Dental Treatment Blog

Concept All on 4 Technique

Concept All on 4 Technique:

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All­ on­ 4 treatment technique for complete rehabilitation of the edentulous (No teeth present in the  jaw), is a surgical and prosthetic medical procedure which is fixed rehabilitation option with  Dental Implants.   All on 4 concept was developed in 1990’s through studies funded by Nobel Biocare in  collaboration with a Portuguese dentist Paulo Maló.   This technique is rehabilitation in the edentulous maxilla and mandible with fixed prosthesis by  placing 4 implants in the anterior maxilla( front upper jaw before sinus and mental foramen),  where bone density is higher, allowing the highest success rate.   The four implants support a fixed prosthesis with 12 to 14 teeth  in each jaw and it is placed  immediately on the day of surgery. All­on­ 4 is a registered trademark of Nobel Biocare.  This technique is time tested and widely accepted in many parts of the world.

Nowadays this concept is copied by various implant companies at a cheaper and affordable  prices. These companies which also give life time warranty on all on technique.    2.Procedure Description of all on 4 technique at The Dental Specialists,  Hyderabad, India:  All­ on ­4  treatment concept provides a permanent, screw­ retained and cement , same day  replacement for the entire upper and lower teeth set. The procedure is best indicated for patients  with major bone loss, tooth loss or decay.   Tooth loss leads to jaw bone which poses the problem of reconstruction of the jaw bone.  Conventional technique requires almost six to twelve months to restore the implants. Moreover  we need to transplant bone from various other parts of the body like iliac crest or skull. Why 12  months is because we have to graft initially and wait for 3 to 6 months till the artificial or natural  bone gets integrated. And achieve good bone density. Later we place implants and again wait for  3 to 6 months till the implants get osseointegrated.     Many of the patients can not undergo transplantation of bone for general health reasons  (diabetes and others).     The All ­on 4  treatment concept, will address these drawbacks because it consists in  establishing a fully customized denture (bridge) based only on four titanium Tall and Tilted  implants. These implants act as “pillars” to the bridge that supports the prosthetic teeth. The  invented process takes advantage of existing bone, even if scarce, avoiding having to use bone  grafts.   The posterior back implants are angled at approximately 45 degrees to avoid compromising the  sinus cavity in the upper jaw and the nerve canal in the jaw.

 

10 reasons why we at THE DENTAL SPECIALISTS stopped using single piece Implants

 

10 reasons why we at THE DENTAL SPECIALISTS stopped using single piece Implants

1.Narrow Diameter Implants: Very thin Implants. Hence more number (Minimum 10-12 in each Jaw) of Implants are required to restore full mouth rehabilitation.

2.Bone Implant Contact(BIC): BIC ratio is very less- No Osseointegration. Polished Surface all over- Thin Implants- Less Surface area- less osseo integration

3. Implant retention: because it engages only the cortical bone. Threads only in tip: leads to spinning or failure of Implant.

4. Need to load the implants for sure if there is no primary stability also (Because it is Single Piece- Implant and Abutment is connected)- leads to failure.

5. Can not be tilted beyond 15 degrees. Abutment breaks and the implant becomes useless.

6. Neck Connection: Implant and Abutment connection is very thin and can break while tightening at high torques or tilting the abutment to make it parallel to the adjacent implant.

7. No US FDA approval

8. Cannot be loaded individually. Needs to be connected to the other implant or tooth which is not suggested. Need to place 2 implants instead of one especially in the load bearing areas.

9. Tilting of the implants is not possible because the implant and abutment is in one piece. Especially in upper anteriors and when there is no bone  tall and tilted implants are necessary to engage the cortical bone- Nasal floor.

10. Palatal placement of the implant is not possible because it cannot be bent. The abutment when  bent can break at the neck of the implant.

To go into depth and detailed description why Single piece Implants are not successful. Read the link below…

Single Piece Implants- Disadvantages

 

To the protocol and technique of TTPHIL Technique follow this link below.

TTPHIL Technique – Permanent Teeth in 2-9 Days

 

Check out the link below to understand the concept of screw retention. Why screw retained bridge is accepted

worldwide and not cemented retained solutions..

SCREW RETAINED BRIDGE VS CEMENT RETAINED BRIDGE

 

 

 

Immediate loading Implants with TTPHIL ™ Technique

Immediate loading Implants with TTPHIL ™ TechniqueTTPHIL IMPLANT

What is  TTPHIL  ™ technique?

  • TTall implants measuring 16 to 57.5 mm depending on the engagement of the Bicortical Basal bone support
  • TTilted implants placed at an angulation of 15 to 70 degrees.
  • PHPinHole – Flapless procedure
  • ILImmediate Loading (Provisional Prosthesis in 2 hrs and Permanent Prosthesis in two days)

WHY TTPHIL- ALL TILT TM Technique? Rationale: Set of reasons and logical basis. A Justification…

Surgical Phase Advantages

1.Immediate Loading- Permanent CAD CAM Ceramic teeth in just 2 days.

2.Avoid Sinus Lifting procedures and other Bone Augmentation procedures unless really needed for aesthetic reasons. – Secondary Morbidity Invasive procedures- Avoidance of additional surgical risks.

3.Local Anesthesia procedure – Minimal Anesthesia

4.Minimal Medication.

5.Can be done in Heart Patients/ Smokers/ Diabetic Patients/ Gum diseases

6.High success rates

7.Low cost to the patient and time saving ( Avoids bone grafting procedures)

8.No healing time required- Immediate function the same day- Permanent prosthesis in 2 days

9.Less post operative pain

10.Most advanced system

11.High success rate in patients with less bone height

12.Employs cortical bone areas which are resistant to infection and resorption.

Prosthetic Phase Advantages

Latest CAD CAM Abutments which are customised have a Q- lock Morse connection when torqued at 25 Newton centimeter becomes cold welded. This cold welding property prevents screw loosening.

Single piece implants have abutments and Implant fixture in one piece, hence needs to be cemented. There is no option for screw retention at all. In TTPHIL ™ Technique the restorations ( Implant Supported Crowns and Bridges ) can be either cement retained or screw retained depending on the case. The main advantage of screw retention is retrievability – In case of any complication ( For eg: Gums shrinkage: Most common in immediate Implantation and loading)  we can remove the ceramic prosthesis simply and add ceramic where required.

Aesthetics is better in cement retained restorations  but now with the Pre Angulated abutments with Micky Mouse screw this also has a solution. But very expensive..

Retrievability – Screw retained better than Cement retained. In case of any complication the bridge can be removed and can diagnose the situation easily.

Retention: In case of less mouth opening less than 7 mm abutments are used screw retained is always better when compared to cement retained restortions

Immediate implant placement: Screw retained restoration better because of repairability and maintenance.

Passivity and provisionals ( Temporary teeth): Both are good

Occlusion: In screw retained restoration you can get it removed and add ons can be done later after osseous integration of the implants. Progressive loading is possible in screw retained restorations.

Immediate loading: Both cement and screw retained can be done.

Impression procedure: Its easy to do cement retained restorations. The doctor should be a Prosthodontist or skilled dental surgeon to take accurate impressions.

Long term Planning: Screw retained restoration is always better than cement retained restoration.

 

8 DIFFERENCES BETWEEN TTPHIL IMPLANT TECHNIQUE AND CONVENTIONAL IMPLANT TECHNIQUE. 8 REASONS WHY WE CHOOSE TTPHIL TECHNIQUE at THE DENTAL SPECIALISTS: ADVANCED DENTAL IMPLANT CENTRE

1.Load Transmission is in the basal Cortical Bone – Because these implants are Tall and Tilted beyond 16mm to engage the cortical basal bone which is highly resistant to resorption. This cortical bone is highly mineralized and more resistant to infections as well as its ready from day 1 to take the loads. Conventional implants the load transmission is in crestal cortical plate leading to crestal bone loss. In thus area it leads to bacterial attack.

2.Polished collar in the crestal region: No penetration of bacteria. No source of Infection and Periimplantitis – Hence No bone losS

3. TTPHIL™ Implants require only patients own, residual bone for anchorage and primary stability.

4. No risky augmentation procedures required- No time delay for augmentation Graft to take up- No secondary morbidity chances

5. Immediate loading- No edentulous phase- No waiting period. 2nd day permanent teeth- Direct Metal Laser Sintered CAD CAM teeth- Improves quality of life..

6. Simple and easy Surgical Phase- No bleeding- Flapless technique- No sutures- Minimal anesthesia- Just 0.2ml. Minimal bleeding- Minimal medication- Minimal discomfort during and after – It will not take more than 30 minutes for full mouth implant placement. Simple Single implant cases takes just 5 minutes. Post operative pain minimum.

7.Extractions and Implants are done on the same appointment. Same Anesthesia- Same Post Operative medications. Even if the teeth have periodontal infection, the teeth are removed, bone

curettage is done and TTPHIL™implants are placed at the same time. Patients are never with out the teeth. Immediate provisional are given in 2 hours. Permanent CAD CAM DMLS teeth are given on the second day.

8. The Implant Design will allow better bone healing and osteonal remodeling.

 

10 reasons why we at THE DENTAL SPECIALISTS stopped using single piece Implants

1.Narrow Diameter Implants: Very thin Implants. Hence more number (Minimum 10-12 in each Jaw) of Implants are required to restore full mouth rehabilitation.

2.Bone Implant Contact(BIC): BIC ratio is very less- No Osseointegration. Polished Surface all over- Thin Implants- Less Surface area- less osseo integration

3. Implant retention: because it engages only the cortical bone. Threads only in tip: leads to spinning or failure of Implant.

4. Need to load the implants for sure if there is no primary stability also (Because it is Single Piece- Implant and Abutment is connected)- leads to failure.

5. Can not be tilted beyond 15 degrees. Abutment breaks and the implant becomes useless.

6. Neck Connection: Implant and Abutment connection is very thin and can break while tightening at high torques or tilting the abutment to make it parallel to the adjacent implant.

7. No US FDA approval

8. Cannot be loaded individually. Needs to be connected to the other implant or tooth which is not suggested. Need to place 2 implants instead of one especially in the load bearing areas.

9. Tilting of the implants is not possible because the implant and abutment is in one piece. Especially in upper anteriors and when there is no bone  tall and tilted implants are necessary to engage the cortical bone- Nasal floor.

10. Palatal placement of the implant is not possible because it cannot be bent. The abutment when  bent can break at the neck of the implant.

 

 

SCREW RETAINED BRIDGE VS CEMENT RETAINED BRIDGE

SCREW RETAINED BRIDGE VS CEMENT RETAINED BRIDGE

Paulo Malo: The Pioneer and inventer of All on 4 technique says in his own words that the screw retention is always better than cement retained bridges.

Listen to him…

 

Hello I’m Dr. Venkat Nag.   The hot topic in implant dentistry today is kind of an old technique is holding your crown in with a screw or holding your dental implant crown in with cement so it’s cement retained versus screw retained crowns and implant bridges so  that’s the topic is which one’s better.Well the reality is one isn’t better than the other and they should on a case-by-case basis be evaluated for what’s really right for you there are people that are very feel very strongly that everything should be retained and everything should be a cement retained but the reality is I do a little bit of both I do what’s best for my patients regardless of perhaps sometimes what they want or what they’ve read on the internet so let me just give you a some basics so screw retained means that the bthe implant holds in place by a screw there is no no cement that holds it if the implant goes into the bone that’s screwed into the bone that stays there but the crown can come on and off with the screw so we know one of the big advantages of screw retained is retrieveability that means if you have to take it out you can for most dental implants.

 

Smoking and Dental Implants

#SmokingandDentalImplants

Question: I am a SMOKER for past 25 years. Can I get Immediate Implants done with TTPHIL technique?

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Most of my patients who are  smokers ask me about the success rates of Dental Implants in Smokers when compared with others.  Clear answer is that there is no problem with Smoking. There is no direct relation between Smoking  and Dental Implants. Smoking indirectly effects the gums if not taken care properly leading to peri implantitis. Whatever you smoke and how often you smoke you are definitely a candidate for immediate load implants one of the reason of course is that you don’t need a bone of limitations you don’t need bone transplant all these procedures which are contraindicated for smokers are not necessary and therefore it is you have the same chance as any other patients if you are smoking even if you are smoking heavily and also this is a question which I get often can I interrupt the operation too small and the clearances of course yes we can give you a break and you relax a little bit you smoke a cigarette and then we continue with the influent procedure with impression or whatever so don’t be worried you have to you don’t have to limit yourself you can just live your normal life and we give you the immediate load implants. Smoking and Dental Implants is not very important in this technique because it is a complete flapless technique and no chance of Infection. Basal Implantology is based on the concept of bicortical anchorage which will allow immediate stabilization of the implant and loading of the implant.

 

According to the Literature , Cigarette smoking has long been known to be associated with a variety of oral conditions including periodontal diseases which are inflammatory diseases affecting the tissues that surround and support the teeth bone loss tissue loss tooth loss and dental implant failure.  The success rate for patients who smoke is significantly lower than for people who do not smoke the nicotine in tobacco has been shown to reduce the blood flow in the mouth pipe smoking can be worse than cigarettes due to the higher temperatures generated in the upper jaw and excessive tooth wear as the teeth clenched the pipe not only is smoking detrimental to implants it’s also bad for conventional bridge work smokers also experience a slower healing time when following implant replacements if you’re a smoker and considering dental implants be sure to talk to your doctor about any increased health risks. So do not neglect your gums. This can lead to implant failure. #Smoking and Dental Implants

 The reason TTPHIL technique is better when compared to Single piece basal implants or conventional two piece implants especially in Smokers is that
1. These implants are tall and longer implants which have more surface are leading to better Osseointegration.
2. By Tilting the Implants we can increase the length of the implant in-turn we are increasing the surface area of the implant.
3. The concept in this technique is that we are engaging the cortical plate on both ends- Single and multicortical anchorage. Hence immediate loading can be done because of high torques and stability (This is the concept and Principle behind the success rate of  Zygomatic implants)
4. Screw retained solutions which is not possible in Single piece basal implants. ( GEN XT. KOS, BCS, BOI , Swiss Etc)
5. Any time it can be removed cleaned and refixed when required which is not possible in any system available in India.
6. No Cement used to fix the Prosthesis. There fore its clean. Cement leads to irritation of the gums.
7. Final Metal ceramic or Zirconia prosthesis is given for immediate loading
8. No Stitches required to do this procedure because it is a Pinhole technique. No Flap Opening- Complete Flapless procedure- Minimal bleedding- Minimal Anaesthesia.
For more details, Appointment
Whatsapp/ SMS/ Facetime: +91-9963511139 or +91-9177671117
The best way to reach us is through Email : dentalspecialistsindia@gmail.com
or Book Online Appointment Now. We will call you back according to your convenient time. You need to fill up the complete detailed case sheet  in the link to explain you the different treatment options and give a ballpark quote.

 

Baby Bottle Tooth Decay

Early Childhood Caries or Baby Bottle Tooth Decay

Even though they are temporary, your child’s baby teeth are important, and are still susceptible to cavities. Tooth decay in infants and toddlers is often referred to as ‘Baby Bottle Tooth Decay’, or ‘Early Childhood Caries’. Children need strong, healthy teeth to chew their food, speak and have a good-looking smile. Their first teeth also help make sure their adult teeth come in correctly. These primary teeth hold space for permanent teeth to erupt and contribute greatly to a child’s self esteem.

It’s important to start infants off with good oral care to help protect their teeth for decades to come. Being parents, one need to realize that a baby’s teeth are at risk for decay as soon as they appear in the mouth. By the time the cavities are large enough for you to see, it may be too late to save the child’s teeth.
What is early childhood caries?
Early childhood caries (ECC), also referred to as baby bottle tooth decay, is a condition that can destroy the teeth of an infant or young child. It is a severe form of decay in the primary (baby) teeth due to prolonged and frequent exposure to sugary liquids such as formula, milk, breast milk, juice, and sodas.

 

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What causes early childhood caries?
Plaque is a thin, sticky film of bacteria that continually forms on everyone’s teeth and gums – even babies. The bacteria found in plaque use sugars to produce acid. After frequent, repeated acid attacks, tooth decay can occur. It’s not just what children drink, but how often and how long their teeth are exposed to decay-causing acids.
If a child goes to bed with a bottle of juice, milk, or formula, there is a chance that their teeth can decay. That’s called Early Childhood Caries (ECC). It can be very painful and sometimes surgery is needed to fix the harm caused by ECC. Your child can get the germs that cause tooth decay or gum disease from anyone who has these problems. Baby Bottle Tooth Decay most often occurs in the upper front teeth, but other teeth may also be affected.
There are many factors which can cause tooth decay. One common cause is the frequent, prolonged exposure of the baby’s teeth to drinks that contain sugar. Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby.
Tooth decay is a disease that can begin with cavity-causing bacteria being passed from the mother (or primary caregiver) to the infant. These bacteria are passed through the saliva. When the mother puts the baby’s feeding spoon in her mouth, or cleans a pacifier in her mouth, the bacteria can be passed to the baby.I f your infant or toddler does not receive an adequate amount of fluoride, they may also have an increased risk for tooth decay. The good news is that decay is preventable.

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Symptoms of more severe decay include:
• Brown or black spots on the teeth
• Bleeding or swollen gums
• Fever, swelling or irritability, which could indicate infection
• Bad breath
If your child shows any of these symptoms, it’s imperative to see a dentist as soon as possible. If decay spreads, your child could face extensive restoration treatments and even tooth loss.

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How to keep baby safe from ECC?

Wipe your baby’s gums and teeth with a soft damp cloth after feeding, before bedtime, and at naptime. Don’t let your child take formula, milk, juice, sugar-water, or food to bed. If your child must take a bottle to bed, fill it only with water. Water can’t harm teeth the way other drinks and food can. You and your dentist: partners to protect your child. Gently lift your child’s upper lip and look for white or dark spots on their teeth. If you see these spots on their teeth, make an appointment with your child’s dentist right away. If your child does not have a dentist, ask your doctor for the name of a dentist who will see young children.
Preventing Baby Bottle Tooth Decay
• Try not to share saliva with the baby through common use of feeding spoons or licking pacifiers. After each feeding, wipe your child’s gums with a clean, damp gauze pad or washcloth.
• When your child’s teeth come in, brush them gently with a child-size toothbrush and a smear (or grain of rice sized amount) of fluoride toothpaste until the age of 3.
• Brush the teeth with a pea-sized amount of fluoride toothpaste from the ages of 3 to 6.
• Supervise brushing until your child can be counted on to spit and not swallow toothpaste—usually not before he or she is 6 or 7.
• Place only formula, milk or breast milk in bottles. Avoid filling the bottle with liquids such as sugar water, juice or soft drinks.
• Infants should finish their bedtime and nap time bottles before going to bed.
• If your child uses a pacifier, provide one that is clean—don’t dip it in sugar or honey.
• Encourage your child to drink from a cup by his/her first birthday.
• Encourage healthy eating habits.
• When your child’s first tooth appears, talk to your dentist about scheduling the first dental visit. Treat the first dental visit as you would a well-baby checkup with the child’s physician.
• Remember: starting early is the key to a lifetime of good dental health.
• Foods containing proteins and fats cannot be utilized by bacteria to produce acids. They tend to increase the ph levels and neutralize the acids that may have been produced eg seeds and nuts, raw vegetables and fruits.
• Parental tooth cleaning, especially with a very small amount of fluoridated dentifrice, is helpful when accomplished at least once a day. Twice a day is even better.
• A counseling approach, providing the parent with choices has been found effective. The sugar substitute xylitol has been found to be effective at reducing levels of harmful micro-organisms in the mouth, and has recently been promoted as a cavity reducing agent in the form of disposable wipes.

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The Importance of Treatment for Baby Bottle Tooth Decay

It’s a common misconception that the premature loss of baby teeth isn’t a problem. After all, these teeth are going to fall out anyway, so why worry if they fall out earlier than scheduled?
In fact, there are many reasons to be concerned about the premature loss of baby teeth.
The permanent teeth — which will serve your child into adulthood — are present in the jawbone from your baby’s early years. The baby teeth act as a placeholder for the permanent teeth. If they are lost prematurely, the spacing of the permanent teeth can be affected. Premature loss of baby teeth can lead to misaligned permanent teeth along with other issues that could require extensive orthodontic treatment. Tooth loss can also make it difficult for your child to eat a healthy, nutritious diet. It can also affect his or her ability to speak properly. Proper diction requires the presence of front teeth, so premature tooth loss could lead to a need for future speech therapy.
Bad hygiene habits could follow your child into adolescence and adulthood. The best way to ensure ongoing dental health as your child matures is to be sure that he or she learns good oral hygiene from the beginning. The best approach to baby bottle tooth decay is prevention. If your child does experience early childhood dental caries, you and your child’s dentist can work together to determine the best treatment options.

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SINGLE PIECE BASAL IMPLANTS VS ACTIVE THREADED TTPHIL™ BICORTICAL BASAL ANCHORED IMPLANTS

WHAT ARE THE DIFFERENCES BETWEEN SINGLE PIECE BASAL IMPLANTS VS  ACTIVE THREADED TTPHIL™ BICORTICAL BASAL ANCHORED IMPLANTS?

This post is not to support one particular technique. Each technique has its own pros and cons. We need to decide which is the best for your particular case. Every case is different. Every patient is different. Each one has their own priorities.. You need to take a call based on the presentation below. But before taking the decision you need to read this article.  

In this post we would like to tell the advantages of our technique and not to criticize the other techniques. We do both Single piece implants and Two piece Implants in our practice. We decide which implant technique to be used based on the patient location, Budget, treatment planning, number of teeth missing, location of the teeth missing- Front / Back, Upper Jaw/ Lower Jaw.

The first and foremost thing one should note is that Single piece implants have abutments and Implant fixture in one piece, hence needs to be cemented. There is no option for screw retention at all. In TTPHIL ™ Technique the restorations ( Implant Supported Crowns and Bridges ) can be either cement retained or screw retained depending on the case. Watch the video below to understand what are Single piece implants and two piece implants.

The other thing one should understand is that whether we are doing immediate loading or delayed loading. In Immediate loading we need to splint  or connect the bridges if multiple teeth needs to be replaced for equal force distribution in either of the techniques.  Because of this reason we prefer screw retention when we are replacing many teeth.  If one of the implant for suppose has a problem in future cement retained implant crown and bridges retrievability is impossible. We cannot repair the bridge. We need to cut the whole bridge which is traumatic. If you are planning to get a single implant replaced you can choose cement or screw retained option in case of front tooth missing. In case of back tooth missing it is advised to go for screw retained restorations because it is not located in the esthetic region. Now the recent developments in case of front tooth/ teeth replacements we are using pre angulated abutments.

screw retained restoration(Why we at THE DENTAL SPECIALISTS prefer cemented restorations is because  in these situations having a screw access in a visible area is unacceptable. When screw access to the implants are in aesthetic areas, the screw access can be re directed at times with use of pre angled abutments or the restoration should be retained with custom-made  CADCAM abutments and cement retained Implant supported restorations can be attached to implants with screws or can be cemented to abutments which are secured to implants with screws.)

This article will be written from this perspective and the advantages and disadvantages of each method of retention. It will be discussed under the following 10 headings:

1.Aesthetics

2.Retrievability

3. Retention

4. Immediate Implant placement

5. Passivity

6. Provisionals

7. Occlusion

8.Immediate loading

9. Impression procedures

10.Long term treatment planning

This post is mainly regarding Single Visit Dental Implant treatment. In most of the cases we at THE DENTAL SPECIALISTS  place Flap less or Pinhole or Key hole Implants ( without opening the gums) based on the clinical and radiographic guide assessment. But sometimes when the bone availability is less we prefer to open the gums and place the implants and bone grafts for better visibility and safety and long term results. Both the flapless ( Less when compared to Flap Opening) and flap opening procedures lead to gum shrinkages when we load immediately. Usually we replace the crowns and bridges immediately with in 2 days to week depending on the case. We used to do single piece implants for multiple and full mouth rehabilitations for Single Visit Dental Implants before, but because of three reasons we are now preferring screw retained restorations- gum shrinkage in cement retained implant restorationsFirst reason: We can expect some gum shrinage which cannot be  repaired in cemented bridges. In screw retained bridges with multi unit abutments  and CAD CAM MLS and ZIRCONIA technology we can repair it by sending it to the ceramic  laboratory Though screw retained restorations are more expensive they can be maintained and repaired. Second reason: In Cemented retained restorations the cement gets entrapped in the gums which leads to gum shrinkage leading to inflammatory changes because of the left out cement particles in the gum sulcus which  later leads to bone loss.

cutting the bridge cement retained restoration

Third reason: We need to cut the whole restoration or the bridge if any issue comes. If it is one single tooth replacement it is easy to cut but if multiple teeth replacements or full mouth replacements have to be done cutting the bridge is not easy. The only advantage of cement retained restoration is that the bridge will not come out but what if there are any issues in the implants. We should expect those and get the implants done.  We are getting them done once for all. Now its you to choose whether to go for cement or screw retained restorations based on the above article.

Aesthetics is better in cement retained restorations  but now with the Pre Angulated abutments with Micky Mouse screw this also has a solution. But very expensive..

Retrievability – Screw retained better than Cement retained. In case of any complication the bridge can be removed and can diagnose the situation easily.

Retention: In case of less mouth opening less than 7 mm abutments are used screw retained is always better when compared to cement retained restortions

Immediate implant placement: Screw retained restoration better because of repairability and maintenance.

Passivity and provisionals( Temporary teeth): Both are good

Occlusion: In screw retained restoration you can get it removed and add ons can be done later after osseous integration of the implants. Progressive loading is possible in screw retained restorations.

Immediate loading: Both cement and screw retained can be done.

Impression procedure: Its easy to do cement retained restorations. The doctor should be a Prosthodontist or skilled dental surgeon to take accurate impressions.

Long term Planning: Screw retained restoration is always better than cement retained restoration.

These are the prosthetic advantages why we choose ACTIVE THREADED TTPHIL™ BICORTICAL BASAL ANCHORED IMPLANTS?

We wish you to read the below articles which are more interesting about the TTPHIL™ technique.

Single Piece Implants- Disadvantages

TTPHIL Technique – Permanent Teeth in 2-9 Days


Still have doubts please feel free to call us on 00919963511139/ 00919959448800/ +919177671117. Its important for our team to clarify your doubts before you take a decission. The best way is to email us your  X-rays, OPG, CBCT and Intra Oral photos to dentalspecialistsindia@gmail.com. Our team will call you or email you which ever you are comfortable.

 

 

Sedation in Dentistry

At The Dental Specialists, we offer a number of options to help you find relief from dental anxiety, including oral sedation and intravenous (IV) sedation. We prioritize your comfort by using reliable methods of sedation dentistry in our hospital.

Our high standards of service and clinical expertise, and the environment in which we work, all reflect the best of modern dentistry.

We offer a prompt service for emergency cases, such as severe pain, swelling or trauma. To take advantage of this service, please call us on +91 99594 48800. Where possible we will see your patient on the same day or the following day for emergency care.

In a single session under sedation, different procedures including restorations, pulp therapies, extractions, preventive procedures and a lot of other dental treatments can be done. The quality of dental care is much better with general anesthesia for the reason that the dentist can perform treatment for the patient  without having to constantly adjust for the patient’s movement and without having to prepare and encourage the patient.

 

Oral Sedation Dentistry at the Dental Specialists

Some patients experience fear regarding dental procedures. Oral conscious sedation is an effective option in sedation in dentistry because it works well for most patients.

Sedation is one modality that makes sure that the patient received effective pain control. It is more convenient and time saving than treatment in office setting.
Benefits of Oral Conscious Sedation

Easy administration – tablet form

Effectiveness and the ability to have successful, longer appointments

A good option for those with fear of injections/needles.

Well-tolerated by the majority of our patients

Little to no memory of your treatment

 

Benefits of Nitrous Oxide Sedation

Rapid onset which means that the sedative effects are felt quickly

Reduces gag reflex

Has few-to-no after effects


Intravenous sedation

Intravenous sedation is very effective for creating a calm state in anxious dental patients who might also have some kind of phobia regarding dental treatment. One of its benefits is that it creates little to no memory of the dental procedure after the treatment and is a popular choice for patients with anxiety. Patients who have IV sedation require a companion to bring them to and from their dental appointment and to stay with them afterward.

The IV is inserted and an anti-anxiety sedative is administered by a doctor qualified to administer it.

The onset is rapid and the patient experiences a state of conscious relaxation with little or no memory of the experience.

Patient is able to communicate, allowing the dental team to confirm the state of the sedation.

Pulse and oxygen levels are monitored throughout the procedure for patient safety.

Most patients are “awake” with little or no memory of the event.

The procedure is always supervised by dental professionals trained in IV sedation.

Please feel free to talk to one of our professionals at The Dental Specialists regarding sedation in dentistry or any other procedure you may have a question about.

 

Pre-Operative Care
The following instructions are general guidelines. Follow the instructions you received during your pre-op consultation as they will be more specific to your needs.

No food or water 8 hours prior to your appointment.

Do not drink any alcohol.

Inform us of any prescription drugs you are taking.
Post-Operative Care

Patient cannot drive for 24 hours after sedation

Do not operate any hazardous devices for 24 hours

A responsible adult should be with the sedated patient for several hours after the appointment until the effects for the medication has worn off. This amount of time varies from person to person.

Patient can eat and drink as soon as they would like and doing this will likely ‘wake them up’ faster than if they did not.

Patient should drink fluids as soon as they are able to.

Patient may be drowsy after they leave our office. They may also seem alert. Attend to both alert and drowsy people the same.

Always assist the patient when they are walking.

Call us if you have any questions or difficulties. If you feel that your symptoms need a physician, you can go to the closest emergency room immediately.

 

Dental Medicine

Today the world is more focused and diverted towards the specialization.  Dentistry is one such field with many specializations. If you are aware about different dental specialists, it helps to know which type of dentist can help you most efficiently. A simple example will help you to have a better understanding: we go to orthopedist for bone problems or defects and not to a cardiologist because both are doctors. An orthopedist have specialization in bones related problems and a cardiologist is a heart surgeon . Similarly, Dentistry is a field of Medicine which has 9 specializations.

What are the different specialties in Dentistry?

  1. Prosthodontics

 

Prosthodontists are the specialists who deals with the treatment of missing teeth .They replaces the missing teeth by fabricating the artificial prosthesis which replicates the natural teeth .The replaced teeth are made such that they fulfills the  aesthetical and fuctional requirement. They make sure that the mastivatory forces are evenly distributed to prevent traumatic occlusion. The missing tooth or teeth are replaced by different measures ; it can be removable or fixed depending upon the health of supporting structures i.e gums , alveolar bone and the adjacent teeth.. If the supporting structures are not strong enough we go for removable prosthesis. This removable prosthesis can be inserted by oneself. It has to cleaned daily for proper hygiene. These prosthesis gets their strength via metallic framework attached to it. The fixed prosthesis includes bridges or implants. The bridges or crowns can be metal ceramic or zirconia crowns depending on the requirement. Sometimes for preparing a crown we need to do intentional root cal treatment to avoid any hypersensitivity of teeth. Another prosthetic approach to tooth replacement is the dental implants , which is a surgical intervention. Dental implants are the titanium screws which are drilled into the alveolar bone to serve as anchors for the tooth to be replaced.the implants are now accepted world wide as it does not involves root canal treatments of adjacent teeth for support.the implants can even be loaded immediately and thus it also fulfills the aesthetical requirement by not revealing the missing tooth .. Implantology is now developing to a field by itself.

 

2.Periodontics

Periodontics is the branch  of dentistry that deals with Gum disease : its causes  and treatments. If you have bleeding gums then you need to visit to pereiodontist without delay as this could be the early sign of any gum disease. Gums constitutes the major part of oral health. Unhealthy gums lead to several dental problems and also its associated with some other health issues like diabetes  or heart diseases. Any defect in the gums and its adjoining structures results in early loss of teeth. Plaque and calculus are the deposits which gets  accumulated along the gum line and irritates and inflames the gingiva. This results in gum  diseases  like gingivitis and periodontitis.  Further more any gum recession or bone recessions are uplifted by doing flap surgeries which are undertaken by the periodontist. Periodontal treatment includes the cleaning of the plaque deposits and calculus with the hand instruments or ultrasonic scalers. Bony and gum defects are treated by raising the gingival flaps and deep cleaning or (curettage) ; to remove the granulomatous or necrosed  tissue. Mobile teeth may be splinted together for support and stabilization during the healing process.

 

3.Pediatric Dentistry

Pediatric dentistry is a field that deals with treatments for kids and teens. It is recommended by the American dental academy that an infant’s first visit to the dental clinic should be made till his/her first birthday .Children have their primary or milk teeth till the age of 13 years. The problems related to the primary set of dentition is taken by pedodontist. Teens have the mixed dentition that includes both primary and permanent dentition.Kids and teens have special type of problems which are treated by specialist .pediatric practice not only deals with treatment but also prevention from dacay by educating both parents and the children. If the milk tooth sheds before time the space has to be maintained for the future permanent tooth. This space is maintained by using space maintainers. Its very important to guide the correct eruption of teeth to avoid the malocclusion and the subsequent trauma due to occlusion. If your kids have problems related to cavities or tooth fracture then they need to visit the pedodontist to treat it by fillings or rct or pit and fissure sealants.

 

4. Endodontics

When the tooth becomes infected or the decay involves the pulp it has to be treated by a root canal treatment which is done by an endodontist. The pulp is the innermost layer of the teeth comprising of blood vessels and nerves. When this pulp gets infected it causes extruciating pain. It can also be effecting the periapical region. Endodontist also helps you to design your smile and thus enhancing the cosmetic appearance. They can give strength to your tooth by builing the lost structure of your tooth .

 

5.Oral and MaxillofacialSurgery
This branch of dentistry involves dealing with surgical interventions. The problems that require surgical treatments are done by an oral surgeon. The problems associated with your temporo mandibular joint or any jaw deformities are taken by this specialist. Cleft lip or palate cases are resolved by the surgeon providing you a better life. The most common problems associated with erupting wisdom tooth or impacted wisdom tooth due to lack of space in the jaws are treated by removing that tooth surgically by oral surgeon .The tooth can be impacted horizontally or vertically and has to be carefully removed preserving the vital structures .Emergency treatments like accidental trauma , fracture of maxilla or mandible or removal of any cyst or tumour is also undertaken by an oral sugeon.

 

6. Orthodontics

Orthodontics is the branchy that deals with the study and diagnosis, detection ad prevention of the malocclusion. Malocclusion conditions are best treated by orthodontist .Malocclusion occurs due to discrepancy in tooth to jaw relationship. It can be either dental or skeletal problem or both. Faulty occlusions like deep bite ,proclined teeth or crowded teeth has to be treated at the earliest to prevent traumatic stress to the teeth and the tissues. Faulty habits like bruxism (grinding of teeth) ,thumb sucking or tongue thrust also deviate the occlusion from the normal condition. .the orthodontist corrects all the above defects or problems by special clips and appliances and also does the surgical intervention if required.

 

7. Oral Pathology

This field is concerned with the study and diagnosis of any pathology or lesion of oral tissues.this is a non cliniucal field od dentistry. It explains the cause of the pathology and its treatment.these pathologies have the ability to cause the alterations of the structure and their function. Oral disease is diagnosed by microscopic studies , sputum test or the biopsies taken by excising or incising the affected tissue. The oral pathologist, who usually works in the laboratory of a hospital, serves the patient only indirectly via consultation with the general phycisian or dentist.

 

8. Oral and Maxillofacial Radiology

This is the field of dentistry that deals with the study of the x rays of the oral tissues and all the oral structures .x rays are important way of diagnosis ; it helps diagnosing pulpal infection or periodontal infection .further more they are also helpful in the detection of the bony defects or any cyst or tumour.

 

9.Public Health Dentistry

This field relates to the study material comprising of the data linked with the public health. It explains the rate or growth of any dental disease in the particular area.it explains the prevention and control of dental diseases and educating people about the dental health and its importance, through organized community efforts and standardized data.. It offers career areas in dental public health and clinical research.

 

 

 

 

 

 

 

 

 

ONE VISIT DENTAL TREATMENT FOR KIDS

Though many parents are knowledgeable that children must get rid of the baby feeding bottle at the age of one year and that the baby by no means should go to sleep while clutching the bottle, many just can’t discontinue the habit, or else, many merely surrender with the intention that the family can get a little much-needed sleep. The fault hits hard, however, while these parents get their toddlers to the Pedodontist and realize that they require up to 10 to 20 fillings, crowns and/or tooth extractions to undo the harm caused by ECC.

ECC….Does it really matter!

Yes it does! A glance at the occurrence and seriousness of this condition, demonstrates why it is so significant for the dentists to lay emphasis on prevention and as necessary, recommend different treatment options to these kids.

Evidence———————38% of children aged I to 2 years and

56% of children aged 2 to 3 years develop ECC.

In certain economically underprivileged families, almost 80% of infants and preschoolers were found to have ECC.

What is ECC by the way!!

Early childhood caries (ECC)
Also commonly known as – Baby bottle caries,

Baby bottle tooth decay,

Bottle rot

ECC is a severe decay in the teeth of infants or young children and is characterized by extensive, rapidly progressive, deep decay of the upper front milk teeth and often the back teeth.

Wake up before it is too late!

 

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If neglected……

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lf delayed your child’s decayed teeth may very soon become necrotic and can cause alveolar abscesses, which often leads to diffuse swelling of the surrounding soft tissues.
These abscesses are quite painful and can also harm the underlying, developing permanent tooth buds.Worse yet this condition can cause disfigurement and hamper the child’s ability to eat.

Consequences of ECC

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What can be done?

Pedodontists find themselves walking a fine line while helping the children facing this problem. Most young children can be treated adequately using behavioral techniques. On the other hand,
some kids cannot receive treatment via these conventional methods. Infants and children who have not yet attained the emotional maturity, neither have the ability to understand the need for the treatment nor the effective and appropriate skills to get through invasive and potentially uncomfortable and expressively frightening dental procedures. For many of these children, treatment under General anesthesia in a hospital setting represents the best possible or the single venue to deliver the required oral health care.

Literature support:
• Dental management using general anesthesia is a one-step rehabilitation treatment for young children with severe dental problems.
• What is GA?……… GA is a controlled state of unconsciousness.
• It is almost three decades that dental rehabilitation under GA had been delivered to young children.
• In many cases, GA is the only practically possible and time-saving mode of treatment.
In a single session under GA, different procedures including GIC or composite restorations. Pulp therapies, stainless steel crowns (SSCs), extractions, preventive procedures like pit and fissure sealants and fluoride varnish applications are offered.
• The quality of dental care is much better with general anesthesia for the reason that the dentist can perform treatment for the child without having to constantly adjust for the child’s movement and without having to prepare and encourage the child.

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What are the advantages of Comprehensive Dental Rehabilitation Under GA?

 As already stated, under GA all the necessary treatments are delivered in a single session in a hospital setting, thus providing efficient services in a safe and secure mode. Furthermore. GA is one modality that makes sure that the child received effective pain control.
 The added advantage is GA does not need the child’s cooperation as one prerequisite for treatment.
 Dental GA is more convenient and time saving than treatment in office setting.
 It has also been reported that dental treatments performed under GA have superior quality and durability than conventional treatments (BMC Oral Health 2014).

How much time does it take for the treatment?

The time requisite for dental rehabilitation under GA is considerably fluctuating with an average of 1 to 4 hours being the usual treatment time elapsed on a day-care basis. The total time required for the treatment is influenced by number of teeth to be restored and the type of dental procedure.

Improved scheduling….We are glad to add to your information that you need not dependent on the availability of operating suites at hospitals as we are now able to schedule and plan our procedures to deliver treatment to patients in a timely approach. On top, the scheduling flexibility makes it possible for the working parents and dentists in our practice to plan events to meet their requests as well.

Changing Parental Attitudes towards GA….

Most of the parents convey “panic,” “fear,” and “concern, with some level of nervousness towards GA. However, attitude of parents concerning GA has altered over time in the favor of it. Currently.there is a swing towards growing acceptability of GA in parental opinion. After treatment under GA is complete, parents reported a reduction in the amount of dental pain or no pain, improvement in the sleeping pattern, eating habits and increased acceptance of parental tooth brushing. Dental rehabilitation under GA resulted in the instant improvement of the oral health, physical, emotional and social quality of life of the treated children. It as well has a positive and encouraging impact on the family providing an enhanced opportunity for parent and child education on positive oral health behaviors which can lead to positive behavioral changes and improved oral health for life time.

We are happy that most parents today, recognize dental GA as a treatment modality that optimistically affects the quality of life of their young children (Pediatr Dent 2012).

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