GEISTLICH BIOMATERIALS
LOCAL NEWS VOLUME 16, ISSUE 1, 2022
Help us Regenerate The Great Barrier Reef
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1st Geistlich Symposium - Sydney
Pioneering Science Delivers New Life to the Great Barrier Reef; Coral IVF Babies Breed for the First Time Ever!
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The Great Barrier Reef Foundation is Saving Our Reef
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Clinical Cases by Dr Justin Soon and Dr Peter Chen PAGE 16-17
Soft Tissue is the Issue A New Approach to Soft Tissue Regeneration
Recent events
Geistlich + You
10-11 March, 2022
There were so many reasons for attending the 3rd edition of our popular international congress! Over 4000 clinicians from around the world attended, listening to interactive lectures by renowned experts, and participating in our unique virtual hands-on workshop with Dr Nadja Nänni. The event took place across two sessions on 10 and 11 March 2022 to
accommodate both east and west time zones and simultaneously translated in Chinese, French, and Spanish. Joining Prof Ronald Jung (Switzerland), as the moderator, were top-class lecturers from the field of regenerative dentistry including A/Prof Stephen Chen (Australia), Prof Jae-Kook Cha (Korea) and many more.
ADX Sydney 16-19 March, 2022
The Australian Dental Expo is Australia’s premier dental event and was held this year at the International Convention Centre, Sydney following on from the ADA’s Sydney International Dental Conference (SIDCON). As such, this was the perfect opportunity for us to launch Geistlich Fibro-Gide® to Australian clinicians. This unique product for soft tissue management is now fully approved by the TGA and is available to all trained clinicians in Australia. It is a porcine, porous, resorbable and most importantly volume-stable collagen matrix, specifically
designed for soft tissue regeneration. Also, returning in 2022, were our very popular in-booth hands on sessions. These interactive demonstrations, provided our visitors with the chance to feel and experience the handling of our biomaterials and meet our very special Geistlich Product Specialists. And not to be missed, we were pleasantly surprised by the popularity of our learning labs, presented by our very own Dr George Alexopoulos BDSc. (Melb.), MBA (Monash), MSc. Oral Implantology (Frankfurt), PhD (Melb) where attendees learned the role of biomaterials in Guided
ANZAP One Day Hybrid-Meeting 25 March, 2022
In light of the ever-changing nature of travel restrictions, the Australia, New Zealand Academy of Periodontists (ANZAP) had planned a hybrid event with face-to-face meetings in different locations around the country for local clinicians to attend. Held in Perth, Melbourne, Sydney, Adelaide, Brisbane and Auckland, they were well attended with live streaming of all
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lectures and discussions into local groups. In particular Italy’s renowned physician Dr Paolo Casentini’s presentation on Prosthetically Guided Regeneration: Novel Techniques in Soft Tissue Thickening & Customised Bone Augmentation. As proud sponsors, we were excited to be a part of this fantastic hybrid event and provide ongoing support for the continuing education of our industry.
Bone Regeneration, Alveolar Ridge Preservation and the role of collagen in soft tissue management. Without doubt a fantastic few days and it was enormously satisfying to be back in touch with our customers and the industry as a whole.
Recent events
1 st Geistlich Symposium Sydney
21-22 October, 2022
SAVE THE DATE The Future of Regeneration is Here! Advances in Oral Regeneration Venue: Park Hyatt, Sydney Program: Stay tuned! More information coming soon!
International speaker: Matteo Chiapasco
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Focus
The Great Barrier Reef Foundation is Saving our Reef The Great Barrier Reef is a unique ecosystem; home to thousands of species of marine life, including fish, whales, dolphins, and six of the world’s seven species of marine turtle and one of the Seven Wonders of the World. Geistlich Pharma Australia and New Zealand are partnering with the Great Barrier Reef Foundation, donating much needed funds to this worthwhile cause. Regeneration is close to our heart, and the similarities between our regenerative products and coral reefs is amazing. So while the Great Barrier Reef Foundation is saving our reef and all its living diversity for future generations, Geistlich are proud to be the leader in hard and soft tissue regeneration. The Great Barrier Reef Foundation; All fundraising is directed at projects with large-scale impact – helping protect the coral reefs and the animals that depend
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on them. Working closely with the Great Barrier Reef Marine Park Authority, we help to regenerate and restore the Great Barrier Reef, building its resilience in the face of major threats. With the landmark review and implementation of the Reef 2050 Long-Term Sustainability Plan, we’re helping to deliver practical solutions and actions for the Reef more quickly, more efficiently and more effectively. We use independent science to better understand the true condition of the Reef and the challenges it faces so we know where to focus our efforts. We inform and educate people about what needs to be done to address the causes of the problem, including advising government and industry and we take practical action to fund hard work and innovative technologies from the best minds in Australia and beyond to protect the Reef.
Our Reef is an irreplaceable eco-system facing a growing combination of threats, but there is hope, together with our partners we are already making an impact with our Coral IVF project, Coral Probiotics, saving reefs in a warming ocean, and Cementing Coral Reefs, which provides a stabilising reef structure in an ever-changing environment, to name just a few. The Foundation is directly advised by an International Scientific Advisor Committee (ISAC) made up of leaders of research and management on the Reef including the Great Barrier Reef Marine Park Authority, the Australian Institute of Marine Science, University of Queensland, James Cook University and the CSIRO which is an incredibly important component of the rigorous governance process for prioritising projects. Ref: The Great Barrier Reef foundation
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Pioneering science delivers new life to the Reef Our Reef is the largest living thing on Earth, with rich corals spanning an area visible from space. But it’s facing a growing combination of threats and without help the outlook is bleak. Saving the Reef is a huge task, but there is hope. Our first batch of Coral IVF babies, which we grew from microscopic larvae and planted on the Reef in 2016, have reproduced for the first time, giving hope that this innovative technique could successfully restore damaged reefs. In an exciting development, researchers revisited 22 large coral colonies around Heron Island that were born through the first Coral IVF trial on
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the Great Barrier Reef and noted they have survived a bleaching event and grown to maturity. In this year’s coral spawning event, they produced their first batch of coral larvae, or baby corals. This is the first time a breeding population has been established on the Great Barrier Reef using this groundbreaking process. Coral IVF is a world-leading technique to grow baby corals and use them to restore damaged coral reefs. Our researchers capture coral eggs and sperm, called spawn, from healthy reefs and rear millions of baby corals
in specially-designed floating pools on the Reef and in tanks. When they are ready, we deliver them onto damaged reefs to restore and repopulate them. Great Barrier Reef Foundation Managing Director Anna Marsden said the results are promising. “We couldn’t be more excited to see that these coral babies have grown from microscopic larvae to the size of dinner plates, having not only survived a bleaching event but are now reproducing themselves – helping to produce larvae that can restore a degraded reef,” she says. “After seeing the potential of this gamechanging technique, the Great Barrier Reef
Focus
Foundation and its partners brought Coral IVF to the Reef back in 2016 – bringing together people and science to give nature a helping hand. “Saving the Reef is a huge task, but having proof that this innovative, cutting-edge science works gives us hope.” Lead Researcher and Southern Cross University Distinguished Professor Peter Harrison said Coral IVF is the first project of its kind to re-establish corals on damaged reefs. “The ultimate aim of this process is to produce new breeding populations of corals in areas of the Reef that no longer
have enough live corals present, due to being damaged by the effects of climate change,” Professor Harrison says. “This is a thrilling result to see these colonies we settled during the first small-scale pilot study on Heron Island grow over five years and become sexually reproductive. “The larvae generated from these spawning corals have dispersed within the Heron Island lagoon and may settle on patches of reef nearby, helping to further restore other reef patches that have been impacted by climate change. “This has given me and the rest of the team renewed enthusiasm as we
research additional techniques on Lizard Island, through the Reef Restoration and Adaptation Program in collaboration with CSIRO, QUT and with support from Australian Institute of Marine Science, that will enable us to scale up and optimise this technique.” The Reef Restoration and Adaptation Program is the world’s largest and most ambitious effort to develop, test and deploy at-scale protection, restoration and adaptation interventions to ensure that the Great Barrier Reef and coral reefs globally can resist, adapt to, and recover from the impacts of climate change. Ref: Cristina Langley, Southern Cross University
Coral IVF babies breed for first time ever on the Reef GEISTLICH LOCAL NEWS VOL 1 - 2022
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Great Barrier for Succes The Great Barrier Reef The Great Barrier Reef is the largest living structure on Earth and one of the richest and most complex natural ecosystems in the world. It’s home to thousands of species of marine life including fish, dolphins and six of the world’s seven species of marine turtle. Climate change is the biggest threat to the future of our Reef. Its impacts, which include rising water temperatures, ocean acidification and more severe weather events, make it difficult for the Reef to recover and adapt fast enough to survive. The facts are clear; coral reefs and their communities are on the front line of climate change and we know this is the critical decade in which to act with urgency. “In order to save this irreplaceable ecosystem, we must also take urgent action to fast-track its recovery by restoring reefs damaged by the impacts of climate change.” Anna Marsden, Managing Director Great Barrier Reef Foundation
Reef Restoration and Regeneration Right now, the Great Barrier Reef Foundation is part of the world’s largest and most ambitious effort to protect, restore and adapt coral reefs at unprecedented scales. It’s aiming to regenerate 10 million corals on the Great Barrier Reef by 2030. One such regeneration method is Coral IVF. During annual coral spawning, millions of tiny coral eggs and sperm from healthy reefs are collected in speciallydesigned floating larvae pools. The coral larvae is reared in the pools, then the ‘babies’ are delivered onto damaged reefs so they can regenerate.
In March - May 2022 Geistlich Pharma Australia and New Zealand is proudly supporting the Great Barrier Reef Foundation, the lead science-based charity driving the immediate change needed for the Reef’s very survival. The passion for science and regeneration makes the Great Barrier Reef Foundation and Geistlich Pharma excellent partners.
Coral Bleaching and Coral IVF Program The past two decades have seen several incidents of widespread coral bleaching events on many of the world’s coral reefs. Coral bleaching happens when corals are under stress due to environmental disturbances like rising temperatures, UV radiation, or poor water quality (toxins). Under stress, they release the algae that feeds them and become white. If they are not given a chance to recover they can starve and die. The Great Barrier Reef Foundation’s pioneering Coral IVF Program is a critical step in coral reef restoration to protect Australia’s Great Barrier Reef and has the potential to regenerate reefs around the world. The first batch of Coral IVF babies, which were grown from microscopic larvae and planted on the Reef in 2016, reproduced for the first time in 2021, giving hope that this innovative technique could successfully restore damaged reefs. Researchers revisited large coral colonies that were born through the first Coral IVF trial on the Great Barrier Reef and noted they have survived a bleaching event and grown to maturity. REFERENCES 1. Schwarz F et al. Clin. Oral Implants Res. 2006;17(4):403-409. (Pre-clinical study) 3. Schwarz F et al. Clin Oral Implants Res. 2014 Sept;25(9):1010-5. (Clinical study) 5. Rothamel D et al. Clin. Oral Implants Res. 2005; 16(3): 369-378. (Pre-clinical study 7. Rothamel D et al. Clin. Oral Implants Res. 2004;15:443-449. (Pre-clinical study) 9. Schwarz F et al. Clin. Oral Implants Res. 2008;19(4): 402-415. (Pre-clinical study 11. Buser D et al. J Periodontol 2013; 84(11): 1517-27. (Clinical study).
For EVERY two Geistlich Bio-Gide® purchased during March – May ’22, Geistlich Pharma Australia and New Zealand will plant 1 coral baby on behalf of your practice to regenerate the Great Barrier Reef. As a gesture of our appreciation, you will receive a Regeneration Recognition Certificate from the Great Barrier Reef Foundation.
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2. Rothamel D et al. Clin. Oral Implants Res. 2005; 16(3): 369-378. (Pre-clinical study) 4. Tal H et al. Clin Oral Implants Res. 2008; 19(3) : 295-302. (Clinical study) 6. Zitzmann NU et al. Int J Oral Maxillofac Implants.12, 1997;844-852. (Clinical study) 8. Becker J et al. Clin Oral Implants Res. 2009; 20(7):742-749. (Clinical study) 10. Perelman-Karmon M et al. Int J Periodontics Restorative Dent. 2012 Aug;32(4):459-65. (Clinical study) 12. Jung RE et al. Clin. Oral Implants Res. 2013 Oct;24(10):1065-73. (Clinical study)
Proudly supporting the Great Barrier Reef regeneration!
cessful Regeneration Why Geistlich Bio-Gide® provides a great barrier for your bone regeneration? Geistlich Bio-Gide® is a collagen membrane for reliable bone regeneration and optimal tissue integration.1-3. The natural collagen structure of Geistlich Bio-Gide® permits prompt and homogeneous vascularisation and so brings about optimal tissue integration and wound stabilisation.5 The smooth side of Geistlich Bio-Gide® prevents soft tissue from growing into the defect and serves as a scaffold for the attachment of fibroblasts. 1,4-7 The rough, open-pored layer side of Geistlich Bio-Gide® serves as a framework for bone cells and blood vessels. 1,8. Geistlich Bio-Gide® is used in combination with a bone substitute such as Geistlich Bio-Oss® or Geistlich Bio-Oss® Collagen. Leading clinicians rely on Geistlich Bio-Gide® for: > Optimal tissue integration and wound stabilisation1,5,9 > High therapy safety even in case of dehiscence 4,8 > 11% more new bone formation with Geistlich Bio-Oss® and Geistlich Bio-Gide® vs Geistlich Bio-Oss® alone10 > Simplified surgery without removal of the membrane > Aesthetically stable results after 5-9 years11 > Long-term data over 12 to 14 years show predictable results of bone augmentations with Geistlich Bio-Oss® and Geistlich Bio-Gide®12
Guided Bone Regeneration with a Proven Barrier Membrane Provides the Optimal Basis for the Natural Process of Bone Formation. How much barrier time is actually enough? Dr. Jordi Caballé-Serrano investigated membranes with different barrier times and their impact on bone regeneration. His findings shed new light on a question our customers often ask. Visit: www.regeneration-expert.com
Help us Regenerate The Great Barrier Reef Buy 2 x Geistlich Bio-Oss® Collagen 100mg and 2 x Geistlich Bio-Gide® Shape 14x24mm
GET 18% OFF GEISTLICH BIO-GIDE ® SHAPE SAVINGS OF $100* AND we will plant 2 coral babies on behalf of your practice E-SHOP CODE: CORAL100
LOCAL NEWS VOL 1 - 2022 *Valid from 18th April – 31st May 2022. Discount is GST inclusive and applies exclusively to the purchase of 2 Geistlich Bio-Gide® GEISTLICH Shape with 2 Geistlich Bio-Oss® Collagen 100mg based on thefull retail price. The offer does not apply to government and corporate customers. No further discount applies.
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STAGED APPROACH AFTER IMPLANT PLACEMENT
Predictable Management of an Implant Dehiscence Defect with Guided Bone Regeneration
Dr Justin Soon | Principal Dentist Maylands Dental Centre
Aim: To functionally and aesthetically restore missing tooth 11 and to reduce the extent of gingival recession on the labial aspect of tooth 13. Tooth 11 was missing due to a traumatic injury that resulted in avulsion of tooth 11 and damage to the associated labial plate. Conclusion: Guided bone regeneration has become one of the most commonly used techniques to manage bony dehiscence defects and contour deficiencies.
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Geistlich Bio-Oss® and Geistlich Bio-Gide® are complimentary xenogeneic materials that are ideally suited to GBR; providing a safe and predictable treatment option. Long-term clinical data reports that implants placed in sites managed with GBR have similar survival rates to implants placed in pristine bone (R.E. Jung et al., 2021). Geistlich Bio-Oss® has a low substitution rate, a feature that ensures long-term volume stability of the augmented tissues.
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2 Intra-operative situation demonstrating placement of implant and labial bony dehiscence. The morphology of the defect is favourable in terms of guided bone regeneration (GBR). The bone augmentation material (Geistlich Bio-Oss®) will be stabilised by the existing bony walls and overlying barrier membrane (Geistlich Bio-Gide ®).
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A 50:50 mixture of autogenous bone and Geistlich Bio-Oss® was placed over the exposed implant; filling the entire bony defect. Geistlich Bio-Gide® membrane was positioned over the augmentation material to stabilise it and to serve as a temporary barrier (yet to be folded into final position in this image).
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ost-operative healing after 3.5 months. The horizontal P ridge dimension has been re-established.
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After 4 months of healing, the implant was uncovered and a healing abutment placed. Concurrent autogenous connective tissue grafting was performed to improve the soft tissue volume and to reduce the extent of the gingival recession on tooth 13 (connective tissue graft and coronally advanced flap).
A screw-retained implant crown was delivered and the composite restoration on tooth 21 was replaced. The gingi val tissues appear healthy with a harmonious and aestheti cally pleasing outcome.
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Final peri-apical radiograph demonstrating sufficient mesial and distal crestal bone levels.
The presurgical situation (occlusal view). Note loss of labial ridge contour at site 11 (significant loss of alveolar ridge width).
T ension-free primary wound closure achieved (with aid of periosteal release) using PTFE sutures. The situation was restored with an aesthetic “suck-down” temporary denture; being careful to not impinge on the healing soft tissues.
7 Tension free primary wound closure achieved using PTFE sutures. Note the coronal advancement of the flap over tooth 13.
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References: R.E. Jung, L.V. Brügger, S.P. Bienz, J. Hüsler, C.H.F Hämmerle, N.U. Zitzmann. Clinical and radiographical performance of implants placed with simultaneous guided bone regeneration using resorbable and nonresorbable membranes after 22-24 years, a prospective, controlled clinical trial. Clinical Oral Implants Research (2021). 32(12);1455-1465
STAGED APPROACH AFTER IMPLANT PLACEMENT
Managing the Failing Maxillary Central Incisor with Guided Bone Regeneration and Implant Therapy
Dr Peter Chen | Periodontist Brisbane Implant Dentistry and Perio Care
Aim: Tooth 21 was deemed unrestorable subsequent to injury from a car accident (mid-root fracture). The aim of the treatment was to replace tooth 21 with an implant-supported crown. The treatment plan involved the careful extraction of tooth 21 and subsequent early implant placement. Guided bone regeneration was performed at the time of implant placement to re-establish the required alveolar bone volume.
Conclusion: The predictable use of Geistlich Bio-Oss® and Geistlich Bio-Gide® for simultaneous grafting of implant dehiscence defects is well-documented1. In this clinical case, excellent bone height and width has been achieved at 3-months, with minimal comorbidity compared with autogenous grafting. Geistlich Bio-Oss® is a material with a low substitution rate; long-term stability of the soft and hard tissues is expected.
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T he pre-treatment clinical situation showing tooth 21 in position. As a consequence of the damage caused by recent trauma, the tooth was deemed not restorable (fractured tooth root)
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linical situation 6 weeks following extraction of tooth 21. C Soft tissue closure over the healing extraction site has been achieved.
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Prosthetically-driven implant placement. bony dehiscence can be clearly observed.
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Guided Bone Regeneration was performed. Geistlich BioOss® was placed over the exposed implant surface and to fill the bony defect.
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Geistlich Bio-Gide® was placed over the defect to help stabilise the bone augmentation material and to act as a temporary barrier to exclude soft tissue cells from invading the bony defect.
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Immediate post-operative situation showing tension free primary closure of the surgical flap.
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Excellent healing of the soft tissues observed at 2 weeks post-implant placement.
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Final restorative situation; 3-months after insertion of the final crown (screw-retained crown).
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Final periapical radiograph (3-months post-restoration) showing the stable situation of the mesial and distal crestal bone levels.
References: 1. R.E. Jung, L.V. Brügger, S.P. Bienz, J. Hüsler, C.H.F Hämmerle, N.U. Zitzmann. Clinical and radiographical performance of implants placed with simultaneous guided bone regeneration using resorbable and nonresorbable membranes after 22-24 years, a prospective, controlled clinical trial. Clinical Oral Implants Research (2021). 32(12);1455-1465
labial
Upcoming events
AOS/ASP Sydney 18 - 20 August, 2022 The Australian Society of Periodontology is joining forces with the Australasian Osseointegration Society to bring their biennial conference to the International Convention Centre (ICC) Sydney this August. The Biennial Conferences of both ASP and AOS have established themselves as premiere periodontal and implant events which brings together
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opinion leaders from around the world. This gathering will attract practitioners from all fields of dentistry as a unique combined event of the two Societies. The theme of this year’s conference is Integrating Science into Everyday Practice and will encompass all aspects of treatment planning, management and continuing strategies to further enhance patient care. Geistlich is proud to be a
Platinum Sponsor and provide support to this major educational event. The extensive program, includes local and international speakers who are leaders in their fields including Prof Mauricio G. Araújo, Prof Sašo Ivanovski, Prof Daniel Thoma, Dr Lydia Lim and many more. We look forward to seeing you there at our booths 1-4!
Upcoming events
ANZAOMS NZ Queenstown 24-25 June, 2022 Take 3! After 2 years of not being able to attend this event our team in New Zealand are keeping their fingers crossed for a successful event in 2022! This year’s annual meeting will be held at the beautiful QT hotel in Queenstown on Friday and Saturday 24 and 25 June. This year’s event has been modified and will include a half day trainee
pathology teaching session. The brilliant array of international and regional speakers at this year’s event, includes Dr Lou Mercuri, the inaugural John Edwards speaker, reflecting on a long career in the management of TMJ disorders, Dr Anita Nolan who will be running the trainee day in oral medicine and Dr Mark Izzard reflecting on
advances in head and neck surgery. Don’t miss out on Lou Trent talking on sustainability in medicine from an environmental point of view and Dr Ron Patterson will be delivering the Sir John Walsh lecture. Ron is an entertaining and reflective professor of law, and, amongst other roles, previous Health and Disability Commissioner.
We look forward to seeing you there!
ANZAOMS RACDS Melbourne 8-10 September, 2022 Joining forces with the Royal Australasian College of Dental Surgeons (RACDs), this year’s event will be held face-to-face culminating with a dinner at the Sofitel Hotel in Melbourne. From Thursday 8 September to Saturday 10 September, the theme for this gathering is ‘The Fine Edge of Dentistry’ and will include an extensive program featuring
presentations and lectures from international and local dental experts. Don’t miss Dr Markus Seller, the inventor of Yxoss CBR, who will be presenting and also running a preconference workshop. Visit geistich.com. au/cpd or contact your local Geistlich Product Specialist for more information. To register visit Geistlich.com.au/cpd
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Upcoming events
Geistlich for Excellence 365 Brisbane 20 May, 2022 Join us at the W Hotel in Brisbane for a 'social but socially distanced' evening of table-served drinks and canapes in a relaxed, laid-back setting and engage in discussions around the right choice of biomaterials, the importance of patient education in your practice and much more. During this evening you will have the opportunity to handle our products with
two interactive hands-on demonstrations, hosted by our knowledgeable Geistlich Product Specialists, gain fascinating insight into the differences in biomaterials with our popular ‘Under-the-Microscope’ session, and learn more about stoma®, our trusted dental instrument manufacturer from Germany, and their excellent product range for Dental Hygienists.
Additionally, there will be a segment on Infection Control, and for 2022 we are excited to announce that Curaprox – premium oral health care products, will also be joining us for this event. Don’t miss out on sending your team to this evening designed for dental support teams.
Program 1, as in Brisbane, is tailored for support teams (dental nurses, hygienists, practice managers and implant coordinators), this event will have all of the same information and sessions we have planned for our Brisbane event. Program 2 is tailored for the clinician, join us for a Saturday Premium High Tea with your team at the Grand Hyatt,
followed by your own break-away 2-hour session with Dr George Alexopoulos BDSc. (Melb.), MBA (Monash), MSc. Oral Implantology (Frankfurt), PhD (Melb.) which includes a lecture and handson session focussing on Soft Tissue Management. Why not bring the team for an afternoon of social networking and education.
Melbourne 29 October, 2022 In addition to all of the traditional and exciting new elements we have in store for Brisbane, we are proud to announce that we have created a brand-new addon educational event to look after our clinicians. Two separate programs running simultaneously will be offered on the same day.
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Major Bone Augmentation
NEW r BioBriefs?
Curious about othe
www.bio-brief.com
Dr. Christopher Ho
Advanced Ridge Augmentation with 3-D Printed Titanium Scaffold GEISTLICH LOCAL NEWS VOL 1 - 2022
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Upcoming courses
SOFT TISSUE IS THE ISSUE
A new approach to soft tissue regeneration The gold standard treatment for soft tissue volume regeneration involves the harvesting of autologous connective tissue, usually from the palate. Harvesting of connective tissue can be somewhat technically challenging and is associated with donor site morbidity (i.e. pain, bleeding, and risk of infection). Geistlich Fibro-Gide® is a novel xenogeneic biomaterial designed specifically for soft tissue regeneration. It is a porcine derived, porous, resorbable, and volume-stable collagen matrix that encourages angiogenesis, the ingrowth and formation of new connective tissue. This can now be achieved without the need of tissue harvesting, offering an exciting new alternative for connective tissue grafts. To learn more about Geistlich Fibro-Gide® and how it can be incorporated into your soft tissue management around natural teeth and dental implants, register for one of our upcoming hands-on workshops, online hands-on webinar or live surgeries. Limited spots are available to attend our hands-on workshops so make sure you don’t miss out. For more information go to www.geistlich. com.au/education/courses and congress.
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A/Prof Tino Mercado Tino has been a Periodontist for more than 20 years with private practices in Penrith and the Blue Mountains (Specialist Periodontal and Implant Centre). Tino holds an A/Prof position at the Periodontal Post-Graduate Department at the University of Queensland. His PhD topic and latest publications in peer-reviewed high impact journals are on predictable management of periimplantitis and management of periodontal recession on teeth and implants using autologous and alternative tissues. He is the NSW Councillor for the Australian and New Zealand Academy of Periodontists and Periodontal examiner at the Royal Australasian College of Dental urges (RACDS).
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Upcoming courses
Hands-On
Lecture
Pig-jaws
Webinar
Dr Ehsan Mellati
Clin. A/Prof Mehdi Valizadeh
Dr Ehsan Mellati has obtained his undergraduate dental degree with first class honors and subsequently worked in th public and private sectors. His growing interest in periodontology and implant dentistry prompted him to pursue 3 years of full-time postgraduate training at Melbourne Dental School to become a specialist periodontist and now practices periodontics and implant dentistry. He is the recipient of the prestigious ITI grant for his postgraduate thesis focusing on healing of soft and hard tissues around immediate implants. Dr Mellati is a published clinician and an active member of International Team for Implantology, Australian Dental Association, Australian and New Zealand Association of Periodontists and Australian Society of Periodontology.
Mehdi is the founder and clinical director of Vision Periodontics, a specialist centre for advanced periodontics and implant dentistry located at South Perth, WA. Overseas trained, board-certified and Australian-registered he is a specialist periodontist with a special interest in advanced implant surgeries, bone grafting procedures, periodontal and peri-implant mucogingival surgeries, as well as periodontal regenerative procedures. His academic background has always led to teaching roles in academic institutions alongside his clinical work. Formerly an assistant professor internationally. he has been a clinical supervisor exclusively for DCD (Doctor of Clinical Dentistry) course in Periodontics at dental school/OHCWA, University of Western Australia (UWA) since 2017. Currently, he has an adjunct appointment as clinical associate professor at UWA (Mehdi Valizadeh – the UWA Profiles and Research Repository). He is also actively involved in research projects in the field of clinical implant dentistry.
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Geistlich Fibro-Gide for Recession Defects ®
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STAGED APPROACH AFTER IMPLANT PLACEMENT
Don Prof D’t Miss Ou t aniel Thom! ‘LIVE a ’ Han
Insufficient Soft-Tissue Thickness in a Single Tooth Gap in the Anterior Maxilla
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“Geistlich Fibro-Gide® is one of the major innovations in regenerative dentistry in the last 20 years.”
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PD Dr. Daniel Thoma | Zurich, Switzerland
Aim: Gain in soft-tissue thickness in the aesthetic area with Geistlich Fibro-Gide®.
Conclusion: After 6 months, the final restorations were placed. The natural look of the augmented soft-tissue can be appreciated, and no implant translucency is visible.
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Baseline frontal view: missing central incisor. Implant visible through mucosa due to thin biotype.
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Baseline occlusal view: soft-tissue deficit in the buccal and occlusal area.
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Flap elevation on the buccal side using a full flap crestally and a split flap buccally.
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Adaption of Geistlich Fibro-Gide® (15 × 20 × 6 mm) to the defect size.
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Palatal island flap prepared to alow for ten sion-free wound closure. Geistlich Fibro-Gide® in situ, immobilised with a mattress suture.
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Tension-free wound closure using single interrupted sutures (Dafilon 5-0, Braun).
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Suture removal 7 days post-surgery.
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Abutment connection.
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6 months follow-up: final crown in place.
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Geistlich Fibro-Gide® Handling at a Glance Flap Design Use your preferred flap design. A generous release of the flap is the key to promoting successful healing by complete
Minimally Invasive Application Tunneling and/or pouch techniques are still clinical-
Trim To Fit Geistlich Fibro-Gide® can be adjust-
ly being investigated. However, current data
ed in size and thickness in order Trim Wet Or Dry Geistlich Fibro-Gide® can to best achieve the desired augmentation. be cut and trimmed both in a dry or wet Precise Trimming Using a scalpel will help
state using either scissors and/or a scalpel.
in achieving smooth edges and bevels for improved wound adaptation and precise fit
Volume Changes Swelling of the device upon wetting must be taken into account when de-
Thickness Close to wound margins, reduction
termining final dimensions. The device will
of the thickness of the Geistlich Fibro-Gide® to 2–3 mm may be recommendable in order to
Application Geistlich Fibro-Gide® can be applied either in a dry or wet state upon individ-
Adhesion Geistlich Fibro-Gide® becomes
ual preference. Pre-wetting can be
adhesive when soaked with blood and keeps a In Situ Adaptation Prior to wound closure, stable position once inserted. Suturing the the size of the device should be finally assessed in light of a tension-free wound cloWound Closure A tension-free closure of the flap is key for a successful and comHealing Clinical experience shows low inciplication-free healing and avoidance of any dence of wound healing complications.3,18 Learning Curve As with any new product, you will experience a learning curve until getting used to the handling properties and 20
GEISTLICH LOCAL NEWS VOL 1 - 2022
Contents are based on preclinical and clinical evidence gained during the Geistlich Fibro-Gide® pre-launch phase.
All our knowledge in your hands Geistlich Pharma AG is known for the thorough evaluation of its products and the generation of a vast amount of clinical data1 beyond the requirements for regulatory clearance. Besides gaining thickness of oral soft-tissue, Geistlich Fibro-Gide® is approved and is being used successfully for covering recession defects in a clinical setting.1,2 Whilst research is still being undertaken into the use of Geistlich Fibro-Gide® in recession coverage, the results to date highlight that it is a viable alternative to connective tissue grafts.
This brochure, summarises the most recent clinical data and knowledge available relating to the use of Geistlich
Fibro-Gide® for treating recession defects.
In a Nutshell Made of Collagen Geistlich Fibro-Gide® is a porcine, porous, resorbable and volume-stable collagen matrix.1
Volume Stability The reconstituted collagen undergoes smart cross-linking for volume stability of the device.1
Soft-Tissue Integration In vivo animal models have shown good integration of Geistlich Fibro-Gide® into the surrounding soft-tissue while maintaining stability.3
1 Instructions for use of Geistlich Fibro-Gide® 2 http://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00009669 3 Thoma DS. et al. Clin Oral Implants Res. 2012 Dec; 23(12):1333-9. 4 Thoma DS. et al. J Clin Periodontol. 2016 Oct; 43(10): 874–85. 5 Thoma DS. et al. Clin Oral Implants Res. 2015 Mar; 26(3): 263–70. 6 European Patent Specifi cation – EP 3 055 000 B1. 7 Data on file. Geistlich Pharma AG, Wolhusen, Switzerland.
Supports Soft-Tissue Formation The porous network of Geistlich Fibro-Gide® supports angiogenesis, formation of new connective tissue and stability of the collagen network in submerged healing situations.4,5
GEISTLICH LOCAL NEWS VOL 1 - 2022
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Can half a commitment earn all of your trust? Exactly. Our unmatched collagen processing innovations co Guided Bone and Tissue Regeneration
Gain of Keratinized Tissue
Gain of Soft-Tissue Thickness
THE CHALLENGE >Protection of the bone graft >Maintain soft-tissue integrity >Second surgical procedure for e-PTFE membrane removal
THE HISTORY e-PTFE membranes: > Subject to adverse events13 > Membrane removal required
THE BREAKTHROUGH Geistlich Bio-Gide® innovation >No foreign body response 14,15 >Resorbable membrane
THE CHALLENGE > Gain of keratinized tissue >Reliable scaffold >Second surcigal site for soft-tissue harvesting
THE HISTORY Free Gingival Graft (FGG) > Limited availability > High patient morbidity16
THE BREAKTHROUGH Geistlich Bio-Gide® innovation > No foreign body response 14,15 > Resorbable membrane
THE CHALLENGE > Gain of soft-tissue thickness > Volume stability > Second surgical site for soft-tissue harvesting
THE HISTORY Connective Tissue Graft (CTG) > Limited availability > High patient morbidity19
THE BREAKTHROUGH Geistlich Fibro-Gide® innovation > Increase of soft-tissue thickness22,23 > No second surgical site
IMPORTANT FACTS ABOUT COLLAGEN > Collagen fibers and fibrils are connected to each other in every native mammalian connective tissue.24 Without these vital connections the integrity of the tissue would be compromized. > In their natural state, fibers and fibrils are cross-linked, bonding one polymer or protein chain to another.24 The products with additional artificial collagen connections are called cross-linked in the dental market. References: 1: GBR, Prof. Buser, Switzerland, 2: Dehiscence over e-PTFE membrane, Dr. Scheyer, USA, 3: SEM picture Human Schneiderian membrane, Prof. Benner, Germany, 4: SEM picture Geistlich Bio-Gide®, Geistlich Pharma AG, Switzerland, 5: Lack of keratinized tissue, Dr. Panaite & Dr. Charles, USA, 6: Harvesting site of FGG, Dr. Thoma, Switzerland 7: Histologic section, Free Gingival Graft, University of Zurich, Switzerland, 8: SEM, Geistlich Mucograft®, Geistlich Pharma AG, Switzerland, 9: Lack of soft-tissue volume, Dr. Thoma, Switzerland, 10: Harvesting of CTG, Prof. Jung, Switzerland, 11: Histologic section, Sub-epithelial connective tissue graft, University of Zurich, Switzerland, 12: SEM, Geistlich Fibro-Gide®, Geistlich Pharma AG, Switzerland, 13: Zitzmann, N. et al. (1997). Int J Oral Maxillofac Implants. 12(6): 844-52 (clinical). 14; Ghanaati, S. et al. (2011). Biomed Mater. 6(1): 015010 (pre-clinical). 15: Ghanaati, S. et al. (2012). Acta Biomater.
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GEISTLICH LOCAL NEWS VOL 1 - 2022
ns come from a 100% focus on regeneration. 1st PURIFICATION
> Clean native collagen > No foreign body reaction 14,15
1st PURIFICATION
2nd SEPARATION
3rd ASSEMBLY
> Reconstituted collagen without artificial cross-linking > Allow open healing 16,17,18
1st PURIFICATION 2nd SEPARATION
3rd ASSEMBLY 4th STABILIZATION
> Smart Cross-linked collagen > Provide volume 22,23 > Maintain cell compatibility and tissue integration22
> The number of connections can be artificially changed by different means and procedures based on different levels of expertise. These additional artificial tissue connections are called cross-linked in the dental market. > Artificial cross-linking processes used in the market up until now tend to have a negative impact on the soft-tissue reaction to the product.25,26 It takes real Collagen Expertise to create desired product properties without adversely impacting the soft-tissue acceptance and integration within 8(8): 3061-72 (pre-clinical). 16: McGuire, MK. et al. (2014). J Periodontol. 85(10): 1333-41 (clinical). 17: Nevins, M. et al. (2001). Int J Periodontics Restorative Dent. 31(4): 367-73 (clinical). 18: Schmitt, CM. et al. (2013). J Periodontol. 84(7): 914-232011 (clinical). 19: McGuire, MK. et al. (2010). J Periodontal. 81(8): 1108-17 (clinical). 20: Cardaropoli, D. et al. (2012). J Periodontol. 83(3): 321-8 (clinical). 21: Aroca, S. et al. (2013 ). J Clin Periodontol. 40(7): 713-20 (clinical). 22: Thoma, DS. et al. (2016). J Clin Periodontal. 43(10): 874-85 (clinical). 23: Zeltner, N. et. al. (2017). J Clin Periodontal. 44(4): 446-53 (clinical). 24: Lodish, H. et al. (2000). Molecular Cell Biology. 4th edition. New York: W. H. Freeman; (2000). Section 22.3, Collagen: The Fibrous Proteins of the Matrix. 25: Tal, H. et al. (2008). Clin. Oral Impl. Res. 19(3): 295-302 (clinical). 26: Schwarz, F. et al. (2008). Clin. Oral Impl. Res. 19(4): 402-15 (pre-clinical).
GEISTLICH LOCAL NEWS VOL 1 - 2022
23
SIMULTANEOUS APPROACH WITH GUIDED BONE REGENERATION (GBR)
Stay Tu
ned!
Insufficient Soft-Tissue Thickness in Extended Gap in the Posterior Mandible
Ha Worksnds-On hop To ur w
ith iele Ca rdarop oli Austra lia 202 3
Dr Dan
“Geistlich Fibro-Gide® is one of the best innovations for gaining soft-tissue thickness.” Dr. Daniele Cardaropoli | Torino, Italy
Aim: Increasing the thickness of soft-tissue around dental implants with Geistlich Fibro-Gide® in the posterior area of the mandible to support protection and to restore function.
Conclusion: Geistlich Fibro-Gide® can be used as an alternative to connective tissue grafts (CTG) to significantly increase the soft-tissue thickness around dental implants.
1
2
3
4
5
6
7
8
9
1
Baseline before implant placement showing the soft tissue deficiency.
2
Implant surgery after implant placement showing the need for GBR.
3
Guided Bone Regeneration (GBR) 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 combiing 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
1 year follow-up after final ceramic crown placement.
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GEISTLICH LOCAL NEWS VOL 1 - 2022
Upcoming events
THE WAIT IS FINALLY OVER! r o F n o ti lu o S e re -F te la a P Your ! re e H Is n o ti ra e n e g e R e su is T ft So
Alternative treatment option to connective tissue grafts! The NEW
solution for soft tissue regeneration greatly appreciated by your patients!
Inspired by Nature Engineered by Geistlich For more information please contact your local Geistlich Product Specialist or call 1800 776 326. GEISTLICH LOCAL NEWS VOL 1 - 2022
25
Geistlich Pharma announces global takeover of Meta Technologies
culture being the driving force behind both companies. We look forward to welcoming the entire Meta team to our extended Geistlich family.” With
this
acquisition,
Geistlich
Swiss
often used together, particularly when
Pharma has become the exclusive supplier
manufacturer of biomaterials, has acquired
harvesting autologous bone and mixing
of Meta bone scrapers world-wide, and
the Italian bone scraper manufacturer
it with Geistlich Bio-Oss® granules,
Geistlich Pharma Australia and New
Meta Technologies s.r.l. with immediate
for long-term predictable bone volume
Zealand, known for providing clinicians
effect. The two companies were quick
augmentation.
with
Geistlich
Pharma
AG,
a
predictable,
regenerative
products
evidence-based researched,
to point out that this acquisition brings
“This marks a significant milestone for
together what has been an excellent match
Geistlich Pharma!” said Geistlich Pharma
developed and manufactured under one
for many years. Meta’s bone scrapers
Australia’s managing director, Dr. Torben
roof, is now also the go-to brand providing
(Safescraper®, Safscraper® Twist and
Hackl, “as this is our first, but probably
quality, high-end bone scrapers made by
Micross®) and Geistlich’s biomaterials
not last, takeover in the company’s 170-
the world’s leading manufacturer.
(Geistlich
Bio-
year history. Both companies are known
Gide®, Geistlich Mucograft® and now
worldwide for their highly regarded,
For more further information please
also Geistlich Fibro-Gide®, the latest
gold standard product portfolios, but the
contact our customer service team on 1800
innovation in soft-tissue regeneration)
synergies extend beyond our products
776 326 or your local Geistlich Product
are typically used in oral regeneration and
to the people and the family-oriented
Specialist in Australia and New Zealand.
26
Bio-Oss®,
Geistlich
GEISTLICH LOCAL NEWS VOL 1 - 2022
The Surgical Application of Geistlich Fibro-Gide®
Live Surgery Complimentary Course 1st June, 2022 @ 7.00pm (AEST) The gold standard treatment for soft tissue volume deficiencies involves the harvesting of autologous connective tissue, usually from the palate. Harvesting of tissue necessitates management of a donor site and the associated morbidities (i.e., pain, swelling, bleeding, and risk of infection). Geistlich Fibro-Gide® is a novel xenogeneic collagen matrix designed as an alternative to the connective tissue graft. This porcine-derived, porous, resorbable, and volume-stable matrix helps address many of the disadvantages of the connective tissue graft. Watch Clinical Assoc./Prof. Mehdi Valizadeh perform a soft tissue volume augmentation procedure using Geistlich Fibro-Gide®. He will discuss the surgical steps employed and answer questions regarding the clinical application of Geistlich Fibro-Gide®.
n Cli
Registration
T 1800 776 326 E info@geistlich.com.au
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ph
to
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is
/P
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fM e h di Valiza d e h
at er H o ( M o d er
or
)
Watch this live surgery at geistlich-anz.live
Ch Dr
Register online now
Visit: https://geistlich-anz.live/streaming-event/soft-tissue 27 GEISTLICH LOCAL NEWS VOL 1 - 2022 Refer to the website for terms and conditions, future courses and events
Publisher ©Geistlich Pharma AG Subsidiary Australia / New Zealand The Zenith, Tower A, Level 21 821 Pacific Highway Chatswood NSW 2067, Australia Phone +61-(1)-800 776 326 Phone +64-(0)-800 500 043 Fax +61-(1)-800 709 698 Fax +64-(0)-800 500 044 www.geistlich.com.au www.geistlich.co.nz