Yxoss CBR®Customized Bone Regeneration

CAD/CAM Technologies for

Tailor-Made Bone Regeneration

www.reoss.eu

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ReOss®

Quality and Precision are our strengths

ReOss® provides solutions for custom bone regeneration. Patient-specific titanium mesh scaffolds are manufac-tured utilizing modern CAD / CAM technology and delivered tailored to precisely fit the defect. Simply send CT- or DVT data, assess the design and augment according to the prefabricated custom-shaped titanium mesh.

ReOss® - Technology (patented)

In bone defect augmentation, the final bone structure is an important success criterion for satisfying high aesthetic expectations. In addition to the barrier function of Bio-Gide®, the positional stability of the augmentation is of highest priority for regeneration.

The high quality mesh scaffold (Yxoss CBR®, made of pure titanium) generated through the ReOss® digital work flow system control the shape of the bone augmentation and fit perfectly over the bone defect

Images: Dr. Marcus Seiler MSc, Filderstadt

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1. Horizontal and vertical bone defect

3. Yxoss CBR® ® for custom-made bone augmentation (CBR - Customized Bone Regeneration)

2. Model and virtual regenera-ted bone

1. Horizontal and vertical bone defect of the maxilla

2. 3D-Design

3. Yxoss CBR® - high quality mesh scaffold of pure titanium

4. Accurate placement with perfect fitover the bone defect

5. Mesh scaffold in situ filled with auto-genous bone

6. Fixation with a mini-screw

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Custom Bone Regeneration

Individually made Yxoss CBR® mesh scaffolds provide the augmentation site with previously unmet stability and form-fit for the planned augmentation volume.

The Yxoss CBR® mesh structure allows undisturbed bone healing, free from compressive loads and other physical influences.

With the patented manufacturing process for the preparation of individual patient solutions, ReOss® provides high quality individual products for „custom bone regeneration“.

1. 3D-model of the bone defect 2. Definition of the desired final volu-me for the regeneration

3. 3D-model mesh scaffold in position 4. 3D-model: occlusal view

5. View of the crestal breaking pointfor easy removal

The ReOss® - technology unites function and design for success

• custom-fit and tissue compatibility

• high stability during the healing phase

• predefined augmentation volume

• simple fixation and easy removal (Easy Removal Design®)

• reconstruction of original anatomical shape (e.g. Jugae alveolariae)

• easy use and significantly shortened operating time

• for regeneration of complex bone defects

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ReOss® Products

Yxoss CBR® - Tailor-made design

Yxoss CBR® has revolutionized oral bone augmentation by customizing the commonly used “titanium meshes” during production with digital work-flow to fit the individual anatomy of each patient.

Each titanium mesh is custom-made for a precision fit that accurately reflects the specific patient data provided. Time-consuming impressions, cutting, shaping and adapting are no longer necessary and sharp edges from cutting conventional meshes are entirely eli-minated. The unique mesh structure enables superb load-bearing capacity in both compression and shear forces.

Computation of Augmen-tation Volume

On request, ReOss® calculates the necessary augmentation volume for your case planning. As part of a design order, this service is free of charge.

You obtain the data together with a 3-D design proposal made by our ReOss® design center. The volume is given in cubic millimeters. This gives the advantage that exact planning for the amount of bone required is possib-le, or enough information is at hand to allow selection of the correct Bio-Oss® package size

Images: Dr. Marcus Seiler MSc, Filderstadt

DVT-presentation of the mesh scaffold in position

Filling of the mesh with boneand/or Bio-Oss®

The design shape and the tissue com-patibility of pure titanium allow good nourishment for the regenerating bone.

The augmentation region remains un-disturbed within the scaffold during the healing phase.

Harvesting of autogenous bone Bio-Oss® and bone chips

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Yxoss CBR® - Easy Application

The Yxoss CBR® custom-made device is delivered double packaged in sterilization pouches. Sterilization is achieved before surgery simply by autoclaving the device in its inner package.

The mesh structure is then filled with the preferred bone augmentation material and fitted to the defect. Fixation is performed with a self-tapping titanium screw (recommended length: 5-8 mm, may vary depending on the situation; diameter 1.2 mm). The innovative design allows for variable placement of the fixation screws.

Simple Removal with Easy Removal Design®

Our engineers design an area in the crestal region of each device to allow for atraumatic removal. This predefined breaking point allows easy removal with a raspatory, without necessitating a full-thickness flap.

Easy fixation with mini titanium screws in any position.

Separation with periosteal elevator after removal of the mini-screw

Both side plates can now be easily removed

Lifting the second side plate with a raspatory

Completely regenerated ridge afterremoval of the mesh scaffold

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ReOss®Case 1

59-year-old patient with a com-bined horizontal and verticalbone deficit in regions 35 - 37 and 45 - 47. In addition, difficultsoft tissue situation.

Surgeon: Dr. Marcus Seiler MSc, Filderstadt

1. Initial clinical situation 2. Significant horizontal deficit visiblein DVT

4. Virtual 3D model to represent the bone deficit

5. Surgical approach with a split-flap technique

7. Yxoss CBR® mesh scaffold with incor-porated pre-determined breaking point

3. Sagittal view in DVT

6. Exposure of the alveolar ridge after preparation of the split-flap

9. Grinding of the bone cylinders in a bone mill

10. Mixture of Geistlich Bio-Oss® and autogenous material (ratio 1:1)

8. Retromolar bone harvesting with a hollow trephine drill

11. Yxoss CBR® loaded with autoge-nous bone and Geistlich Bio-Oss®

12. Yxoss CBR® in situ with fixation screws

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17. Clinical situation four weeks after soft-tissue healing

19. Inserted implants in region 35-37 for subsequent single-tooth restorations

20. Clinical situation in region 45-47before re-entry

22. Removal of the fixation screw 23. Separation at the „breaking point“ with a periosteal elevator

18. Presentation of regenerated alveolar ridge in region 35-37

21. Crestal incision for removal of Yxoss CBR®

27. Healed soft-tissue with gingiva formers in place

26. Insertion of 3 dental implants in region 45-47

15. DVT-control five months postope-rative - transverse plane

16. DVT-control five months postope-rative - sagittal plane

29. Prosthetic restoration phasewith impression posts(Final restoration not yet available at time of printing)

13. Wound closure with a collagen mem-brane (Geistlich Bio-Gide®) in place

14. Two-layered suture closure withGore-Tex®

24. Removed Yxoss CBR® plates afterseparation at the breaking point

25. Regenerated alveolar ridge in region 45-47

28. Postoperative OPG after implan-tation

ReOss®Case 2

32-year-old patient with a pro-nounced horizontal and verticalbone deficit in regions 33 and34 after removal of a central giant-cell granuloma.

Surgeons: Dr. Dr. Keyvan Sagheb and Prof. Dr. Dr. Wilfried Wagner, University Medical Center Mainz 2. DVT imaging of the defect area

3. Model simulation with Yxoss CBR® 5. Try-in of Yxoss CBR®

6. Bone harvesting with the Safe-scraper® method

9. DVT six months later to examine the regeneration process

10. Re-entry showing the regeneratedalveolar ridge

4. Surgical approach with a poncho flap

8. Situation after complete soft-tissue healing

12. Insertion and positioning of theimplants

13. Plastic wound closure with single sutures

11. Yxoss CBR® mesh and fixation screws after removal

1. Significant horizontal and vertical bone deficit in regions 33 und 34

7. Fixation with osteosynthesis screws

14. Postoperative OPG after implan-tation

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ReOss®Case 3

49-year-old patient with a substantial vertical and horizontal bone defect in region 11-22 after explantation of three alio loco inserted implants.

Surgeon: Dr. Karl-Ludwig Ackermann, Filderstadt

1. Radiological initial situation beforeexplantation

10. Covering with a collagen membrane (Geistlich Bio-Gide®)

3. Virtual augmentation 4. Yxoss CBR® inlay with predetermined breaking points

11. Two-layered wound closure

12. OPG after positioning the Yxoss CBR® mesh scaffold

2. 3D model simulation of situation after several months of bone healing

5. Ausgangssituation mit extrem un-günstiger vertikaler Komponente

6. Surgical approach with a poncho flap 7. Try-in of Yxoss CBR® - planned bone volume can be seen

13. Wound healing 1 week post-op

9. Fixation of Yxoss CBR® with mini-screws

14. Clinical situation five months post-op

8. Autologous bone chips mixed with Geistlich Bio-Oss® for filling

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ReOss®Case 4

68-year-old patient with a combined horizontal and vertical bone defect in regions 12 - 22 and 32- 42 with a difficult soft-tissue situation.

Surgeon: Dr. Marcus Seiler MSc, Filderstadt

1. Initial clinical situation with thin gingival biotype

2. Significant horizontal deficit both buccal and palatal

4. Virtual augmentation in 3D model 5. Custom-fit Yxoss CBR® model withpredetermined breaking point

7. Crestal surgical access with presen-tation of the alveolar ridge

3. Virtual 3D model to represent the bony situs

6. Clinical situation from occlusal view

9. Retromolar removal of bone cylinderswith a hollow trephine

10. Filled Yxoss CBR® (autogenousmaterial and Geistlich Bio-Oss®)

8. Yxoss CBR® before insertion

11. Fixed Yxoss CBR®

12. Five months after augmentation -with natural jaw contour

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17. Horizontal and vertical bone deficitin region 32-42

19. Surgical approach through a crestalincision

20. Yxoss CBR® with integrated breaking point

22. Filling of Yxoss CBR® with autoge-nous material and Geistlich Bio-Oss®

23. Fixation of Yxoss CBR® - fill of the bone harvesting site with collagen

18. Sagittal view of DVT showing the alveolar ridge

21. Try in of the custom-made Yxoss CBR®

25. Separation at the predetermined breaking point (Easy Removal Design®)

26. Regenerated alveolar ridge in region 32-42

24. Control DVT after five month shows good regeneration

28. Insertion of two implants (positions 32 and 42) for subsequent bridge restoration

29. Soft-tissue situation after exposure of the implants

27. Wound closure13. The control DVT after five months shows good regeneration

14. Inserted implants 12-22

16. Clinical situation in region 32-4215. Exposed implants in region 12-22

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ReOss®Case 5

39-year-old patient with a sub-stantial horizontal and verticalbone deficit in region 15-22after trauma.

Surgeons: Dr. Dr. Keyvan Sagheb and Prof. Dr. Dr. Wilfried Wagner, University Medical Center Mainz 2. Initial clinical situation

3. Surgical approach through a crestalincision

5. Try-in of Yxoss CBR® - occlusal view

6. Filled Yxoss CBR®

9. Postoperative OPG with Yxoss CBR® in situ

10. Situation three weeks after augmen-tation

4. Try-in of Yxoss CBR® - buccal view

8. Wound closure

12.Careful detachment of Yxoss CBR®

13. Regenerated alveolar ridge afterremoval of Yxoss CBR®

11. Control DVD to verify regeneration five months post-op

1. Large horizontal and vertical bone defect in region 15-22

7. Yxoss CBR® covered with PRF-A

14. Insertion of 4 implants in positions 15,13,12 and 22

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ReOss®Case 6

56-year-old patient wished fixed dentures. Horizontal augmentation of 15 - 25. After healing, implanta-tion in positions 15, 13, 12, 22, 23 and. 25.

Surgeon: Dr. Marcus Seiler MSc, Filderstadt

1. Horizontal deficit from many years of wearing mucosa-supported full dentures

10. DVT six months later

3.Presentation of the bony situs with a full-thickness flap

4 Yxoss CBR® with several incorporatedpredetermined breaking points

11. Separation at the predetermined break points (Easy Removal Design®)

12. Introduction of six implants in posi-tions 15, 13, 12, 22, 23 and 25

2. Initial clinical situation

5. Try-in of Yxoss CBR® - planned bone volume can be seen

6. Autologous bone chips after retro-molar bone harvesting

7. Filled Yxoss CBR®

13. Exposed implants before definitiveprosthodontic treatment

9. Saliva-proof plastic wound closure

14. Definitive prosthetic restoration

8. Fixation of Yxoss CBR® with fourmini-screws

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ReOss®

Design, manufacturingand customer service

Through a patented process we produce a custom-made dimen-sionally stable mesh scaffold made of pure titaniumaccording to your specifications submitted by CT or DVT images for patient-specific bone regeneration (CBR = Cus-tomized Bone Regeneration).

We also offer complete customersupport through the product design process for your surgery. Our specialists know in great detail the practice internal processes, the surgical challenges and the bio-logical limitations.

ReOss® Products

How to Order

Use the simple ordering processand data upload over our website.

In your personal „MyReOss“account you will easily and at any time find all information onyour cases and the respectivedesign and production steps.

Or simply send us your CD-ROM with the DICOM data with CT or DVT images. We take care of setting up your personal „MyReOss“ account and the first data upload..

Questions about the ordering process:

Geistlich BiomaterialsTel. 07223 9624-19www.geistlich.de

Questions about treatment planning or your account:

ReOss® GmbH Talstrasse 23 · D-70794 Filderstadt eMail: contact@reoss.eu

From Germany:Tel. 0800 700 1199Fax 0800 700 1188

6. Data Transfer:Easy and safe transmission of 3D-data (CT or DVT)

7. 3D display technology:Before the product is made, you receive a 3D design for evaluation and ordering

8. You keep an eye on everything: From order to delivery

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Our products fulfill the defined requirements of the European Directive RL93/42 EEC, Annex VIII for custom-made medical devices in terms of product performance and patient safety.

Quality assurance

Every step of the manufacturing processes of ReOss® implants fulfils quality requirements according to EN/ISO 13485.

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1. Start with ReOss®: Registration and order

2. Fill out the order form: Information on the planned OP

3. Odontogram:Choose augmentation area

4. Order at a fixed price:Immediate offer, no hidden costs

5. Pay conveniently:By credit card or bank transfer

Yxoss CBR®Easy ordering atwww.reoss.eu

Request and OfferEnter patient data in the protected area „MyReOss“,

upload to ReOss® GmbH...

-> You will immediately receive an offer for the

design process and can place an order.

3D-Design to review - quick and easy online... click CT or DVT data, upload to ReOss® GmbH start

and place order. Within a few days you will receive

the notification to assess the design on „MyReOss“.

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Assessment and orderAssess the 3D-Design and order production

of Yxoss CBR® titanium mesh scaffold.

Experienced clinicians are available for

a consultation.

The delivery arrives a few days after the

production order is placed and you can

implant your Yxoss CBR® titanium mesh

scaffold immediately after receipt and

sterilization.

ReOss® GmbH Talstrasse 23 · D-70794 Filderstadt

eMail: contact@reoss.eu · www.reoss.eu

From Germany::

Tel. 0800 700 1199 · Fax 0800 700 1188

International:

Tel. +49 711 489 660 60 · Fax: +49 711 489 660 66

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Kontakt GeistlichGeistlich Biomaterials Vertriebsgesellschaft mbH

Schneidweg 5, 76534 Baden-Baden

Tel. 07223 9624-19 · Fax 07223 9624-10

eMail: emil.endress@geistlich.de

www.geistlich.de