Geistlich - Indication sheets X2 - Failure Management | Page 3

Fig. 4 The bone is initially curetted taking care not to over-instrument the surface of the implants (except with non-metallic scalers) and then decontaminated, firstly by packing gauze soaked in 0.12% chlorhexidine around the implants and into the defects which is left in situ for 5 minutes. Fig. 5 Afterwards decontamination is proceeded by direct irrigation with a 1g in 20ml sterile saline solution of tetracycline. Fig. 6 The resulting bone surface appears clean and healthy and the implant surfaces while showing some evidence of instrumentation are also free of debris. Fig. 7 A Geistlich Bio-Gide® membrane is prepared by punching holes through it, so that it drapes accurately around the implants. Fig. 8 Geistlich Bio-Oss® is now rehydrated in the tetracycline solution and packed into the defects and around the implants. Fig. 9 Geistlich Bio-Oss® in situ. The membrane is placed over the Geistlich Bio-Oss®. Fig. 10 The membrane is then tucked under the reflected flap to fully cover the grafted area. Fig. 11 Flaps are repositioned and sutured and the milled bar secured back into place. The patient was prescribed Azithromycin 500mg o.d. for 3 days. Fig. 12 & 13 The pre- and 2-month postoperative radiographs demonstrate the change in appearance at the defect site. Clinically there is an absence of any further pain of purulence. Fig. 14 Healthy clinical situation after 1 month. Fig. 15 Clinical situation with final prosthetic restoration in place. 3