GEISTLICH BIOMATERIALS
Building a Foundation for Implant Success
Geistlich Biomaterials offers a combination of solutions to preserve the extraction socket and build up bone and soft tissue for long-term implant success
Many of the patients who come into your office have one question in mind: Can you fix my smile? This is especially true for those with fractured or extracted teeth. And when they visualize their newly restored smile, they see only the surface of a bright, shiny new crown—not the foundation that needs to support the restoration.
As clinicians, it’s imperative to dig beneath the surface and understand that the more time and effort spent planning for a solid prosthetic foundation, the better the restorative outcome will be in terms of both function and esthetics. While this can certainly be a challenge in our culture of instant gratification, it is equally as important as the prosthetic placed into and on top of an extraction socket.
Geistlich Biomaterials has been leading regeneration in the dental world for more than three decades through a robust offering of bone substitutes, membranes, and collagen matrices that work in tandem to simplify implant insertion.
The flagship Geistlich Bio-Oss is a highly researched xenogeneic bone-grafting material with particles that are incorporated over time within living bone. This offers several benefits, including effective and predictable bone regeneration, long-term volume preservation, and, ultimately, higher implant survival rates.
Creating Stability and Support
Extraction almost always precedes implant placement, and when it comes to treating both intact and non-intact extraction sockets, choosing the right approach paired with the right team of products is key to success. When clinicians are faced with an intact socket where all four walls remain undamaged from the extraction or previous infection, the goal is to maintain a truly regenerative space of vital bone and soft tissue.
Creating a hard tissue scaffold with Geistlich Bio-Oss Collagen helps support the vitality of vascularized bone and healthy soft tissue, which, in turn, support the prosthetic placed on the extraction site. Geistlich Bio-Oss Collagen is a combination of 90% Geistlich Bio-Oss granules and 10% porcine-derived collagen. Placing a collagen matrix such as Geistlich Mucograft Seal in tandem with Geistlich Bio-Oss Collagen helps keep the graft within the socket undisturbed, while minimizing resorption of the ridge and preserving more bone volume.
“It’s very common to come across an intact extraction socket that requires a bone-graft procedure before implant placement,” said Ron Wang, DMD, Manager of Clinical Science & Education at Geistlich Biomaterials. “The goal in these cases is to stabilize the blood clot and support the overlying soft tissue. By using a bone-graft material such as Geistlich Bio-Oss Collagen, we create a scaffold that helps stabilize the blood clot inside the socket. When that is paired with a membrane or matrix to seal the socket and prevent soft-tissue migration, a regenerative environment is created."
The addition of collagen to Geistlich Bio-Oss promotes rapid vascularization and cell migration, in addition to improving handling in a way that makes it easy to mold and tailor the material to the morphology of the defect. Geistlich Bio-Oss Collagen has a low resorption rate, which means the material is slowly integrated into the new tissue and maintains its volume.
"Geistlich Bio-Oss Collagen creates a scaffold that helps stabilize the blood clot inside the socket and prevent soft-tissue migration."
-Ron Wang, DMD
Rebuilding the Buccal Wall
Whenever there is a bony defect, various tissue types compete to fill the space. Because soft-tissue cells such as fibroblasts migrate and proliferate faster than bone progenitor cells, it is important to use a barrier membrane to block out those unwanted cells and maximize bone regeneration.
“When a tooth is extracted, there’s often damage to the buccal bone, which is usually very thin and oftentimes lost during the procedure,” said Dr. Wang. “In these situations, you can’t simply fill the hole with grafting material, because there needs to be some type of barrier between the scaffold and the soft tissue." Without it, he shared, there is a higher risk of the graft resorbing or of soft tissue growing into an area where there should be bone.
One-wall voids, which generally occur on the facial side, are common and pose a significant esthetic challenge if the soft tissue is not managed properly. Placing an implant into a site with insufficient buccal hard tissue may lead to unesthetic outcomes, such as show-through of the fixture through the mucosa and marginal recession.
Geistlich Bio-Gide Shape, a precut resorbable collagen membrane, is ideally structured for one-wall defects. The material contours to the defect and provides an optimal barrier to prevent soft-tissue cells from infiltrating into the socket space that will accommodate an implant in the future. It is tucked over the socket opening to provide barrier functionality on both the buccal and occlusal surfaces.
A Partner in Regeneration
Understanding and respecting the materials needed to preserve the extraction socket and regenerate bone and soft tissue are just as important as placing the implant itself. While clinicians have many options for creating this foundation, Geistlich offers the benefit of working with a partner that specializes in and researches only one thing: biomaterials.
