HANSAmed Geistlich Major Bone Augmentation

Horizontal Bone Augmentation

Successful placement of implants in complete or partly edentulous patients requires sufficient alveolar ridge width. Horizontal bone augmentation procedures increase the width of the ridge. 

Conventional approaches include fixing an autogenous bone block graft into remaining lingual/palatal walls or stimulating new bone formation under titanium-reinforced membranes. 

Autogenous bone block grafts

Autogenous bone block grafts are the material of choice to compensate for insufficient bone width. However, extensive resorption  of the autogenous block graft can result in functional and esthetic failures.1 Contouring the autogenous bone block graft with Geistlich Bio-Oss® and covering the grafted area with Geistlich Bio-Gide® considerably reduces graft shrinkage.2

Fixation of an autogenous bone block graft on a horizontal defect.
Contouring of the autogenous bone block with Geistlich Bio-Oss® granules as a protective measure against resorption of the autogenous graft.
Covering of the autogenous bone block graft and Geistlich Bio-Oss® with a Geistlich Bio-Gide® resorbable membrane.
Implant placement into the reconstructed ridge.

Case by Prof. Carlo Maiorana & Dr. Mario Beretta, Milan, Italy

Reinforced Membranes

An alternative GBR approach to obtaining additional bone width utilizes titanium-reinforced membranes which create space for bone formation.3 However, due to their material properties, they are associated with impaired healing of the overlaying soft tissue and are non-resorbable, requiring a second surgical procedure for membrane removal.4 In order to overcome this complication, Geistlich Bio-Gide® can be used to completely immobilize and protect a particulate bone graft that results in horizontal bone augmentation.5

  • Geistlich Bio-Gide® is fixed securely with pins on the lingual/palatal and buccal aspects.
  • The area is packed compactly with autogenous bone chips and Geistlich Bio-Oss® granules, creating a sausage skin effect.
  • Graft material is completely immobilized and remains stable.

Geistlich Bio-Gide® collagen membrane provides a viable replacement for non-resorbable barrier membranes and does not require a second surgical procedure. 

Occlusal view of severely atrophied posterior mandibular ridge.
Buccal view after application of a 1:1 mixture of autogenous particulate bone and Geistlich Bio-Oss® granules.
Buccal view of a single Geistlich Bio-Gide® membrane, which is stabilized with titanium pins into the cortical bone of the jaw. Using the “sausage technique” the fixed membrane completely immobilizes the bone graft creating the sausage skin effect.
Two implants were placed with good primary stability. Note the excellent incorporation of the Geistlich Bio-Oss® with the autograft.

Case by Dr. Istvan Urban, Budapest, Hungary

  1. Maiorana C, et al.: Int J Periodontics Restorative Dent 2005; 25(1): 19-25.
  2. Maiorana C, et al.: Open Dent J 2011; 5: 71-78.
  3. Urban I, et al.: Int J Oral Maxillofac Implants 2009; 24(3): 502-10.
  4. Zitzmann N, et al. : Int J Oral Maxillofac Implants 1997; 12(6): 844-52.
  5. Urban I, et al.: Int J Oral Maxillofac Implants 2011; 26(2): 404-14. 

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