Soft-Tissue Success with the. Clinical Success. Proven Matrix. with the Proven. Geistlich Mucograft Geistlich Mucograft Seal

Transcription

1 Soft-Tissue Success with the Clinical Success Proven Matrix with the Proven Bone Geistlich Mucograft Substitute Seal

2 The Softer Side of Geistlich Innovation Decades of collagen expertise leads naturally to soft-tissue regeneration. At Geistlich, our pioneering path from biomaterial developer to market leader has been built firmly upon science. Beyond our dedicated scientific team, we collaborate with more than 100 universities as well as leading surgeons throughout the world. After thorough development and documentation, we manufacture with the highest quality and safety standards, resulting in three interconnected product lines Bone Substitutes, Membranes and Matrices. Histology showing mature connective tissue covered by keratinized epithelium 13 weeks after grafting with. Methylene blue-azurre II. Histology by Dr. Peter Schupbach Horgen, Switzerland. Our breakthrough resorbable collagen matrix,, has become an essential tool for soft-tissue regeneration and another proven reason Geistlich biomaterials are the products you trust. Documented More than 1,000 publications Reliable More than 30 years of clinical experience Experienced More than 163 years of Geistlich collagen competence The Ideal Biomaterials for Regeneration These proven and reliable products provide a foundation for long-term clinical success in regenerative dentistry. Our product lines include: Matrices Seal Bone Substitutes Geistlich Bio-Oss Geistlich Bio-Oss Collagen Geistlich Bio-Oss Pen Membranes Geistlich Bio-Gide Geistlich Bio-Gide Perio Combination Products Geistlich Combi-Kit Collagen Geistlich Perio-System Combi-Pack 2 3

3 The Soft-Tissue Regeneration Solution In the patented production of, a combination of intact and fragmented fibrillar collagen is used to create an ideal matrix. Compact Macro-structure The unique stabilizing dense structure along with a cell signaling spongy structure results in organized and vascularized regenerative healing. is designed to provide a requisite, reinforcing matrix and a signaling source for regenerative wound healing. Fibroblasts respond to the collagen by attaching, orienting and producing new collagen integration. Collagen research suggests that in such scaffolds, endothelial progenitor cells are activated for angiogenesis and the intact Biofunctionality Spongeous Micro-structure was intentionally designed for soft-tissue regeneration. collagen fibrils serve as conduits for endothelial cells and the formation of vascular channels of nutrition. These vascular channels are surrounded with perivascular mesenchymal stem cells with anti-inflammatory properties. 1-4 Due to these properties, the clinical result observed with is optimal soft-tissue regeneration rather than soft-tissue repair. 5-8 Key Factors for Success Collagen Structure: consists of natural collagen that is specially processed, with no artificial cross-linking, which supports optimal ingrowth for healthy bone formation. Easy Vascularization: Histology showing early vascularization of Geistlich Mucograft 15 days after implantation (mouse model). Arrow indicates the formation of a blood vessel. Circles show soft-tissue cells in the collagen matrix. 6 Cell Ingrowth: Histology 30 days after implantation (mouse model), showing soft-tissue cell ingrowth into. ST: soft-tissue; GMG-cms: compact macro-structure; GMG-sms: spongy micro-structure 6 Integration/Regeneration: Complete soft-tissue integration of within human connective tissue 6 weeks after clinical implantation, without any signs of foreign body reaction. Circles show soft-tissue cells in the collagen matrix. 6 For extraction socket cases where both a soft-tissue regeneration and additional bone volume are needed, Geistlich Bio-Oss Collagen is a natural companion to Seal.* Collagen Structure Early Vascularization Normal connective tissue and vascular extension Bone 1 Nien, Y. et al. (2003). Wound Repair Regen. 11(5): into 2 Tran, K.T. et al. (2004). Wound Repair Regen. 12(3): Davis, G.E. (1992). Biochem Biophys Res Commun. 182(3): Histology by Mei Lu 4 Tran, K.T. et al. (2005). J Dermatol Sci. 40(1): Chicago, IL, USA. 5 Badylak, S.F. et al. (2009). Acta Biomaterialia. 5(1): Ghanaati, S. et al. (2011). Biomed Mater. 6(1): * Additional information regarding indications for 7 Rocchietta, I. et al. (2012). Int J Periodontics Restorative Dent. 32(1): e Geistlich Bone Substitutes can be found on the back 8 Nevins, M. et al. (2011). Int J Periodontics Restorative Dent. 31(4): panel of this brochure. 9 Biocompatibility according to ISO :2001. Data on file, Geistlich Pharma AG, Wolhusen, Switzerland. 4 5 Cell Ingrowth ST GMG -cms GMG -sms ST Integration/Regeneration 20 µm 100 µm 10 µm Biofunctionality in a Predictable Matrix is a unique resorbable collagen matrix designed specifically for soft-tissue regeneration as an alternative to autologous soft-tissue grafts. 9 The matrix was developed using the free gingival graft as a model. The collagen in is specifically processed to encourage immediate blood clot stabilization. This leads to early vascularization, 6,7 facilitates soft-tissue cell ingrowth 6 and excellent integration of the matrix with the surrounding tissues. 6,7 Clinical Efficacy and Ease of Use is indicated for recession defects and increasing the zone of keratinized tissue, as illustrated in the image below. Case courtesy of Dr. Michael K. McGuire and Dr. E. T. Scheyer Houston, TX, USA.

4 Unique Collagen Matrix 1 Rapid Blood Clot Stabilization and Vascularization 2,3 Significant Soft-Tissue Cell Ingrowth Leading to Integration 2,3 Soft-Tissue Regeneration and Long-Term Clinical Success Biocompatibility according to ISO :2001. Data on file, Geistlich Pharma AG, Wolhusen, Switzerland. 2 Ghanaati, S. et al. (2011). Biomed Mater. 6(1): Rocchietta, I. et al. (2012). Int J Periodontics Restorative Dent. 32(1): e Schmitt, C.M. et al. (2016). Clin Oral Implants Res. 27(11):e

5 Proven Advantages for Your Patients Less Pain and Morbidity: Absence of a donor site significantly reduces post-operative pain. 1 Avoids post-operative complications such as numbness, which often persists for several weeks. 2,3 Less Surgical Chair Time: Eliminates need to harvest an autologous graft. Surgery time is reduced by 30% compared to connective tissue grafts. 1,4 Faster Soft-Tissue Healing: Early healing of a surgical wound in open healing situations is significantly faster when covered with than in spontaneous healing. 5 Natural Soft-Tissue Color and Structure: Natural texture and color match to surrounding native tissues resulting in improved esthetics after treatment with. 6,7 Clinical studies show that the use of significantly reduces total surgery time and post-operative pain. Time (min) Advantages for Your Patients 32.5 Geistlich Mucograft Total Surgery Time 30% less chair time 46.3 CTG Significantly less surgical chair time with when compared to connective tissue graft (CTG). 4 The Essential Treatment for Soft-Tissue Regeneration delivers esthetic results while improving patient comfort Sanz, M. et al. (2009). J Clin Periodontol. 36(10): Del Pizzo, M. et al. (2002). J Clin Periodontol. (9): Soileau, K.M. et al. (2006). J Periodontol. 77(7): Lorenzo R, et al. (2012). Clin. Oral Impl Res. 23(3): Thoma D, et al. (2012). J Clin Periodontol. 39(2): McGuire, M.K. et al. (2010). J Periodontol. 81(8): McGuire, M.K. et al. (2016). J Periodontol. 87(3): Ibuprofen dose (mg) Total Ibuprofen Dose 10 Days Post-Operative 720 Geistlich Mucograft Less pain 5140 CTG Significantly less patient pain with as compared to connective tissue graft (CTG)

6 Recession Coverage Treatment with Dr. Michael K. McGuire Houston, TX, USA 1 Year Excellent outcome in the esthetic zone Treatment to Increase Keratinized Tissue with Dr. Alan Charles Pasadena, CA, USA 4 mm Keratinized tissue at 6 months post-operatively Objective: Achieve root coverage combining Geistlich Mucograft with coronally advanced flap (CAF) without the morbidity of soft-tissue graft harvest. Conclusion: Recession coverage with and CAF provides an acceptable option to connective tissue graft and CAF. A notable creeping attachment of the gingiva is observed in this case with during the healing of the surgical site and optimal outcomes after 6 months appear to have further improved at 1 year follow-up. is the ideal solution as an alternative to autologous soft-tissue grafts to increase the width of keratinized tissue and regeneration of the soft-tissue in recession defects. Objective: Increase the width of keratinized tissue around implants with, while also achieving vestibule creation and improved access for oral hygiene. Conclusion: can be used as an alternative to significantly increase the zone of keratinized and attached tissue around existing implants. In addition, good texture and color match to the surrounding native tissues was observed on the mucogingival tissues regenerated with the collagen matrix. provides early vascularization and good tissue integration with no harvest-site morbidity. 1-7 Jaw Region Restorative Status Gingival Biotype Upper Jaw Anterior Tooth Thick Lower Jaw Posterior Implant Thin Jaw Region Restorative Status Gingival Biotype Upper Jaw Anterior Tooth Thick Lower Jaw Posterior Implant Thin Material/Technique >, Split-thickness flap (coronally advanced) and submerged healing Material/Technique >, Split-thickness flap and open healing Pre-operative image showing the recession defect on tooth #6. 2 After elevation of a partial thickness flap, the interdental papillae are de-epithelialized. 3 is placed over the defect and sutured to the papillae. 4 The flap is coronally advanced and sutured completely covering the collagen matrix. 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 is sutured to the recipient bed and left exposed. 4 Underneath the fibrin clot, the area appears to granulate 1 week post-operative. 5 Healing of the surgical site 1 week after treatment. 6 Post-operative situation after 4 weeks. 7 Surgical site 3 months post-operative. 8 Outcome 1 year after treatment. 5 Excellent wound healing 4 weeks after surgery. 6 Surgical site view 3 months post-operative. 7 Lugol s iodine staining delineating keratinized tissue at 6 months. 8 Mucogingival appearance (4 mm of keratinized tissue) 6 months post-surgery. 1 Sanz, M. et al. (2009). J Clin Periodontol. 36(10): Konter, U. et al. (2010) Deutsche Zahnärztliche Zeitschrift. 65: Herford, A.S. et al. (2010). J Oral Maxillofac 1 Surg. 68(7): McGuire, M.K. et al. (2010). J Periodontol. 81(8): Cardaropoli, D. et al. (2012). J Periodontol. 83(3): Ghanaati, S. et al. (2011). Biomed Mater. 6(1): Rocchietta, I. et al. (2012). Int J Periodontics Restorative Dent. 32(1): e

7 Our Extended Product Range Extraction Socket Treatment with Seal Dr. Ken Akimoto Issaquah, WA, USA 8-10 Weeks for soft-tissue maturation and quality with Geistlich Mucograft 1 Objective: Minimize alveolar ridge remodeling and natural soft-tissue appearance following tooth extraction for early implant placement in the esthetic zone. Conclusion: The use of biomaterials post-extraction resulted in minimizing alveolar ridge volume reduction and maximizing soft-tissue healing. 2,3 The combination of Seal and Geistlich Bio-Oss Collagen provides the ideal solution for the successful management of extraction sockets. Jaw Region Restorative Status Gingival Biotype Upper Jaw Anterior Tooth Thick Lower Jaw Posterior Implant Thin Material/Technique > Geistlich Bio-Oss Collagen, Seal Soft-Tissue Management Following Tooth Extraction Ridge preservation with Seal and Geistlich Bio-Oss Collagen minimizes ridge resorption in extraction sockets with preserved alveolar buccal walls. Soft-tissue quality and maturation after 8 10 weeks provides an ideal contour for early implant placement. 1 Seal and Geistlich Bio-Oss Collagen preserve significantly more bone volume than spontaneous healing. 1 1 Pre-operative situation, tooth #7 with periapical infection and horizontal fracture. 2 Occlusal view of the clinical situation prior to extraction of tooth #7. 3 Extraction socket with Geistlich Bio-Oss Collagen in place. 4 Seal is placed over the extraction socket and secured with single interrupted sutures. Clinical Benefits Faster wound healing 1,2 and tissue integration 1,3 Natural color and texture adaptation 2,3 Simple application and shorter procedure times Ideal when paired with Geistlich Bio-Oss Collagen for early implant placement 5 Soft-tissue healing at the time of implant placement, 3 months following tooth extraction. 6 Buccal view showing excellent soft-tissue healing and keratinized tissue. 7 Buccal view at 5 months post implant placement. 1 Jung, R.E. et al. (2013). J Clin Periodontol. 40(1): Seal report on the meeting of the Advisory Committee, data on file 3 Thoma, D. et al. (2012). J Clin Periodontol. 39: Final restoration in place, 2 years post-extraction

8 Product Range by Therapeutic Area Mucograft Product Range Our matrices are essential components in the treatment of a broad range of therapeutic areas and are available in a variety of options to meet your handling and delivery needs. Sizes: 15x20mm, 20x30mm Resorbable Collagen Matrix designed specifically for soft-tissue regeneration. Recommended Matrices Products By Therapeutic Area Matrices Products Extraction Socket Management Minor Bone Augmentation Soft-Tissue Regeneration Major Bone Augmentation Sinus Floor Elevation Periodontal Regeneration Peri-Implantitis Seal Size: 8mm in diameter Resorbable Collagen Matrix designed specifically for extraction socket management. Seal At Geistlich Biomaterials, we are committed to developing treatments that are uniquely matched to the clinical situations you see every day. That s why we do more than bring you a family of products we provide proven solutions in specific therapeutic areas. Extraction Socket Management Minor Bone Augmentation Soft-Tissue Regeneration Major Bone Augmentation The Ideal Combination For extraction socket cases where additional bone volume is needed, Geistlich Bio-Oss Collagen is the ideal companion to Seal. Sinus Floor Elevation Periodontal Regeneration Peri-Implantitis 14 15

9 Geistlich Pharma North America, Inc. 202 Carnegie Center Princeton, NJ Customer Care Toll-free: CAUTION: Federal law restricts these devices to sale by or on the order of a dentist or physician. Indications: and Seal are indicated for the following uses: Covering of implants placed in immediate or delayed extraction sockets, localized gingival augmentation to increase keratinized tissue (KT) around teeth and implants, alveolar ridge reconstruction for prosthetic treatment, recession defects for root coverage. Warnings: As and Seal are collagen products, allergic reactions may not be totally excluded. Possible complications which may occur with any surgery include swelling at the surgical site, flap sloughing, bleeding, dehiscence, hematoma, increased sensitivity and pain, redness and local inflammation. Indications: Geistlich Bio-Oss Collagen is indicated for the following uses: 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); and Filling of peri-implant defects in conjunction with products intended for GBR. Warnings: Possible complications which may occur with any surgery include swelling at the surgical site, flap sloughing, bleeding, local inflammation, bone loss, infection or pain. As Geistlich Bio-Oss Collagen contains collagen, in very rare circumstances cases of allergic reactions may occur. For more information on contraindications, precautions, and directions for use, please refer to the Geistlich Biomaterials Instructions for Use at: GB E 2018 Geistlich Biomaterials