. This leads to a good integration of the matrix without any signs of foreign body reaction3,4.
References:
Rocchietta I, et al.: Int J Periodontics Restorative Dent 2012; 32(1): e34-40.
Ghanaati S, et al.: Biomed Mater 2011 Feb; 6(1): 015010.
Nevins M, et al.: Int J Periodontics Restorative Dent 2011; 31(4): 367-73.
Camelo M, et al.: Int J Periodontics Restorative Dent 2012; 32(2): 167-73.
Geistlich Mucograft® Seal consists of porcine collagen and is specifically designed for soft-tissue regeneration. The matrix is built up of a compact structure that gives stability while allowing open healing, and a spongy structure that supports blood clot stabilisation and ingrowth of soft-tissue cells.
Geistlich Mucograft® Seal needs the support of Geistlich Bio-Oss® Collagen underneath for a good ridge preservation of the soft and the hard tissues. After 8 weeks, the soft tissues are healed but the mixture of the blood clot, Geistlich Bio-Oss® Collagen and the newly forming bone is still soft. Nevertheless the implant can be drilled carefully into the socket and the remaining Geistlich Bio-Oss® Collagen will favour the volume preservation of the ridge.
The resorption time of every biomaterial including Geistlich Mucograft® Seal depends on multiple factors: defect size, metabolism and general health of the patient, etc. On the other hand, to determine an average resorption time of Geistlich Mucograft® Seal in humans, biopsies would be needed of the healing soft tissues after tooth extraction at different time points. This procedure is obviously not ethical and thus the average resorption time cannot be measured. However, single histologies indicate that after 8 weeks Geistlich Mucograft® is completely integrated into the newly formed soft tissue.
Geistlich Mucograft® Seal is specifically designed for soft-tissue regeneration1. The collagen of Geistlich Mucograft® is specially processed to favour immediate blood clot stabilisation. This leads to early vascularisation1,3, facilitates soft-tissue cell ingrowth2 and excellent integration of the 3D-matrix with surrounding tissues2,3. In contrast to other collagen products in the market, Geistlich Mucograft® and Geistlich Mucograft® Seal are well scientifically documented and their clinical benefits are proven.
References:
Biocompatibility according to ISO 10993-12001. Data on file Geistlich PharmaAG, Wolhusen, Switzerland.
Ghanaati S, et al.: Biomed Mater 2011; 6(1): 015010.
Roccietta I, et al.: Int J Periodontics Restorative Dent 2012; 32(1): e34-40.