Gold standard in open healing: Geistlich Bio-Gide^®

The Situation

The patient complained of ‘tooth mobility’ that first occurred three months previously, after a sports accident that caused a trauma in that region. As he had no serious pain, he assumed that everything would go back to normal after a while. However, clinical control and a CBCT scan demonstrated that there was a root fracture at tooth 11, and, due to the root micromovement in the alveolar ridge together with the periodontal bacterial infiltration, the buccal bone was resorbed (type 2 class).

The Approach

Tooth 11 was extracted atraumatically and the socket preservation procedure was performed in accordance with the open-healing protocol. Geistlich Bio-Oss® and Geistlich Bio-Gide® were used. The procedure involved no flap elevation or periosteal incisions; instead, the membrane was intentionally left exposed, and a continuous PTFE suture was meticulously placed along the free gingival margins to stabilise the membrane.

The Outcome

Clinical control and CBCT scan showed long-term stability of soft and hard tissues. The final outcome was stable, from both functional and aesthetic points of view, reinforcing the biological advantages using the open-healing technique followed by flapless tissue level implants in the aesthetic zone.

Keys to Success

• No flap
• No incision in the periosteum
• Membrane insertion inside the extraction socket
• Bone granules to fix the membrane inside the extraction socket
• Tension-free suturing
• Continuous PTFE sutures