“With this combination, just two weeks after surgery, the quality of the soft tissue is much improved”
Interview with Prof. Francesco Cairo by Turgut Gülay and Verena Vermeulen
Prof. Cardaropoli, you have extensive experience in recession coverage with different materials, both autologous and biomaterials. Is there still room for improvement?
Prof. Cardaropoli: Yes, I think so. Because good wound healing is key for the success of recession coverage, and enhancing wound healing has a huge potential to improve treatments. Different groups of researchers around the globe are therefore trying to better understand the process of wound healing and how they can promote it. Surgical techniques, incisions, flap design, etc. play a role - but also products such as biologics.
Where do you see the biggest benefit of combining REGENFAST® and Geistlich Fibro-Gide® for recession coverage?
The quality of the soft tissue on the day of suture removal, two weeks after surgery, is so much better with this combination. And long-term outcomes might be influenced by this short-term benefit.
We see something similar with other biologics like hyaluronic acid or enamel matrix derivative. Twenty years ago, we only knew about EMD’s effect on periodontal regeneration. But seeing our patients for suture removal, we realized that the wound healing was better than usual. And of course, we realized that this effect could have a huge impact on the final outcome.
Do you also use REGENFAST® on sutures and incision lines?
I do. At the end of the procedure, I add the rest of the product on the suture lines, both for recession coverage and Guided Bone Regeneration cases. It helps the healing.
How do you rate the result of your surgeries?
I have been using Geistlich Fibro-Gide® for recessions for several years, and my results are very good anyway. But I found clearly enhanced wound healing on the day of suture removal. And during surgery, the handling and management of Geistlich Fibro-Gide® embedded in Regenfast® is more convenient.
Do you think it improves patient experience?
Patients are always happy if they can avoid the harvesting of a palatal graft by using a soft-tissue substitute such as Geistlich Fibro-Gide®. In addition, I think that Regenfast® reduces morbidity and inflammation post-op - so there is less swelling and less pain.
But this needs to be investigated in clinical studies, because just observing our patients, it is hard to draw conclusions. They don’t know if pain and swelling are related to the surgical technique, the material used or something else. And they certainly cannot compare their current state to an “average morbidity”, for example. So sound study design and randomized patient groups are needed for conclusive results.
Are there any tips & tricks you would like to share with colleagues who are just about to start using the product combination for recession coverage?
Take your time for the procedure. It takes several minutes to get the Geistlich Fibro-Gide® well-embedded in the gel. And I use a thickness of only 3-4 mm of Geistlich Fibro-Gide® for recession coverage, not the original 6 mm.
There’s another important point, too: If the surgery is not done properly - and we know that soft-tissue matrices are not as forgiving as autologous grafts - REGENFAST® cannot compensate for this. So, with or without the use of a biologic, good surgical skills as well as proper flap design and sutures are indispensable.
Is the use of REGENFAST® going to be part of your day-to-day clinical practice?
Yes, because enhancing soft-tissue healing is key to success. I really see better outcomes after two weeks compared to when REGENFAST® is not used.