Exactly like no other... Your 2018 guide to Geistlich Biomaterials

Transcription

1 Exactly like no other... Your 2018 guide to Geistlich Biomaterials

2 Contents Exactly like no other...3 Can half a commitment, earn all of your trust?... 4 How do you guarantee a solid implant foundation?...5 What do you value most from a biomaterial?... 6 Are all biomaterials really the same?... 7 Is GBR more effective with or without a membrane?... 8 What are the benefits of early membrane vascularisation? What is the optimal barrier time for a collagen membrane?...12 Geistlich Bio-Gide in the Sausage Technique...14 UK Case focus: Dr. Nihir Shah...16 Geistlich UK 2018 Price List...18 Geistlich Partner Products & 2018 Price List...19 Regeneration resources...20 Geistlich 2018 Education programme...21 Your Geistlich Product Specialist contact details... 22

3 Exactly like no other... Dear Dental Colleague, Your Geistlich Regeneration Support Team would like to welcome you to your 2018 guide to Geistlich Biomaterials. With this document, we have sought to provide you with a single resource, to which you can refer for all matters relating to the regeneration of hard and soft tissue. The guide contains information relating to; educational resources and upcoming events, resources to support hard and soft tissue regeneration, pricing and ordering details for the expanded range of Geistlich biomaterials, including all Geistlich partner products. And of course, contact details for your local Geistlich Product Specialist. If you have any feedback or requests regarding Geistlich biomaterials, please speak to your Geistlich Product Specialist and as a team, we will endeavour to support you to the best of our ability. Best Wishes for 2018 Your Geistlich Regeneration Support Team 3

4 Can half a commitment, earn all of your trust? Geistlich company founder, Dr. E. Geistlich s expertise is the origin of what we have become today: No. 1 in regenerative dentistry. Regeneration isnt just part of our business, it s 100% and always has been. Thanks to intensive research and close collaboration with scientists and dentists over 30 years ago, Dr. Peter Geistlich created pioneering products for a new technology, Guided Bone Regeneration (GBR). Organic components were removed from bone for the first time without alteration to its microstructure and mineral part. This is how Geistlich Bio-Oss, a bovine-based bone replacement material whose structure and chemical composition resembles human bone, came into being. In consequence, Dr. Peter Geistlich achieved another milestone with the development of Geistlich Bio-Gide, a natural bi-layer collagen membrane. Geistlich Bio-Gide enables surgical techniques to be simplified, superseding non-resorbable e-ptfe membranes. Prof. Mariano Sanz Madrid, Spain Geistlich products have gained my trust down the years. 4 Expertise in collagen processing Along with bone-processing, Geistlich has specialised in the processing of collagen for over 160 years and have refined this expertise from generation to generation. Manufacturing processes and systems have been continually optimised to make them cutting edge in their field. Today's range comprises many specialised collagen products such as a membrane with a barrier function (Geistlich Bio-Gide ), with a scaffold function for soft tissue regeneration (Geistlich Mucograft ) and products designed for easy handling (Geistlich Bio-Oss Collagen).

5 How do you guarantee a solid implant foundation? How about GBR using Geistlich Bio-Oss and Geistlich Bio-Gide! Guided Bone Regeneration uses the body s regenerative capability to reconstruct missing bone. Compared to other regenerative techniques, GBR has proved to be especially dependable. 2 Predictable results can be obtained both functionally and aesthetically, even in complex cases. The GBR success story is the result of close and inspiring collaboration between Geistlich Biomaterials and leading dental specialists. The combined application of Geistlich Bio-Oss and Geistlich Bio-Gide as a part of GBR is today considered the standard therapy for a wide range of indications. 4 The Dream Team With Geistlich Bio-Oss and Geistlich Bio-Gide a dentist can have confidence that they are using complimentary products that have extensive scientific documentation and proven efficacy in millions of clinical applications. > High long-term implant survival rate 3 > Excellent aesthetic long-term results 4 > Easy and safe to use Prof. Daniel Buser Berne, Switzerland GBR with biomaterials from Geistlich succeeds aesthetically and functionally, is extremely reliable and features minimal risk of aesthetic complications. Prof. Maurício Araújo MARINGÁ, BRAZIL I have faith in Geistlich Biomaterials because they are scientifically proven and have been used successfully in practice for years. 2 Aghaloo TL et al., Int J Oral Maxillofac Implants. 2007; 22(suppl): Jung R et al., Clin Oral Implants Res Oct;24(10): Buser D et al., J Dent Res Dec;92(12 Suppl):176S 82S. 5 Pubmed 2014 Search term, Bio-Oss or Bio-Gide or Mucograft. 6 idata Research Inc., US Dental Bone Graft Substitutes and other Biomaterials Market, idata Research Inc., European Dental Bone Graft Substitutes and other Biomaterials Market,

6 What do you value most from a biomaterial? How about long-term evidence from the worldwide no. 1 reference? Geistlich Bio-Oss and Geistlich Bio-Gide are the experts in regenerative dentistry. Some 1,000 pre-clinical and clinical studies5 prove the successful use in practice. No other supplier has the experience of Geistlich Biomaterials when it comes to the number of patients treated and products sold. For almost 30 years Geistlich Biomaterials has been the undisputed no. 1 in regenerative dentistry. 6,7 Numerous studies prove excellent long term results... After years implants that were placed in bones augmented with Geistlich Bio-Oss and Geistlich Bio-Gide show the same survival rate as implants in pristine bone. 3 Implants in intact bone GBR with Geistlich Bio-Oss and Geistlich Bio-Gide Reliable 91.9% Implant survival rate after years Implant survival rate (%)...and stable aesthetic results Guided Bone Regeneration with Geistlich Bio-Oss and Geistlich Bio-Gide yield reliable results in aesthetic terms. Due to the contour augmentation the facial bone wall was able to be preserved in 95% of patients over a period lasting from 5 to 9 years. 4,5 Predictable Excellently preserved facial bone wall after 5 9 years Minor bone augmentation, Prof. D. Buser 3 Jung R et al., Clin Oral Implants Res Oct;24(10): Buser D et al., J Periodontol Nov;84(11): Jensen SS et al., J Periodontal Nov;85(11):

7 Are all biomaterials really the same take a closer look! Unique biofunctionality The excellent results of Guided Bone Regeneration with Geistlich Bio-Oss and Geistlich Bio-Gide are largely due to their unsurpassed biofunctionality. The products are perfectly suited to combined use: Geistlich Bio-Oss forming the scaffold for the in-growing blood vessels and bone-forming osteoblasts while Geistlich Bio-Gide shields the young bone from the surrounding connective tissue cells and supports in wound healing. Geistlich Bio-Oss the bone replacement material with outstanding biofunctionality Geistlich Bio-Oss is very similar to human bone in its structure and chemical make-up. The biofunctional biomaterial aids vasculari sation and the formation of new bone.8 The slow resorption of Geistlich Bio-Oss increases the stability of the augmentation material9 the best prerequisite for long-term implant survival rates.3 Geistlich Bio-Oss : Unique macro- and micropore structure Magnification: 200x Magnification: 5000x Magnification: 200x Magnification: 4900x Geistlich Bio-Gide the unique bi-layer collagen membrane Geistlich Bio-Gide is a porcine collagen membrane without any artificial cross-linking which closely resembles human collagen. The natural bi-layer structure promotes reliable bone regeneration10 and excellent tissue integration on account of an optimal barrier duration. The soft tissue heals without scarring and largely without complications.11 Geistlich Bio-Gide : Unique arrangement of collagen fibres (rough side) Jung R et al., Clin Oral Implants Res Oct;24(10): Galindo-Moreno P et al., Clin Oral Impl Res. 2010;21: Orsini G et al., Oral Diseases. 2007; 19: Schwarz F et al., Clin Oral Implants Res Sep;25(9): Becker J et al., Clin. Oral Implants Res. 2009; 20(7):

8 Is guided bone regeneration more effective with or without a collagen membrane? More bone volume and improved bone quality lead to a higher implant survival rate 5 98% 95% 92% 89% 86% Implant survival rate (%) % 9.3% 88.60% Membrane 83% 80% without membrane with membrane By using a membrane for sinus floor elevation, the implant survival rate is significantly increased by 9.3% (meta-analysis in humans). 6 The high therapy safety, delivered by Geistlich Bio-Gide, is the basis for a high-quality treatment.

9 More bone volume with better bone quality Significantly more bone formation 3 (Graph 1) and a 37% higher bone density 4 (Graph 2) underneath Geistlich Bio-Gide compared to defects without membrane covering. Defect closure in % Bone density in % ,8 2 weeks 60,2 26,9 88,7 32,8 90,0 4 weeks 12 weeks ,0 75,6 65,5 89,9 8 weeks 16 weeks Graph 1: measured by microradiography and micro-ct imaging in a rat model Graph 2: measured by CT scan and compared to the intact adjacent alveolar bone in a dog mandible Control (no membrane) Synthetic test membrane eptfe Geistlich Bio-Gide Control (neither bone substitute nor membrane) Geistlich Bio-Oss Geistlich Bio-Oss and Geistlich Bio-Gide 1 Gielkens PFM et al., Clin Oral Implants Res. 2008; 19(5): Kim M. et al., In Vivo. 2008; 22(2): ; 12(1): Pjetursson BE et al., J Clin Periodontol. 2008; 35:

10 What are the benefits of early membrane vascularisaion? Early membrane vascularisation supports bone regeneration. The early membrane vascularisation of Geistlich Bio-Gide plays a central role in guided bone regeneration (GBR) 1, 2, 6 as angiogenesis is fundamental to new bone formation. The benefits of early membrane vascularisation Supports bone formation 1, 6 Wound stabilisation 2, 3 2, 3, 6 Oxygen and nutrient transfer Tissue integration 3, 7 Uneventful wound healing 4, 5 Membrane with slower vascularisation 1. Schwarz F et al. Clin. Oral Implants Res. 2008; 19 : Hardwick R et al. Quintessence Publishing. 1994; Schwarz F et al. Clin. Oral Implants Res. 2006; 17 : Becker J et al. Clin. Oral Implants Res. 2009; 20(7) : Tal H et al. Clin. Oral Implants Res. 2008; 19(3) : Wang Y et al. Ann N Y Acad Sci. 1117, 2007 : Rothamel D et al. Clin. Oral Implants Res. 2005; 16 :

11 * dog model The dense network of blood vessels is surrounded by newly formed trabeculae of woven bone at two weeks. New bone formation occurs not only adjacent to the bone defect but also directly underneath Geistlich Bio-Gide due to its early and complete vascularisation.1 Wound healing is characterised by ongoing bone formation at six weeks. The blood clot has transformed into a primary spongework of woven bone, reinforced by parallel-fibred bone.1 By 12 weeks, healing is mainly characterised by ongoing filling of the intertrabecular spaces where maturation to lamellar bone begins.1, 7 Early vascularisation with Geistlich Bio-Gide

12 What is the optimal barrier time for a collagen membrane? Stabilisation of the defect 0 days Grafting strong foundation The bony defect is grafted with Geistlich Bio-Oss and covered with Geistlich Bio-Gide. Bleeding ends and hemostasis is initiated. The unique bi-layer structure of Geistlich Bio-Gide comprises a smooth and a rough, open-pored layer. Due to its porous structure and high hydrophilicity Geistlich Bio-Gide takes up the blood quickly including growth factors and nutrients day 2 7 days 1 2 weeks Coagulum first stabilisation Proliferation re-integration Remodelling active osteoblasts Via coagulation the blood clots. A fibrin network forms within 24 hours to stop blood from running. It is essential that the coagulum remains stable.13 This enables the structure of the regenerating tissue to adapt to the surrounding tissue. Early proliferative phase is characterised by the formation of blood vessels to ensure oxygen supply. During approximately seven days the coagulum is replaced by granulation tissue.14 Epithelial proliferation begins from the margins of the wound. Granulation and connective tissue are present after 7 days14 and the formation of osteoid matrix is underway. Remodeling phase starts after 1 2 weeks centripetal from the residual walls along the vascular structures.14 Osteoblasts continue to deposit osteoid matrix and start mineralisation. Geistlich Bio-Gide stabilizes the grafted area, protecting bone particles from dislocation.6 At the same time Geistlich Bio-Gide separates soft and hard tissue.5 Geistlich Bio-Gide protects the blood clot.13 New blood vessel formation occurs not only adjacent to the bone defect but also directly underneath Geistlich Bio-Gide due to its early and complete vascularisation.13 The rough membrane layer, facing the bony part of the defect, enables osteoblast growth. 12

13 Easy to pin if you choose to! Protective function fulfilled Geistlich Bio-Gide in the Sausage Technique Combining winning factors available is the key to success. Your surgical expertise is supported by the material excellence provided by Geistlich Bio-Gide : The carefully preserved native bilayer structure of Geistlich Bio-Gide supports reliable hard tissue regeneration.1 Due to its good adhesive properties Geistlich Bio-Gide does not need additional fixing in most applications weeks CorticalIsation stable scaffold Bone formed from woven fibres occupies almost the whole defect volume prior to corticalisation. After 2 3 months the tissue has been gradually replaced by lamellar bone and bone marrow.14 The structure is fairly stable although the bone is not yet mature. The protective function of the Geistlich Bio-Gide membrane is fulfilled. It assisted the natural healing process long enough: The regenerating areas are pre-determined for their desired function and will develop accordingly. Until 6 months Maturation final stability Maturation of the bony trabeculae continues until they are adapted to the structure of the surrounding tissue.14 Additionally the new bone as well as residual graft particles are subjected to continuous remodelling processes. Its elasticity enables the surgeon to create a mechanically stable augmentation area.3 The good liquid uptake of Geistlich Bio-Gide ensures that growth factors and nutrients from the blood are taken up.4 The membrane effectively protects the graft by secluding the grafted area from both ingrowth of soft tissue5 and mechanical dislocation.6 Geistlich Bio-Gide s outstanding biofunctionality7,8 reduces the risk of dehiscences during healing in comparison to other membranes.6,9,10 Temporary barrier instead of unnecessary blockade: Once the protective function of Geistlich Bio-Gide has been fulfilled the membrane resorbs. The natural complex structures of the soft tissue, with all the intrinsic components such as the periosteum are formed.15 11

14 Key to success Your surgical expertise Clinical case by Prof. Istvan Urban Budapest (Hungary) Occlusal view of severely atrophied posterior mandibular ridge. Full thickness flap is opened using a mid-crestal incision plus two divergent vertical incisions. 4 A periosteal releasing incision connects the two vertical incisions achieving enough flap elasticity. The flap is then sutured in two layers using horizontal mattress sutures and single interrupted sutures. 2 Buccal view after application of 1:1 mixture of autogenous particulated bone and Geistlich Bio-Oss granules. The Geistlich Bio-Gide membrane is secured on the crest before the application of the graft. 5 Occlusal view of the regenerated ridge at re-entry after 7 months. Two implants were placed with good primary stability. Note the excellent incorporation of the Geistlich Bio-Oss with the autograft. 3 Buccal view of a single Geistlich Bio-Gide membrane, which is fixed with titanium pins. The fixed membrane immobilizes the bone graft creating the sausage skin effect. 6 Final outcome 2 years after implant loading. Ask your local Geistlich contact person for the detailed Indication Sheet. Please note: The use of pins is part of the displayed surgical technique. In the great majority of surgical procedures fixing Geistlich Bio-Gide with pins is not needed. Pins used: Meisinger Key to success our expert membrane Combining winning factors available is the key to success. Your surgical expertise is supported by the material excellence provided by Geistlich Bio-Gide : The carefully preserved native bilayer structure of Geistlich Bio- Gide supports reliable hard tissue regeneration. 1 Due to its good adhesive properties Geistlich Bio-Gide does not need additional fixing in most applications. 2 Its elasticity enables the surgeon to create a mechanically stable augmentation area. 3 The good liquid uptake of Geistlich Bio- Gide ensures that growth factors and nutrients from the blood are taken up. 4 The membrane effectively protects the graft by secluding the grafted area from both ingrowth of soft tissue 5 and mechanical dislocation. 6 Geistlich Bio-Gide s outstanding biofunctionality 7,8 reduces the risk of dehiscences during healing in comparison to other membranes. 6,9,10 native bilayer structure 11 Suture pull-out 2 Elongation 2 Liquid uptake 4 Fibroblast proliferation 12 non-native 0N* 0% 0 wet(mg)/dry(mg) 0 cells/mm 2 native 10N* 60% 7 wet(mg)/dry(mg) 70 cells/mm 2 Osteoblast proliferation 12 0 cells/mm cells/mm 2 Level of achievement of Geistlich Bio-Gide * In vitro tests in pig mucosa document a mean breaking force of 10N. 16 difference to given max

15 Geistlich Bio-Gide in the Sausage Technique Easy to pin if you choose to!

16 UK Case Focus: Ridge Preservation using Geistlich Bio-Gide Shape following removal of a lateral incisor & replacement with a bridge Dr Nihir Shah BSc, BDS, FDS RCS (Eng) Specialist in Oral Surgery ADI certified mentor in dental implantology GDC No: Dr Nihir Shah qualified from Kings College London in 1992 having also obtained an additional Intercalated Basic Science Degree. He subsequently trained at some of the leading oral surgery units in the UK and was awarded the Fellowship in Dental Surgery from the Royal College of Surgeons of England in Nihir then worked as a Staff Grade in the Oral & Maxillofacial Unit at Northwick Park Hospital and was actively involved in teaching and research. At the same time he was developing his private practice and acquired the Stag Lane Dental Centre in Nihir is an experienced general dentist as well as being a specialist in oral surgery. He takes referrals for dental implants and oral surgery and is a mentor for the Association of Dental Implantology (ADI). The patient was a 55 yearold male, who presented with a fractured crown on the palatal aspect of the UR1 (Fig 1 and 2). I was acutely aware of the fact that in the future there may well be recession around the pontic site, which would then present an aesthetic challenge. The UL1 tooth also had a porcelain fracture and after discussion of the options, the patient opted to replace both of the long-standing upper central incisor crowns. A pre-op periapical radiograph (Fig 3) however revealed a large radiolucent lesion mid-way on the UL2, from which the patient had no symptoms. The tooth was deemed to be hopeless and a further discussion regarding the available options was had with the patient. These included; extraction of the tooth and provision of a denture, a cantilever bridge from the UL1 (as the crown was to be replaced anyway) or an implant. The patient was not currently in a situation to have an implant, although did express that it was something he would consider in the future. He was keen on the option of a single cantilever bridge and a decision was made to carry out ridge preservation in the meantime. I was acutely aware of the fact that in the future there may well be recession around the pontic site, which would then present an aesthetic challenge. The rationale behind the carrying out a ridge preservation procedure was to preserve the ridge and keep the soft tissue in place to ensure a positive aesthetic outcome in the future. Under local anaesthesia the UL2 was extracted using minimally traumatic techniques including the use of a periotome and a luxator (Fig 4). The socket was thoroughly curetted and soaked with a chlorhexidine swab. A Geistlich Bio-Gide Shape membrane was placed on the buccal aspect and the socket was grafted using Geistlich Bio-Oss particles (Fig 5-7).

17 The top of the Bio-Gide Shape membrane was flipped over the ridge and tucked under the gingiva and, in this case, no suture was placed as the provisional pontic would be holding the membrane in place. A chair-side provisional cantilever bridge was constructed and fitted and the patient was reviewed two weeks later. The extracted tooth (Fig 8) had severe internal/external resorption below the CEJ. Two weeks later, the patient reported minimal discomfort and the surgical site was healing well. 6 weeks later, the patient attended for final impressions and the final zirconia single unit crown on the UR1 and cantilever bridge on the UL1-2 was fitted. (Fig 9) I carry out a number of ridge preservation procedures and in this case, the Bio-Gide Shape membrane performed and handled very well. The patient was delighted with the final outcome and that the RP procedure had worked and that the height and width of the gingiva were maintained. A longer term follow-up is required to further support this outcome. I carry out a number of ridge preservation procedures and in this case, the Bio-Gide Shape membrane performed and handled extremely well. An initial reservation was that the membrane looked large for the required area, however in the end the membrane was not trimmed and tucked in under the gingiva extremely well. The long-term benefits of ridge preservation are well documented and have been shown to be beneficial for the maintenance of sites under bridge pontics

18 Geistlich UK Price List 2018 Clinical Products GBR-System System for Natural Bone Regeneration Price 1 Geistlich Bio-Oss Spongiosa granules mm 0.25 g g g g mm 0.50 g g g Spongiosa block cm 1 block Collagen block (90% Geistlich Bio-Oss ) 100 mg 1 block mg 1 block Geistlich Bio-Oss Pen Spongiosa granules mm 0.5 cc mm 1.0 cc mm 1.5 cc Geistlich Bio-Gide Resorbable bilayer membrane mm 1 membrane mm 1 membrane NEW Geistlich Bio-Gide Compressed mm 1 membrane NEW Geistlich Bio-Gide Shape mm 1 membrane Geistlich Combi-Kit Collagen Geistlich Bio-Gide membrane Geistlich Bio-Oss Collagen block mm 100 mg 1 membrane 1 block Geistlich Bio-Gide Perio Resorbable bilayer membrane mm 1 membrane Perio-System Combi-Pack Geistlich Mucograft Geistlich Bio-Gide Perio membrane Geistlich Bio-Oss Collagen block Collagen Matrix mm 100 mg mm mm 1 membrane 1 block matrix 1 matrix Geistlich Mucograft Seal Collagen Matrix 8 mm 1 matrix NEW Geistlich Fibro-Gide Volume stable Collagen Matrix mm 1 matrix Educational and Patient Support Products Prof. C Maiorana (Textbook) Bone augmentation in the aesthetic area with Bio-Oss & Bio-Gide Prof. C Maiorana & Prof M. Simion (Textbook) Advanced techniques for bone regeneration with Bio-Oss & Bio-Gide Prof. D Buser (DVD) Implant placement with simultaneous GBR Prof. G Watzek (DVD) Perfect sinus lift (Double DVD) Prof. D Buser (CD-ROM film 01e) Implant placement with simultaneous GBR technique Prof. D Buser (CD-ROM film 02e) Surgical techniques for sinus floor elevation Prof. D Buser (CD-ROM film 03e) Lateral ridge augmentation with GBR technique

19 Geistlich Partner products UK Price List 2018 Yxoss CBR An Exclusive Geistlich Partner Product Price 1 Yxoss CBR Area of defect Augmentation in area of 1 tooth Augmentation volume: Augmentation in area of 2 teeth Augmentation in area of 3 4 teeth Augmentation in area of 5 7 teeth Entire Jaw Area The augmentation volume will be calculated free of charge by ReOss FREE Backwards planning Cost per implant Packing and shipping to the UK Bone harvesting Safescraper Twist Pack of Micross Single unit Membrane tacks NEW Tufftack Set Single unit NEW Tufftack 3mm Tacks Pack of NEW Supertack Set Single unit NEW Supertack Hammer Single unit NEW Replacement applicator tip (short) NEW Replacement applicator tip (long) Single unit Single unit Terms and Conditions CARDNET available. 1 ex VAT. A postage, packing and administration charge will apply to all orders under 90. All orders subject to our terms and conditions. No returns accepted unless part of a valid product complaint. Orders received up to 12.30pm: next working day delivery. Orders received after 12.30pm: 2 working day delivery. Price list in effect from 1st January The Geistlich Goodwill offer is available to orders from all independent practitioners (not NHS or corporate orders). It provides for 1 unit of free product (usually Geistlich Bio-Oss small granules 0.5G) when 10 or more items are ordered; after that 2 free units are offered when 15 or more units are ordered; and 3 free units are available when 20 units are ordered in a single order. Please contact Geistlich Customer Service for more information. Geistlich Sons Limited and Geistlich Pharma A.G. are gathering your data in order to give you a better service. Our data is hosted in the server of our HQ in Switzerland, and we are following all the data protection act lawfully. If you do not wish to be part of our database please contact Geistlich Sons Limited at info@geistlich.co.uk to have your details removed. 15

20 Regeneration resources Patient Information Regeneration Expert Blog The Regeneration Expert is the blog for dental practitioners. Patient information leaflets for you to download Geistlich UK Vimeo Page Indication Sheet Concept View the latest surgical movies, animations and lectures High quality case presentations from the world s leading clinicians Indication Sheet V Dr. Mauro Merli Vertical Augmentation Literature 1 Esposito, M., Grusovin, M. G., Felice, P., Karatzopoulos, G., Worthington, H. V., Coulthard, P. Interventions for replacing missing teeth: horizontal and vertical bone augmentation techniques for dental implant treatment. Cochrane Database Syst Rev Cordaro L, Amadé DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. Clin Oral Implants Res 2002;13: Zitzmann NU, Naef R, Schärer P. Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. Int J Oral Maxillofac Implants 1997;12: Reddy KP, Nayak DG, Uppoor AS. A clinical evaluation of anorganic bovine bone graft plus 10% collagen with or without a barrier in the treatment of class II furcation defects. J Contemp Dent Pract Feb 15;7(1): Kim M, Kim JH, Lee JY, Cho K, Kang SS, Kim G, Lee MJ, Choi SH. Effect of bone mineral with or without collagen membrane in ridge dehiscence defects following premolar extraction. In Vivo Mar-Apr;22(2): Merli M, Bernardelli F, Esposito M. Horizontal and vertical ridge augmentation: a novel approach using osteosynthesis microplates, bone grafts, and resorbable barriers. Int J Periodontics Restorative Dent 2006;26: Merli M, Lombardini F, Esposito M. Vertical ridge augmentation with autogenous bone grafts 3 years after loading: resorbable barriers versus titanium-reinforced barriers. A randomized controlled clinical trial. Int J Oral Maxillofac Implants 2010;25: Merli M, Moscatelli M, Mazzoni A, Mazzoni S, Pagliaro U, Breschi L, Motroni A, Nieri M. Fence technique: guided bone regeneration for extensive three-dimensional augmentation. Int J Periodontics Restorative Dent Mar-Apr;33(2): Source of supply for special materials (used suture material, medication, implant system etc.) Vertical alveolar ridge augmentation by means of the fence technique with Geistlich biomaterials > Augmentation: Geistlich Bio-Oss ( mm); Geistlich Bio-Gide (30 40 mm). > Osteosynthesis plate: KLS Martin. > 3-D scanner: 3d DIEMME, Bioimaging Technologies. > Original publication of the technique on PubMed; Merli et al., Int J Periodontics Restorative Dent, 2013 > Suture material: Supramid 4/0, 5/0. > Implant System: Thommen SPI Element Inicell. > Antibiotics: Cefixima (Cefixoral) 400 mg cpr riv. > Histology performed by Dr. Annalisa Mazzoni, University of Bologna, Italy. Your contact > Address: viale Settembrini 17/O, Rimini (RN), Italy Telephone: fax: mauromerli@gmail.com, website: Further Indications Sheets in the same therapeutic area > Horizontal bone regeneration with autogenous intraoral block and Geistlich Bio-Oss contouring as well as Geistlich Bio-Gide covering (Prof. Carlo Maiorana, Dr. Mario Beretta; Italy) > Horizontal ridge augmentation utilising the resorbable Geistlich Bio-Gide membrane and a combination of particulated autogenous bone with Geistlich Bio-Oss (Prof. Istvan Urban, Hungary/USA) > Vertical ridge augmentation with autogenous bone, Geistlich Bio-Oss and a non-resorbable reinforced membrane (Prof. Massimo Simion, Italy; Dr. Isabella Rocchietta, UK/Sweden) > Vertical ridge augmentation with autogenous bone, Geistlich Bio-Oss and Geistlich Bio-Gide (Prof. Matteo Chiapasco, Italy) The Course Directory A full list of all Geistlich led and supported educational events 5 16 Geistlich Facebook page 1. Indication profile Region single tooth gap partially edentulous ridge multiple tooth gaps posterior region free end situation Remark: The shown procedure is also applicable in the aesthetic region, for single tooth loss or larger edentulous sites combined vertical and horizontal bone defect no bone defect present Remark: The shown procedure is applicable for both vertical and horizontal defects. Stay in touch with all the latest news and event updates. Bone situation primary wound closure possible simultaneously with bone augmentation (1 step) Soft tissue situation Implantation 1 primary wound closure not possible sequentially after bone augmentation (2 steps)

21 Geistlich UK 2018 Education Programme Join the UK s leading clinicians in our 2018 education programme! GBR and the open healing concept with Rob Oretti Saturday 8th September, Oakdale Dental, Leicester. Registration fee 99 Soft tissue augmentation with Dr. Charlie Maran Thursday 13th September, Dakota Hotel, Scotland. Registration fee 99 A hard and soft tissue masterclass with Ulpee Darbar and Cemal Ucer Saturday 22nd September, ICE Postgraduate Institute & Hospital, Salford. Registration fee 199. An evidence based approach to sinus augmentation Webinar with Dr. Stephen Barter Wednesday 3rd October, 7pm Fundamentals of Guided Bone Regeneration with Dr. Colin Burns Saturday 6th October, Scottish Centre for Excellence in Dentistry, Glasgow. Registration fee 99 CAD/CAM technology for major grafting cases Webinar with Dr. Marcus Seiler (Germany) Wednesday 14th November, 7pm New trends in bone reconstruction & Optimising GBR healing of biomaterials with L-PRF. With Dr. Mauro Merli (Italy) and Dr. Paul Stone Friday 7th December, Wellcome Collection London. Early bird fee 249 ( 299 after 14th September 2018). REGISTER FOR 2018 EVENTS REVIEW 2017 WEBINARS 17 17

22 Contact details Your Geistlich Product Specialist is here to provide support with all things Regeneration ; from updating you about the latest education courses, to provding you with the best value offers for Geistlich biomaterials. Contact details for Your local Geistlich Product Specialists Scotland & Northern England - Jill Pidgeon E.mail: Jill.Pidgeon@geistlich.com Tel: +44 (0) Central England - Jitesh Patel jitesh.patel@geistlich.com Tel: +44 (0) South West England and South Wales - Sasha Smith sasha.smith@geistlich.com Tel: +44 (0) London and the Home Counties - Adam Jennings adam.jennings@geistlich.com Tel: +44 (0) London and the South East - Nesh Bangard nesh.bangard@geistlich.com Tel: +44 (0) Your Geistlich Regeneration Support Team Geistlich UK Thorley House Bailey Lane Manchester Airport Manchester, M90 4AB Tel: +44 (0) Fax: +44 (0) orders@geistlich.co.uk marketing@geistlich.co.uk 18 18

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24 Geistlich UK Thorley House Bailey Lane Manchester Airport Manchester, M90 4AB Tel: +44 (0) Fax: +44 (0)