Geistlich Fibro-Gide®

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Geistlich Fibro-Gide®

THE Alternative Soft Tissue Graft

3 year data comparing implant sites augmented with volume-stable collagen matrix

Take a closer look at our one-of-a-kind soft tissue treatment innovation and join in the celebration by submitting and viewing clinical cases...

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Clinical Cases

Immediate Implant Placement: Soft-Tissue Thickening
Single Stage Immediate Implant Placement and Soft-Tissue Thickening Dr. Jeffrey Ganeles Ft. Lauderdale, FL, USA
Single Stage Immediate Implant Placement and Soft-Tissue Thickening Dr. Jeffrey Ganeles Ft. Lauderdale, FL, USA
1 - Initial clinical situation, tooth #8 and #9 require extraction.
2 - Clinical view post extraction of tooth #8 and #9.
3 - Evaluation of the buccal soft-tissue thickness.
4 - Trimming of Geistlich Fibro-Gide® to fit in the gap between the buccal soft-tissue and the buccal bone wall.
5 - Geistlich Fibro-Gide® in place: an immediate volume increase of the buccal soft-tissues are visible.
6 - Mixing of autologous bone and Geistlich Bio-Oss® particles for placement in the gaps around the implants.
7 - Immediate implant placement with the bone mixture applied was performed.
8 - Provisional restoration at time of surgery (occlusal view).
9 - Provisional restoration at time of surgery (frontal view).
Immediate Implant Placement and Soft-Tissue Thickening in a Split-Mouth Approach Dr. Waldemar Polido Indianapolis, IN, USA
Immediate Implant Placement and Soft-Tissue Thickening in a Split-Mouth Approach Dr. Waldemar Polido Indianapolis, IN, USA
1 - Implant placement planned for site #3 and #5 with soft-tissue treatment utilizing a CTG and for sites #10, #12 and #13 with soft-tissue augmentation using Geistlich Fibro-Gide®.
2 - Uncovering of site #10 shows a narrow ridge width and an insufficient amount of soft-tissue thickness.
3 - Tooth #10 was extracted and immediately replaced by an implant.
4 - Fill the gap procedure with Geistlich Bio-Oss Collagen® to achieve contour augmentation and preserve horizontal ridge dimensions.
5 - Geistlich Fibro-Gide® was trimmed to half of the thickness to fit the defect and placed into sites #10, 11, 12 and 13.
6 - The entire site was closed tension-free to facilitate uneventful wound healing.
7 - The 3 month follow-up shows uneventful soft-tissue healing and an increase of soft-tissue thickness at the desired sites.
8 - The 6 month follow-up with the final reconstruction shows that the soft-tissue thickness at the desired site is maintained over time. This contributes to an esthetic and pleasing outcome. (Restorative work by Dr. Chao-Chieh Yang, IUSD)
9 - The 2 month follow-up showing a comparison of the treated sites, one with CTG (left) and one with Geistlich Fibro-Gide® (right) in the same patient. Comparable results have been achieved with both treatments, but without the need for a donor site.
Implant Placement & Simultaneous Soft Tissue Graft Using Geistlich Fibro-Gide® Dr. Hawra AlQallaf Indianapolis, INIndiana University School of Dentistry
Acknowledgments to Dr. Waldemar D. Polido
Implant Placement & Simultaneous Soft Tissue Graft Using Geistlich Fibro-Gide® Dr. Hawra AlQallaf Indianapolis, INIndiana University School of Dentistry
Acknowledgments to Dr. Waldemar D. Polido
1 - Initial Clinical Situation, Occlusal/Buccal Shots of Missing teeth #12 and 13.
2 - Intra-Operative, Implant Placement of #12 and 13.
3 - Intra-Operative, Placement of Geistlich Fibro-Gide® in the Buccal Concavity of #12 and 13.
4 - Immediate Post-Operative Buccal Soft Tissue Thickness.
5 - Two Months Post-Operative Healing with Provisional Restorations.
After Implant Placement: Soft-Tissue Thickening
Esthetic Soft-Tissue Augmentation of Two Implant Sites in the Same Patient Dr. Alan Fetner, DMD Jacksonville, FL, USA
Esthetic Soft-Tissue Augmentation of Two Implant Sites in the Same Patient Dr. Alan Fetner, DMD Jacksonville, FL, USA
1 - Thin mucosal tissue over implant #7 creating an unesthetic appearance.
2 - Occlusal view of #7 reveals buccal soft-tissue defects.
3 - Augmentation of the soft-tissue on two implant sites, #7 and #10, using a conventional full thickness flap with vertical releasing incisions on site #7 and an envelope flap on site #10.
4 - Geistlich Fibro-Gide® is split into two 3mm thick matrices to be used in both sites, hydrated with sterile saline and trimmed to the defect dimensions.
5 - Geistlich Fibro-Gide® is secured to the periosteum apically and the interproximal papillae with 5-0 chromic gut sutures.
6 - Passive closure of the flap achieved with 6-0 vicryl sutures.
7 - 1 week post-surgery reveals uneventful healing with maintenance of tissue volume.
8 - Buccal view at 8 weeks reveals uneventful healing with maintenance of tissue volume.
9 - Occlusal view at 8 weeks post-surgery.
Thickening Soft-Tissue When Uncovering an Implant in the Anterior Maxilla Prof. Leonardo Trombelli Ferrara, Italy
Thickening Soft-Tissue When Uncovering an Implant in the Anterior Maxilla Prof. Leonardo Trombelli Ferrara, Italy
1 - Baseline buccal view: immediate implant placement was performed 3 months prior to replacing tooth #8.
2 - Baseline occlusal view: soft-tissue deficiency on the buccal aspect.
3 - Placement of Geistlich Fibro-Gide® with minimal envelope flap and inserting a temporary crown.
4 - Stabilization of Geistlich Fibro-Gide® to the buccal mucosa using internal mattress sutures.
5 - 2 week follow-up at suture removal.
6 - 4 week post-surgery: uneventful wound healing and an increase in soft-tissue volume.
7 - Occlusal view 11 months post-surgery: there is a clear substantial increase in the soft-tissue thickness.
8 - Buccal view 11 months post-surgery: a substantial increase in soft-tissue thickness is evident.
9 - Buccal view 2 years post-surgery.
Insufficient Soft-Tissue Thickness in a Single Tooth Gap in the Anterior Maxilla PD Dr. Daniel Thoma Zurich, Switzerland
Insufficient Soft-Tissue Thickness in a Single Tooth Gap in the Anterior Maxilla PD Dr. Daniel Thoma Zurich, Switzerland
1 - Baseline frontal view: missing central incisor. Implant visible through mucosa due to thin biotype.
2 - Baseline occlusal view: soft-tissue deficit in the buccal and occlusal area.
3 - Flap elevation on the buccal side using a full flap crestally and a split flap buccally.
4 - Adaption of Geistlich Fibro-Gide® to the defect size.
5 - Palatal island flap prepared to allow for tension-free wound closure. Geistlich Fibro-Gide® in situ, immobilized with a mattress suture.
6 - Tension-free wound closure using single interrupted sutures (Dafilon 5-0, Braun).
7 - Abutment connection.
8 - 6 months follow-up: final crown in place.
9 - 2.5 year follow-up shows stable soft-tissue conditions.
Insufficient Soft-Tissue Thickness Around Single Implant in the Posterior Maxilla Prof. Mariano Sanz and Dr. Ignacio Sanz Martín Madrid, Spain
Insufficient Soft-Tissue Thickness Around Single Implant in the Posterior Maxilla Prof. Mariano Sanz and Dr. Ignacio Sanz Martín Madrid, Spain
1 - Baseline buccal view: soft-tissue concavity at the dental implant site.
2 - Baseline occlusal view: volume deficiency on the buccal aspect.
3 - Adapting and trimming of Geistlich Fibro-Gide® to the defect size. Additional bevel cut performed for the area to be positioned close to the incision line.
4 - Position and fixation of Geistlich Fibro-Gide® to the buccal flap with horizontal mattress suture.
5 - Primary closure obtained by horizontal mattress and single interrupted sutures.
6 - 4 months follow-up: showing the healed soft-tissue after augmentation surgery.
7 - 4 months follow-up: provisional restoration. Notice volume recovery.
8 - Occlusal view before final restoration.
9 - 9 months follow-up: final restoration after soft-tissue augmentation surgery.
Simultaneous Guided Bone Regeneration
Ridge Preservation and Simultaneous Soft-Tissue Augmentation in the Posterior Mandible PD Dr. Daniel Thoma Zurich, Switzerland
Ridge Preservation and Simultaneous Soft-Tissue Augmentation in the Posterior Mandible PD Dr. Daniel Thoma Zurich, Switzerland
1 - Baseline occlusal view: situation before removal of tooth #20.
2 - Tooth removal and extraction socket management with Gesitlich Bio-Oss® and Geistlich Bio-Gide®.
3 - Geistlich Fibro-Gide® was trimmed to the defect size, to augment the buccal and crestal soft-tissue area of the ridge.
4 - Geistlich Fibro-Gide® in place, augmenting buccal and crestal area of tooth #20 and buccal in the edentulous area tooth #21 to tooth #19.
5 - Immediate provisionalization of the implants.
6 - 3 weeks post-surgery: occlusal view of augmented area with created emergence profile.
7 - 3 weeks post-surgery: buccal view of augmented area with created emergence profile.
8 - Provisional reconstruction 6 weeks post-surgery.
9 - Final restoration 2.5 years post-surgery: soft-tissue thickness remains stable over time.
Insufficient Soft-Tissue Thickness in Extended Gap in the Posterior Mandible Dr. Daniele Cardaropoli Torino, Italy
Insufficient Soft-Tissue Thickness in Extended Gap in the Posterior Mandible Dr. Daniele Cardaropoli Torino, Italy
1 - Baseline before implant placement showing the soft-tissue deficiency.
2 - Implant surgery after implant placement showing the need for guided bone regeneration.
3 - Guided bone regeneration with Geistlich Bio-Oss® and Geistlich Bio-Gide®.
4 - Geistlich Fibro-Gide® was trimmed to the defect size and placed at full thickness (6 mm) on top of Geistlich Bio-Gide®.
5 - Wound closure (PTFE 5/0 sutures) by combining horizontal mattress sutures and single sutures in a double layer.
6 - 2 weeks follow-up post-surgery.
7 - 3 months follow-up post-surgery.
8 - Re-entry was performed 3 months post-surgery. Soft-tissue emergence profile at the time of final ceramic-crown delivery 4 months after implant placement.
9 - Clinical and radiographic situation 2 years after implant insertion.
Guided Bone Regeneration with Simultaneous Soft-Tissue Augmentation in the Anterior Maxilla PD Dr. med. Vivianne Chappuis Bern, Switzerland
Guided Bone Regeneration with Simultaneous Soft-Tissue Augmentation in the Anterior Maxilla PD Dr. med. Vivianne Chappuis Bern, Switzerland
1 - Baseline frontal view: missing central incisor.
2 - Baseline occlusal view: The facial contour is flattened by physiological dimensional ridge alterations post-extraction.
3 - Full-thickness flap using one releasing incision in the distal aspect of the canine. Simultaneous contour augmentation using GBR was performed with autogenous bone chips to cover the exposed implant combined with a layer of Geistlich Bio-Oss® and Geistlich Bio-Gide®.
4 - Application of Geistlich Fibro-Gide®® on top of the augmented area. A tension-free primary wound closure was obtained by a periosteal releasing incision.
5 - Suture removal 14 days post-surgery. Uneventful wound healing and an increase in soft-tissue volume.
6 - Frontal view 4 weeks post-surgery.
7 - 2 months follow-up combined with abutment connection.
8 - Occlusal view of final restoration 2 years post-surgery.
9 - Final restoration 2 years post-surgery shows pleasing esthetics.
Single Tooth Recession Coverage
Treatment of Single Gingival Recession with Coronally Advanced Flap Technique Prof. Giovanni Zucchelli Bologna, Italy
Treatment of Single Gingival Recession with Coronally Advanced Flap Technique Prof. Giovanni Zucchelli Bologna, Italy
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®.
Geistlich Fibro-Gide® for Gingival Recessions Vanessa Marinho Glendale, Arizona
Geistlich Fibro-Gide® for gingival recessions Vanessa Marinho Glendale, Arizona
1 - Gingival recessions #23 and #22
2 - Sites at the day of the procedure after sutures placed. Tunnel between #23,24 and partial thickness flap raised between #23,22.
3 - 10 week post op healing. Root coverage achieved. Patient reports no problems and is pleased with the results. More follow ups to come.
Multiple Tooth Recession Coverage
Treatment of Multiple Gingival Recession with Coronally Advanced Flap Technique Dr. Raffaele Cavalcanti Bari, Italy
Treatment of Multiple Gingival Recession with Coronally Advanced Flap Technique Dr. Raffaele Cavalcanti Bari, Italy
1 - Baseline: multiple recession defect Miller Class I with keratinized tissue less than 3 mm on teeth #7 to #5.
2 - Coronally advanced flap preparation and elevation for sufficient release.
3 - Geistlich Fibro-Gide® is cut in half to 3 mm thickness.
4 - 3 mm Geistlich Fibro-Gide® is placed in the defect and absorbs blood immediately.
5 - Positioning of Geistlich Fibro-Gide® and fixation with single sutures (7-0 PGA sutures).
6 - Tension-free wound closure with sling sutures (6-0 PGA sutures).
7 - Suture removal 14 days post-surgery.
8 - Follow-up after 12 months: complete root coverage with Geistlich Fibro-Gide® is achieved.
9 - 2 year follow-up: complete root coverage with Geistlich Fibro-Gide®.
Vestibular Incision Subperiostal Tunnel Access (Modified VISTA Technique) Dr. Ulrike Schulze-Späte Jena, Germany
Vestibular Incision Subperiostal Tunnel Access (Modified VISTA Technique) Dr. Ulrike Schulze-Späte Jena, Germany
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.
Root Coverage for Multiple Adjacent Teeth in the Maxilla with Geistlich Fibro-Gide® Vinay Bhide, DDS, MSc, FRCD(C). Aurora, Ontario
Root Coverage for Multiple Adjacent Teeth in the Maxilla with Geistlich Fibro-Gide® Vinay Bhide, DDS, MSc, FRCD(C). Aurora, Ontario
1 - Pre-operative condition: Note that the gingival recession of 3-4 mm is evident as is the cervical root abrasions. The interdental papillae completely fills the embrasure space.
2 - Incision design showing the sulcular incisions with horizontal incisions across the interdental regions ending with a remote oblique vertical releasing incision distal to the first bicuspid tooth.
3 - Geistlich Fibro-Gide® is trimmed in a dry state to 10 x 15 x 6mm. The corners were trimmed for better adaptation and the matrix was then hydrated in sterile saline solution.
4 - The interdental papillae were de-epithelialized and Geistlich Fibro-Gide® was placed over the exposed roots extending onto the bone. Geistlich Fibro-Gide® was not secured with sutures.
5 - Internal periosteal releasing incision was made to allow tension-free coronal advancement of the buccal flap to completely cover Geistlich Fibro-Gide®. The flap was secured with 5-0 Monocryl® sutures.
6 - 1 week post-operative visit: the healing looks good and sutures are intact. There was a small soft-tissue dehiscence at the buccal margin of the canine tooth.
7 - Healing progressed well at 2 months post-operatively and the dehiscence defect seen at 1 week appears to be healing. Soft-tissue thickness is also evident at this stage.
8 - At 6 months, 100% root coverage has been achieved. Note the increase in keratinized gingiva at the canine tooth where there was previously delayed healing. The patient is happy with the esthetic and functional outcome.
Peri-Implantitis
A Regenerative Approach to Peri-implantitis Hector L. Sarmiento, D.M.D., MS c. New York, New York
A Regenerative Approach to Peri-implantitis Hector L. Sarmiento, D.M.D., MS c. New York, New York
1 - 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.
2 - 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.
3 - 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.
4 - A protective Geistlich Bio-Gide® membrane was placed over Geistlich Bio-Oss®.
5 - 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.
6 - 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.
7 - Closure with a tension-free flap was achieved by releasing incisions and secured using 4-0 chromic gut sutures.
8 - 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.
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All you need to succeed



Made of Collagen

A porcine, porous, resorbable and volume-stable collagen matrix.1



Volume Stability

The reconstituted collagen undergoes smart cross-linking for volume stability of the matrix.1



Supports Soft-Tissue Integration

The porous network of Geistlich Fibro-Gide® supports angiogenesis, formation of new connective tissue and stability of the collagen network in submerged healing situations.2,3



Soft-Tissue Formation

Animal models have shown good integration of Geistlich Fibro-Gide® into the surrounding soft-tissue while maintaining stability.4

BIOBRIEF

Root Coverage for Multiple Adjacent Teeth in the Maxilla with Geistlich Fibro-Gide®
Vinay Bhide, DDS, MSc, FRCD(C).
Play VideoDownload (PDF)
A Regenerative Approach to Peri-implantitis
Dr. Hector L. Sarmiento
Play VideoDownload (PDF)
Phenotype Conversion Using Geistlich Fibro-Gide® for Immediate Implants in the Esthetic Zone
Dr. Robert A. Levine
Play VideoDownload (PDF)
Use of Geistlich Fibro-Gide® for Correction of Maxillary Anterior Soft Tissue Peri-implant Ridge Deficiencies
Dr. Israel Puterman
Play VideoDownload (PDF)
Avoiding Post-Implant Placement and Long Term Crestal Bone Resorption by Thickening Vertical Soft Tissue
Tamir Wardany, D.D.S.
Play VideoDownload (PDF)

Surgical Videos

Case 1: Soft-tissue augmentation around a dental implant
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Case 2: Soft-tissue augmentation around a dental implant
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Root Coverage of a single recession defect
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3D Animated Videos

Soft-tissue augmentation around a dental implant
Play Video
Root coverage of a single recession defect
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Geistlich Fibro-Gide® Webinar
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The Differences Between Geistlich Mucograft® and Geistlich Fibro-Gide®
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Handling
at a Glance

As with any new product, initially you will experience some differences in the handling properties and performance of the matrix. The instructions below are intended to provide insights for the successful use and application of Geistlich Fibro-Gide®.

Careful Case Selection

When using Geistlich Fibro-Gide®, it is important to carefully consider the patient and desired outcome to determine the appropriate surgical technique.

Flap Design

Geistlich Fibro-Gide® can be used in both open flap and flapless procedures. A generous release of the flap is the key to successful healing by complete coverage of the matrix (submerged healing).

Trimming and Cutting

Geistlich Fibro-Gide® can be adjusted in size and thickness, in both a wet or dry state. The use of a scalpel is recommended when the matrix is in a dry state and scissors when in a wet state.

Volume Changes

Swelling of the matrix upon wetting must be taken into account when determining final dimensions, as the matrix will gain approximately 25% in volume.

Thickness

A reduction in thickness to around 3–4 mm may support tension-free wound closure. Especially when treating recession defects (Miller Class I/II)* a reduction in thickness is recommended.
*Clinical evidence is continuously being collected for this indication.

Application

Geistlich Fibro-Gide® can be applied in either a dry or wet state upon individual preference. Pre-wetting can be done with the patient’s own blood, you may also dampen with sterile saline solution, but do not fully hydrate the matrix.

Fixation

When hydrated the matrix will adhere rapidly. Suturing the matrix can be performed, however is not always necessary.

Tension-Free Wound Closure

This is key for complication-free healing. It is recommended to bevel the edges of the matrix to accomplish this.

Healing

Primary closure is recommended to ensure maximum soft-tissue thickness gain. In case of exposure Geistlich Fibro-Gide® is forgiving and can heal without additional treatment. Clinical experience shows low incidence of wound healing complications.1,5-8

Post-Operative Instructions

Following the application of Geistlich Fibro-Gide® and during healing, there may be a slight change in the color of the soft-tissue and an increase in volume at the surgical site. Both color matching and a reduction in tissue volume to varying degrees, should be expected over time. It is recommended that this is expressed to the patient, as part of their post-operative instructions, to ensure appropriate expectations, during healing.

Guidance above is based on pre-clinical and clinical evidence gained in Europe and North America during the pre-launch and launch-phase of Geistlich Fibro-Gide®.

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