Frequently Asked Questions (FAQ)

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Dental Products
Geistlich Bio-Oss®
1.
When do you use the large Geistlich Bio-Oss® particles (1-2 mm) and when do you use the small particles (0.25-1 mm)?
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.
2.
Can Geistlich Bio-Oss® also be used without membrane?
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:
  1. Gielkens PF, et al.: Clin Oral Implants Res 2008; 19(5) : 516-21.
  2. Tal H, et al.: Clin Oral Implants Res 2008; 19(3): 295-302.
  3. Becker J, et al.: Clin Oral Implants Res 2009; 20(7): 742-49.
3.
Can Geistlich Bio-Oss® be re-sterilized?
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.
4.
Should Geistlich Bio-Oss® be mixed with antibiotics?
The use of local antibiotics is generally unnecessary when utilizing Geistlich Bio-Oss®.
5.
Is Geistlich Bio-Oss® safe (transmission of diseases such as Bovine Spongiform Encepholapathy (BSE)?

Geistlich Bio-Oss® is made from the mineral part of bovine bone. The strictly controlled manufacturing process ensures high quality and safety standards by:

  • defined origin of the raw material
  • country of origin: Australia (and for some countries also New Zealand) which is historically and currently free of BSE
  • selected and certified slaughterhouses
  • pre- and post-mortem health inspection for each individual animal
  • extremity bone (according to WHO Guideline on tissue infectivity classified as tissues with no detected infectivity or infectious prions)
  • effective inactivation methods with 15h treatment at high temperature and cleaning with strong alkaline solutions
  • sterilization, double sterile packaging
  • official controls by international authorities
6.
Do I have to use venous blood or can I use blood from the defect?
Blood from the defect may be used for mixing. Care should be taken to avoid contamination with salivary bacteria.
Geistlich Bio-Oss Pen®
1.
When do you use the large Geistlich Bio-Oss Pen® particles (1-2 mm) and when do you use the small (0.25-1 mm)?
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.
2.
Can Geistlich Bio-Oss Pen® also be used without membrane?
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. Clinicians should read the package insert prior to use.

References:
  1. Gielkens PF, et al.: Clin Oral Implants Res 2008; 19: 516-21.
  2. Tal H, et al.: Clin Oral Implants Res 2008; 19: 295-302.
  3. Becker J, et al.: Clin Oral Implants Res 2009; 20(7): 742-49.
3.
How much saline or blood is needed to moisten the Geistlich Bio-Oss Pen®?
0.5 cc Geistlich Bio-Oss Pen®: ~0.5 ml
1.0 cc Geistlich Bio-Oss Pen®: ~1.0 ml
1.5 cc Geistlich Bio-Oss Pen®: ~1.5 ml
4.
How many Geistlich Bio-Oss Pen® delivery systems are needed for a sinus floor elevation?
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.
5.
Can the Geistlich Bio-Oss® granules be mixed with autologous bone in the Geistlich Bio-Oss Pen®?
No, Geisltich does not recommend mixing autologous bone with the Geistlich Bio-Oss® granules within the syringe.
6.
Can the Geistlich Bio-Oss Pen® be re-sterilized?
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.
7.
If the applicator tip is contaminated (e.g. has fallen on the floor) can it be re-used?
No. Discard and use a new Geistlich Bio-Oss Pen®.
8.
Can separate applicator tips be ordered?
No. The applicator tips are not available separately.
9.
Are other applicator tips (forms, length, diameter) available?
No. There are no other tips available.
Geistlich Bio-Oss Collagen®
1.
Is Geistlich Bio-Oss® Collagen a collagen plug?
No. Geistlich Bio-Oss® Collagen is a mixture of 90% Geistlich Bio-Oss® spongiosa granules and 10% highly purified porcine collagen in a block form. Geistlich Bio-Oss® is a natural bone mineral of bovine origin. The collagen facilitates adaptation of the Geistlich Bio-Oss® to the defect site.
2.
Do I need a membrane when using Geistlich Bio-Oss® Collagen?
The collagen in Geistlich Bio-Oss Collagen® does not function as a membrane. When space maintenance is required, it is recommended to use a membrane for optimal results1.

References:
  1. Perelmann-Karmon, et al.:  Int J Periodontics Restorative Dent 2012; 32(4): 459-65.
3.
What are the recommended indications for Geistlich Bio-Oss® Collagen?

Geistlich Bio-Oss Collagen® is recommended for reconstruction of bone defects in the following procedures:

  • Augmentation/reconstruction of alveolar ridges.
  • Filling of extraction sockets.
  • Preparation of implant sites, filling of bone dehiscences, and sinus floor augmentations.
  • Filling of periodontal bone defects, membrane support during guided bone regeneration (GBR) and guided tissue regeneration (GTR).

4.
When can I use Geistlich Bio-Oss® and when Geistlich Bio-Oss®Collagen?

Geistlich Bio-Oss® and Geistlich Bio-Oss Collagen® share the same indications. These products may be used interchangeably in the following procedures: 

  • Augmentation or reconstructive treatment of the alveolar ridge.
  • Filling of periodontal defects.
  • Filling of defects after root resection, apicoectomy, and cystectomy.
  • Filling of extraction sockets to enhance preservation of the alveolar ridge.
  • Elevation of the maxillary sinus floor.
  • Filling of periodontal defects in conjunction with products intended for Guided Tissue Regeneration(GTR) and Guided Bone Regeneration (GBR).
  • Filling of peri-implant defects in conjunction with products intended for Guided BoneRegeneration (GBR).

5.
Is it possible to have an allergic reaction to Geistlich Bio-Oss® Collagen?
As Geistlich Bio-Oss Collagen® contains collagen, allergic and inflammatory tissue reactions cannot be excluded. These are, however, extremely rare.
Geistlich Combi-Kit Collagen
1.
What are the recommended indications for Geistlich Combi-Kit Collagen?
Geistlich Combi-Kit Collagen is recommended for the reconstruction of the alveolar ridge, extraction socket management and augmentation of bone dehiscences.
2.
Can I use Geistlich Combi-Kit products separately?
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.
3.
Is it possible to have an allergic reaction to Geistlich Bio-Oss® Collagen and 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.
4.
How does Geistlich Bio-Gide® differ from other collagen membranes?
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®.
Perio-System Combi-Pack
1.
Can you use Perio-System Combi-Pack products separately?
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.
2.
Why do I need Geistlich Bio-Gide® Perio when using Geistlich Bio-Oss® Collagen?
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:
  1. Perelman-Karmon M, et al.: Int J Periodontics Restorative Dent 2013, 32(4): 459-65.
3.
Is it possible to have an allergic reaction to Geistlich Bio-Gide® Perio or Geistlich Bio-Oss® Collagen?
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.
Geistlich Bio-Gide®
1.
Why is a membrane necessary?
Alveolar bone regenerates best with a membrane designed for guided bone regeneration. The use of a membrane leads to increased bone as well as better quality bone compared to procedures that do not include a membrane.1

References:
  1. Schwarz F, et al.: Clin Oral Impl Res 2008; 19(4): 402-15.
2.
How long should a membrane function as a barrier in Guided Bone Regeneration?

Expert clinicians have estimated that a membrane used in Guided Bone Regeneration should maintain its barrier function until the provisional matrix and woven bone are present. Barrier duration is considered to be necessary for 7 to 14 days in most cases. Optimal barrier function now means that occlusiveness is maintained until the wound heals – a process which normally takes about 2 weeks.

Geistlich Bio-Gide® has proven to support bone regeneration on an equivalent level as membranes with a longer barrier function, with a reduction of complications during wound healing.1-3

References:

  1. Tal H, et al.: Clin Oral Implants Res 2008; 19(5): 295-302.
  2. Becker J, et al.: Clin Oral Implants Res 2009; 20(7): 742-49.
  3. Schwarz F, et al.: Clin Oral Implants Res 2008; 19(4): 402-15.
3.
How does Geistlich Bio-Gide® differ from other collagen membranes?

Geistlich Bio-Gide® is a membrane with a unique bilayer structure. It combines optimal bone formation with complication-free wound healing and predictable outcomes. The native collagen of Geistlich Bio-Gide® leads to significantly less soft tissue dehiscences compared to artificially cross-linked membranes.1 A significant number of scientific publications and proven long-term clinical success support the safety and efficacy of Geistlich Bio-Gide®.



References:

  1. Tal H, et al.: Clin Oral Impl Res 2008; 19: 295-302.
  2. Becker J, et al.: Clin Oral Impl Res 2009; 20(7): 742-49.
  3. Schwarz F, et al.: Clin Oral Impl Res 2008; 19(4): 402-15.
4.
Have inflammatory reactions been associated with Geistlich Bio-Gide®?
Inflammation is a possible complication, which may occur with any surgery. However, biocompatibility of Geistlich Bio-Gide® has been verified in numerous studies.
5.
Is it possible to have an allergic reaction to Geistlich Bio-Gide®?
As Geistlich Bio-Gide® is made of collagen, allergic reactions and inflammatory tissue reactions cannot be excluded. However this is extremely rare.
6.
What happens if the membrane is applied with the rough surface towards the soft tissue?
The bilayer structure of Geistlich BioGide® has a compact and porous surface. The compact layer of Geistlich Bio-Gide® 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.
7.
Can Geistlich Bio-Gide® be re-sterilized?
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.
8.
Does the membrane have to be fixed?
As Geistlich Bio-Gide® adheres very well to the defect, it is normally not necessary to utilize fixation screws or pins. However, fixation is possible if required.
9.
How can Geistlich Bio-Gide® be used in extraction socket management for open healing?
Geistlich Bio-Gide® can be used submerged or in an open healing situation1 depending on the surgeon's preference. The advantages of the secondary intention healing of Geistlich Bio-Gide® include the ability to perform a flapless surgery and the preservation of the mucogingival line.

References:
  1. Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2012, 32(4): 421-30.
Geistlich Bio-Gide® Perio
1.
What is the difference between Geistlich Bio-Gide® Perio and Geistlich Bio-Gide®?
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.
2.
Have inflammatory reactions been associated with Geistlich Bio-Gide® Perio?
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.
3.
Is it possible to have an allergic reaction to Geistlich Bio-Gide® Perio?
As Geistlich Bio-Gide® Perio is made of collagen, allergic and inflammatory tissue reactions cannot be excluded. However, this is extremely rare.
4.
What happens if the membrane is applied with the rough surface towards the soft tissue?
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.
5.
Can Geistlich Bio-Gide® Perio be re-sterilized?
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.
6.
Does the membrane have to be secured with fixation screws or pins?
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.
Geistlich Mucograft®
1.
What is Geistlich Mucograft®?
Geistlich Mucograft® is a unique 3D-collagen matrix designed specifically for soft-tissue regeneration as an alternative to autogenous soft-tissue grafts.
2.
What is Geistlich Mucograft® made of?
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.
3.
Is Geistlich Mucograft® resorbable?
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:
  1. Rocchietta I, et al.: Int J Periodontics Restorative Dent 2012; 32(1): e34-40.
  2. Ghanaati S, et al.: Biomed Mater 2011; 6(1): 015010.
4.
Is Geistlich Mucograft® an alternative for free gingival graft (FGG) or for connective tissue graft (CTG)?
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:
  1. Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.
  2. Lorenzo R, et al.: Clin. Oral Impl. Res 2012; 23(3): 316-24.
  3. Nevins M, et al.: Int J Periodontics Restorative Dent 2011; 31(4): 367-73.
  4. McGuire MK & Scheyer ET : J Periodontol 2010; 81(8): 1108-17.
  5. Cardaropoli D, et al.: J Periodontol 2012; 83(3): 321-28.
  6. Rotundo R & Pini-Prato G: Int J Periodontics Restorative Dent 2012; 32(4): 413-19.
5.
Does Geistlich Mucograft® need to be treated prior to application to the defect?
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.
6.
Should Geistlich Mucograft® be handled/applied wet or dry?
Geistlich recommends handling and applying the material dry, as it is easy to trim and pre-suture.
7.
Does Geistlich Mucograft® swell after placement?
Our measurements indicate that there is no additional swelling of the matrix following hydration (90 minute period examined)1.

References:
  1. Data on file, Geistlich Pharma AG, Wolhusen, Switzerland
8.
Can Geistlich Mucograft® be stretched?
No. Geistlich Mucograft® has limited elongation properties and should always be sutured tension-free.
9.
What suture should be used with Geistlich Mucograft®?
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:
  1. Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.
  2. Herford AS, et al.: J Oral Maxillofac Surg 2010; 68(7): 1463-70.
  3. Cardaropoli D, et al.: J Periodontol 2012; 83(3): 321-28.
  4. McGuire MK & Scheyer ET : J Periodontol 2010; 81(8): 1108-17.
10.
Which side of Geistlich Mucograft® should face the bone?
The compact structure should face outward, 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.

11.
How many layers of Geistlich Mucograft® should be used?
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®.
12.
Should Geistlich Mucograft® be placed directly over the bone or over the periosteum?
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:

  1. Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.
  2. Lorenzo R, et al.: Clin Oral Impl Res 2012; 23(3): 316-24.
  3. McGuire MK & Scheyer ET : J Periodontol 2010; 81(8): 1108-17.
  4. Cardaropoli D, et al.: J Periodontol 2012; 83(3): 321-28.
  5. Rotundo R & Pini-Prato G: Int J Periodontics Restorative Dent 2012; 32(4): 413-19.
13.
Should Geistlich Mucograft® be used submerged or in open healing situations?
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:
  1. Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.
  2. McGuire MK & Scheyer ET: J Periodontol 2010; 81(8): 1108-17.
  3. Cardaropoli D, et al.: J Periodontol 2012; 83(3): 321-28.
  4. Rotundo R & Pini-Prato G: Int J Periodontics Restorative Dent 2012; 32(4): 413-19.
14.
Are antibiotics needed after treatment with Geistlich Mucograft®?
After treatment with Geistlich Mucograft®, please follow the same postsurgical management that is usually applied with connective tissue grafts or free gingival grafts.
Geistlich Mucograft® Seal
1.
What’s the difference between collagen sponges made by other manufacturers and Geistlich Mucograft® Seal?

Geistlich Mucograft® Seal is specifically designed for soft-tissue regeneration1. The collagen of Geistlich Mucograft® Seal is specially processed to support immediate blood clot stabilization. This leads to early vascularization1,3, facilitates soft-tissue cell ingrowth2 and excellent integration of the 3D collagen matrix with surrounding tissues2,3.  In contrast to other collagen products on the market, Geistlich Mucograft® and Geistlich Mucograft® Seal have been scientifically documented with proven clinical benefits.


References:

  1. Biocompatibility according to ISO 10993-12001. Data on file Geistlich PharmaAG, Wolhusen, Switzerland.
  2. Ghanaati S, et al.:  Biomed Mater 2011; 6(1): 015010.
  3. Roccietta I, et al.: Int J Periodontics Restorative Dent 2012; 32(1): e34-40.
2.
How long is the resorption time for Geistlich Mucograft® Seal?

The resorption time of every biomaterial including Geistlich Mucograft® Seal depends on multiple factors: defect size, metabolism and general health of the patient, among other variables. In order to determine an average resorption time of Geistlich Mucograft® Seal in humans, biopsies of the healing soft-tissues would be needed following tooth extraction at different time points. This procedure is not ethically possible to conduct and thus the average resorption time cannot be measured. However, single histologic evaluations indicate that after 8 weeks Geistlich Mucograft® Seal is completely integrated into the newly formed soft-tissue. 

 
3.
Does Geistlich Mucograft® Seal absorb blood and saline equally well?
 

The hydrophilic properties of Geistlich Mucograft® Seal result in a rapid moistening of the device with either saline or blood.

 
4.
Why should I use Geistlich Bio-Oss Collagen® with Geistlich Mucograft® Seal, if I plan to place an implant after 8-10 weeks?
Geistlich Mucograft® Seal needs the support of Geistlich Bio-Oss Collagen® underneath for good healing of both the soft and the hard-tissues in order to preserve the ridge volume. 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 support the volume preservation of the ridge.    
5.
What is Geistlich Mucograft® Seal?
Geistlich Mucograft® Seal  is a unique 3D collagen matrix designed specifically for soft-tissue regeneration in extraction sockets for ridge preservation.
6.
What is Geistlich Mucograft® Seal made of?

Geistlich Mucograft® Seal consists of porcine collagen and is specifically designed for soft-tissue regeneration. The 3D matrix is built up of a compact macro-structure that gives stability while allowing open healing, and a spongy micro-structure that supports blood clot stabilization and ingrowth of soft-tissue cells.

7.
Is Geistlich Mucograft® Seal resorbable?
The collagen of Geistlich Mucograft® will be replaced by newly formed soft tissue. The matrix is rapidly vascularized and colonized by soft-tissue cells1,2. This leads to a good integration of the matrix without any signs of foreign body reaction3,4.

References:
  1. Rocchietta I, et al.: Int J Periodontics Restorative Dent 2012; 32(1): e34-40.
  2. Ghanaati S, et al.: Biomed Mater 2011 Feb; 6(1): 015010.
  3. Nevins M, et al.: Int J Periodontics Restorative Dent 2011; 31(4): 367-73.
  4. Camelo M, et al.: Int J Periodontics Restorative Dent 2012; 32(2): 167-73.
8.
Does Geistlich Mucograft® Seal require pre-treatment?

Geistlich Mucograft® Seal is ready to be applied and does not need pre-treatment or hydration before application. Due to its excellent hydrophilicity, the matrix will hydrate quickly following placement into the site with the patient’s blood.

9.
Should Geistlich Mucograft® Seal be handled/applied wet or dry?

Geistlich Biomaterials recommends the handling and application of Geistlich Mucograft® Seal be done in a dry state.  The matrix is easy to trim and easy to pre-suture.

10.
Does Geistlich Mucograft® Seal expand after placement?

Our measurements indicate that the 3D matrix does not expand further following hydration (90 minute period examined)1.

 
References:
  1. Data on file, Geistlich Pharma AG, Wolhusen, Switzerland
11.
Which side of Geistlich Mucograft® Seal should face the bone?

The compact macro-structure should face outward, away from underlying bone, with the spongeous micro-structure facing the bone or soft-tissue wound bed. Geistlich Mucograft® Seal spongeous micro-structure is grooved for easier differentiation of the two sides. The grooved spongeous micro-structure should face the bone.

12.
Can Geistlich Mucograft® Seal be stretched?

No. Geistlich Mucograft® Seal has limited elongation properties and should always be sutured tension-free.

13.
What suture should be used with Geistlich Mucograft® Seal?

Geistlich Mucograft® Seal should be sutured using non-resorbable sutures; tissue adhesives should not be used1. The close adaptation of the device to the soft-tissue borders can be accomplished by single-interrupted, double-interrupted or cross-stitch suturing.

The finest possible suture material comfortably used by the surgeon should be selected: for single-interrupted suturing, a 5.0 or 6.0 suture size is recommended; for cross-stitch suturing, a 5.0 suture size is appropriate1.


References:
  1. Geistlich Mucograft Seal Advisory Board Meeting Report, 2013. Data on file Geistlich Pharma AG, Wolhusen, Switzerland.
Dental Therapeutic Area
Extraction Socket Management
1.
Which Geistlich biomaterials do you recommend for the treatment of extraction sockets?
Geistlich Bio-Oss® OR Geistlich Bio-Oss Collagen® PAIRED WITH Geistlich Bio-Gide® are recommended for bone regeneration in the management of extraction sockets with defects that have intact bony walls. When Geistlich Bio-Oss® and Geistlich Bio-Gide® are used in combination, more bone is regenerated compared to extraction sites where a bone substitute material was used alone1,2.

References:
  1. Perelman-Karmon M, et al.: Int J Periodontics Restorative Dent 2012; 32(4): 459-65.
  2. Geistlich Mucograft Seal Advisory Board Meeting Report, 2013. Data on file, Geistlich Pharma AG, Wolhusen, Switzerland.
2.
Can Geistlich Bio-Gide® be used in extraction socket management for open healing? How?
Geistlich Bio-Gide® can be submerged or used in an open healing situation1 depending on the surgeon's preference. The advantages of the secondary intention healing of Geistlich Bio-Gide® are the ability to perform a flapless surgery and the preservation of the mucogingival line.

References:
  1. Cardaropoli D, et al.: Int J Periodontics Restorative Dent 2012; 32(4) :421-30.
3.
What is bundle bone?
It is a tooth-related structure that resorbs after tooth extraction. The buccal bone wall of the socket is very thin1-3 and consists largely of bundle bone.

References:
  1. Huynh-Ba G, et al.: Clin Oral Implants Res 2010; 21(1): 37-42.
  2. Januario AL, et al.: Clin Oral Implants Res 2011; 22(10): 1168-71.
  3. Araujo MG, Lindhe J: Journal Clin Periodontol 2005; 32(2): 212-18.
4.
Is it possible to regenerate bundle bone with Geistlich biomaterials?
Regardless of the therapeutic approach, bundle bone resorbs following tooth loss or extraction. The bundle bone cannot be regenerated; however, Geistlich Bio-Oss® or Geistlich Bio-Oss Collagen® effectively substitute its function in supporting soft-tissue and compensate for buccal bone loss.1,2

References:
  1. Araujo M, et al.: Int J Periodont Rest Dent 2008; 28(2):123-135.
  2. Fickl S, et al.: Journal Clin Periodontol 2008; 35:356-363.
5.
I treat extraction sockets. If I use your products - when can I expect bone?
After 4-6 months the socket will be regenerated with hard tissue.1

References:

  1. Cardaropoli D, et al.: Int J Periodont Rest Dent 2012; 32(4) : 421-430
6.
Can Geistlich Bio-Oss® and Geistlich Bio-Oss Collagen® be used in an extraction socket if inflammation is present at the time of placement?
It is not recommended to use Geistlich Bio-Oss® and Geistlich Bio-Oss® Collagen in case of infected sites (see package insert).
7.
At what time point does the literature recommend re-entry or implant placement in extraction sockets?
  • Type 1: simultaneous to extraction (immediate)
  • Type 2: 4-8 weeks after extraction (early implantation)
  • Type 3: 12-16 weeks after extraction (delayed implantation)
  • Type 4: more than 16 weeks after extraction (late implantation)1

References:

  1. Chen S, Buser D: ITI Treatment Guide Vol 3.
Soft-Tissue Regeneration
1.
Why do I need keratinized tissue?
Investigators still cannot agree on the importance of the presence of keratinized tissue. Various studies have shown, however, that lack of keratinized tissue around implants is associated with the following:
  • Gingival recession over a period of five years1
  • Soft-tissue attachment loss2
  • Increased plaque accumulation lingually1
  • Inflammation of the soft tissue2
  • More frequent bleeding1
References:
  1. Schrott AR, et al.: Clin Oral implants Res 2009; 20(10): 1170-17.
  2. Chung DMT, et al.: J Periodontol 2006; 77(8): 1410-20.
Patients
Dental Regeneration
1.
What is a biomaterial?
A biomaterial is any matter, surface or construct that interacts with biological systems; they can be derived from nature or synthesized in a laboratory.  When used in a medical application, biomaterials can be implanted to replace or repair missing tissue.
2.
When is a bone augmentation needed?
  1. Dental implants: To support and augment the jaw bone when using dental implants, if the existing amount of bone is not sufficient to stabilize the implant long-term. 
  2. Periodontitis: To preserve existing teeth that have lost the supporting bone in the jaw as a result of periodontal disease (e.g. due to bacterial tooth plaque).
  3. Extensive bone damage: Bone reconstruction after extensive bone loss.
3.
What are the manufacturing criteria for Geistlich biomaterials?

Meticulous selection of raw materials, together with a strictly controlled manufacturing process, allows Geistlich Bio-Oss® and Geistlich Bio-Gide® to conform to the highest safety requirements and ensures high tolerability.


Our strict manufacturing criteria:

  • Careful selection of raw materials for the manufacture of Geistlich Bio-Oss® and Geistlich Bio-Gide®, using bone substance or collagen only from monitored establishments.
  • Highly effective cleaning process using chemical and physical treatments and long periods of heating (Geistlich Bio-Oss®).
  • Monitored production process with regular checks by independent institutions and state authorities.
  • Sterilization of end products.
  • Documented quality assurance system.
4.
What happens after a tooth removal?

The bone recedes in the weeks and months after tooth removal. Some of the following problems may occur: 

  • Esthetic impairment: The gum follows the receding bone leading to visible soft-tissue defects. 
  • Hygiene: recession of the hard and soft-tissues under a fixed bridge can make it more difficult, or impossible to clean adequately. 
  • Difficulty with articulation: bone and soft-tissue loss can create open spaces between the teeth or under a restoration that can affect articulation. 
  • Expensive and complicated follow-up treatments: The loss of bone will have to be replaced and can require extensive bone and soft-tissue augmentation.

5.
What evidence is there that the biomaterials from Geistlich really work?
Geistlich Bio-Oss® and Geistlich Bio-Gide® have been part of the standard therapy in the field of bone reconstruction by dentists and dental surgeons for decades. They are the biomaterials most frequently used in oral regenerative procedures throughout the world. Geistlich Bio-Oss® and Geistlich Bio-Gide® have been extensively studied with results demonstrating the safety and efficacy of Geistlich Biomaterials.  As a result, a significant amount of data regarding long-term clinical success exists. 
6.
What happens to the biomaterials after the implantation?
Geistlich Bio-Oss® becomes interwoven with the new bone after four to six months and is then incorporated into the natural remodelling process of the bone. The protective Geistlich Bio-Gide® membrane is degraded naturally by the body after a few weeks.
7.
What are the causes of bone loss?
Bone loss can have many different causes – e. g. trauma or inflammation of the gums and bone due to bacterial tooth plaque (periodontitis). Also after teeth have been removed, the height and thickness of the jaw bone diminishes due to the lack of mechanical loading.