This clinical case shows that Geistlich Bio-Gide® can be left exposed.

Gold standard in open healing: Geistlich Bio-Gide®

Dr. Alecsandru Ionescu · Romania
 · February 03, 2020

BioBrief - Extraction Socket Management

The Situation

The patient complained of “tooth mobility” that fi rst occurred 3 months priviously, 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. Clinical control and a CBCT scan were performed. After analyzing both clinical and CBCT image data, the conclusion was that there was a root fracture at tooth 11, and, due to the root micro movement in the alveolar ridge together with the periodontal bacterial infi ltration, the buccal bone was resorbed (type 2 class).


The Approach

Tooth  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. There was no fl ap raised, no periosteal incision, the membrane remained deliberately opened and a continuous PTFE suture at the free gingival margins (Corefl on, Poland) was performed to stabilize the membrane.


The Outcome

Clinical control and CBCT scan showed longterm stability of soft and hard tissues. The fi nal outcome was stable, from both functional and esthetic points of view, reinforcing the biological advantages using the open-healing technique followed by fl apless tissue level implants in the esthetic zone.


Keys to Success

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

About the author

Dr. Alecsandru Ionescu | Romania

Dr. Alecsandru Ionescu, DDS, PhD graduated from the Faculty of Dentistry of the “Carol Davila” University of Bucharest in 2001. He is a specialist in minimally invasive oral surgery and implantology. Dr. Ionescu received his PhD in Oral Implantology with his main research topic “Guided tissue regeneration using the open healing technique and fl apless approach in implant patients”. He is involved in multiple studies and research projects related to minimally invasive oral surgery and implantology, periodontology and regenerative dentistry. Dr. Ionescu’s lectures mainly focus on minimally invasive approaches in oral surgery and implantology. He is a trainer for the “open healing” protocol and minimally invasive techniques using soft tissue level implants. Dr. Ionescu works in Bucharest in his private dental clinic, research and training center “aesthetics ONE”.