At The Dental Specialists, India we strongly recommend TTPHIL technique for most of our patients who need a dental implant. Dr. Venkat is a pioneer of this TTPHIL technique. He has written about this technique of dental implants in several international magazines and also in various dental conferences across the world.
While the key advantage of TTPHIL is the quick turnaround (you can get a permanent set of teeth in as little as 2-9 days) and its economical nature, as a patient, we feel it is important for you to understand the treatment procedures and also understand the options available to you. Hence this article aims to provide clear differentiation between the conventional method of dental implants and the TTPHIL technique of Implants.
Conventional Dental Implants vs TTPHIL Implant Technique
TTPHIL ALL TILT TECHNIQUE
CONVENTIONAL IMPLANT TECHNIQUE
Immediate loading: Permanent teeth given within 48 hours
Delayed loading: Permanent teeth given after 3 -6 months
Tall (16-25mm) and tilted(30⁰-70⁰) implants
Anchorage from basal bone
Anchorage from crestal bone
Two piece cortical implant
Two or three piece crestal implants
Single stage implant system
Double stage implant system
Time taken minimum 48 hrs
Time consuming around 4-12 months
Pin hole flapless, no sutures
Sutures are needed as flap is reflected to expose bone
Various implant designs and sizes are available
Limited implant designs and sizes available
No surgical sinus lifting and bone augmentation required
Invasive surgical procedures like sinus lift and bone augmentation are needed in case of insufficient bone
Expensive surgical add on procedures
Can be done in severe gum disease, smokers and diabetics
Can be done with minimal success rate
Proven to be successful in compromised bone conditions
Not a good choice in compromised conditions as the chances of failure are more
Fast and simple
Complicated and time taking
Micro-movement of implant in cortical bone is minimal
Micro-movement in crestal bone is high
Bone loss around the implant in future is around to zero
High chances of bone loss around implant overtime
Basal bone capable of bearing heavy chewing forces
There are different types of Dental Implants in the market all over the world. There are more than 10000 companies in the market all over the world. Which is the best is the question? BRAND or the DESIGN/ FEATURES of the Implant and its Prosthetic components? Is BRAND ruling over EVIDENCE BASED CONCEPTS? Which is more important? Restoring Simple Single tooth missing cases??
For example .When we or our children get simple fever or common cold or cough, What do we do?
We would like to visit our Family physician or a Corporate Hospital. ( Major Criteria for Selection: Know the doctor for long time, Reputed doctor with good experience- Online and offline, cross check with referrals of our family and friends, Patient video testimonials, facebook recommendaations and find out why he visited and message him in prior about their experiences, Neat and Clean premises to prevent cross Infections. In this digital world we can easily find out the doctor how he is – Best or Bad or THE BRAND OF MEDICINES HE IS USING IN HIS PHARMACY)
The Family physician diagnoses a particular disease and prescribes medicines to us, be it an Antibiotic or a Painkiller. We believe in him. We trust him.. because he’s our family physician and go ahead…Are we asking or questioning him? Which brand of Medicine or Drug Is he giving to us? There are so many new brands in the world, thousands of pharmaceutical companies – manufacturing the same molecule or composition. Every pharmaceutical company before selling have to undergo Strict FDA guidelines to enter the country and the market.
Now coming to Dentistry: Dental Implants usage are based on different techniques which are practiced- Transosteal or Sub periosteal or Endosteal or Zygomatic or Pterygoid or TTPHIL Implants? All over the world Most widely used dental implants are the endosteal two piece implants. The endosteal implants can be categorized as Single piece implants, Two-piece implants and Two-Piece Cortical implants The two-piece cortical implants Are having all the advantages of single piece inclines. And two-piece implants They are called the Hybrid implants These hybrid implants take all the advantages from Single piece in plants And Prosthetic advantages of 2-piece implants. As you know that Single piece basal implants have wide variety of disadvantages. We at The Dental Specialists stopped doing them because of their disadvantages.
All the Single piece advantages are with the 2 piece cortical systems. Immediate loading, Flap less Procedures, No cuts or Incisions , No grafts , No waiting Periods are all with the 2 piece cortical Implants. Single piece basal Implants engage the basal bone because of which they are able to load the implants and give immediate teeth. Single piece basal Implants have more disadvantages than advantages as shown in the above link clearly explaing the disadvantages of Single piece basal Implants at each level. Any technique will have Diagnostic, Surgical, Prosthetic, Laboratory and Maintenance problems. Single Piece basal Implants have the disadvantages at each level.
Dental Implants are produced by lots of different manufacturers around the world. Most of them are based around the same theme in that they are screw shaped, varying sizes and lengths. They are made of Titanium because Titanium is biocompatible with the bone. The bone will actually grow on it. They’ll screw shaped so that they can be inserted into the bone and will be stable when they placed the surface of the implant is treated in such a way that it is, cells from the bone and not only encourages early healing but will also maintain the bone over a long period of time. So there are lots of different connection designs and the importance of these connection designs is that they must be stable over a long period of time as they will be subjected to repeated loading. So an implant is effectively a way of attaching a mechanical joint in a biological. The environment and as long as the materials used are of a high quality and the execution of the treatments is of a high standard implants. We know what works we know which design features work, what materials work what connection designs work. We have now been doing implants in this practice for about 13 years and we kind of know what works of short-term and long-term.
To Simplify: Two Piece Implants will be done by Graft believers. Two Piece cortical System is done by the graftless TTPHIL Protocol. These implants are similar to Two piece Implants, the only diffrence is that they are longer engaging the basal cortical plates which give high primary stability for immediate loading which is he primary criteria. Treatment Options when all the teeth are missing?
TTPHIL Ⓡ Believers: These Dentists believe in the theory of utilizing Basal Cortical which is highly resistant to resorption and infections and giving complete function
Advantages: Minimal Invasive: Flapless Key Hole Surgery with 6 implants, No Cuts and Incision, Less Traumatic and Painful, No Morbidity, No Bone Grafts – No Sinus Lifts, Single Visit, Less Expensive, Full set of 14 Screw retained CAD CAM Ceramic teeth (Retrievable), No Cantilevers
If the dental implants are inserted at the same time immediately after the tooth is removed, it is called as Immediate Implants Placement or Immediate Implantation. Previously we used to wait for 3 months after the tooth is removed. Immediate Implantation has lot more advantages than the conventional implant procedure as it avoids the bone and gum changes surrounding the tooth which is going to get removed. It is simple, pain free, convenient for the patients as it allows the surgical treatment to be completed in single visit. But in few cases where there is a pus discharge cyst or abscess or sinus completely pneumatic or severely atrophied cases especially in relation to a badly infected tooth, it is better to first remove the infected tooth and allow it to heal before the dental implants are placed.
If the dental implants are inserted at the same time immediately after the tooth is removed, it is called Immediate Implants Placement or Immediate Implantation. Previously we had to wait for 3 months after the tooth is removed and before the implant could be placed. Immediate Implantation has a lot more advantages than the conventional implant procedure as it avoids the bone and gum changes surrounding the tooth which is going to get removed. It is simple, pain-free, convenient for the patients as it allows the surgical treatment to be completed in a single visit. But in few cases, if there is a pus discharge, cyst or abscess or sinus completely pneumatic or severely atrophied cases especially in relation to a badly infected tooth, it is better to first remove the infected tooth and allow it to heal before the dental implants are placed.
Immediate Functional Loading of Dental Implants
A conventional Dental Implant procedure involves multiple visits for treatment over a period of from 3 months to 1 year: In traditional implantology after the tooth is removed, we wait for 3 months for implant placement. Later these implants are buried inside for 3 to 6 months depending on the quality of the bone of the patient, waiting for the new bone to form. After waiting for 6 months these implants are reopened with the second surgical procedure and they are uncovered and exposed to the oral cavity (mouth). Now repeated visits of the healing cap followed by impressions, jig trials, temporary teeth followed by permanent crowns would again take 3 to 6 months. this repeated connections and disconnections of the prosthetic components can lead to pocket formation which can accumulate the bacteria leading to periimplantitis and other implant infections. So with the delayed loading technique which involves multiple visits, the implant patients would have to wait for a very long time, approximately 1year from the start to the end of treatment. Until then the patient had to wear a temporary removable denture until the implants fuse with the new bone as the new bone gets formed.
At The Dental Specialists, we follow the unique Implant placement procedure called Immediate Implantation by TTPHIL ® – Tall and Tilted Pin Hole Immediate Loading Protocol (ABC-DE IMPLANT PROTOCOL: ANATOMIC GUIDED, BIOLOGIC, BIOMECHANICAL AND CONCEPT DRIVEN EVIDENCE-BASED IMPLANTOLOGY). With today’s digital technology and highly improved quality and design of the implants and the unique TTPHIL® Protocol, which is followed exclusively at THE DENTAL SPECIALISTS, we are able to restore the implants immediately with permanent teeth in just 2 days.
In some cases, the patients may require additional procedures like Root Canal Treatments, Gum Flap surgeries, Curettages, Fillings, for adaptation of the new teeth in the mouth can take some more time which can delay the treatments. So if you are an International patient, always be prepared and plan your visit for a week or a couple of weeks. If it’s just a single or few teeth which are missing and are devoid of infections, we are confident, we can fix your teeth in just 2 days. We recommend you to see all our testimonials across Google and Facebook to understand more about our patient experience.
3 Things to Consider While Going for Single Tooth Implant
This is a once in a lifetime investment – don’t settle for cheap replacement but focus on quality. Go for high-quality FDA recognized and CDESCO cleared Dental Implants
Choose your dental clinic wisely. This is a specialist’s job. Find out every detail about the doctor, the team, the facility and infrastructure and more
Look for reviews for your preferred clinic – Google and Facebook are good places to start.
Teething is a normal physiological process involves tooth movements inside the jaw(bone) until the time they come into the oral cavity(mouth) by piercing the gum.
The first set of teeth that erupts into the oral cavity are called milk teeth or primary teeth. Teething starts from 6 months of age, while a variation of plus or minus 6 months is considered normal.
Teething begins with the lower-front tooth (central incisors) at the age of 6 months. Occasionally a lower-front tooth may even be present at birth called as natal tooth and if tooth erupts into mouth within the first month they are called as the neonatal tooth.
The first set of teeth completes their eruption by 3 years of age with a total of 20 primary teeth. The second set of teeth or permanent teeth starts erupting into the mouth from 6 years of age and continues until 12 to 13 years of age. Wisdom tooth however typically erupts during late teens to adolescence.
Teething Problems in Babies
For few babies teething can be distressful, considering pressure from erupting teeth leave the child to uncomfortable gum irritation and in some babies, teething can even be pain full; excessive saliva lead to drooling, disturbed sleep, stomach upset (vomiting, diarrhoea), loss of appetite(hunger) etc are frequently related tooth eruption.
Babies between 6-12 months are more susceptible to the above-mentioned symptoms.
The Teething window is typically an eight-day duration; four days before the eruption of tooth followed by three days after tooth eruption or tooth emergence. In the first four days, the teething associated pain is constant, dull in nature with growing intensity until the emergence of the tooth followed by a fast decrease in pain unless associated with inflammation. In the case of inflammation, it might require a little longer time to resolve.
Teething Problems and Solutions
Chilled Teething Rings
Frozen fruits & Vegetables
Rubbing gum with chilled spoon / clean finger
Gum soothing gels
Pain killer syrups
Anti Inflamatory Syrups
Excess saliva production and drooling are associated with teething and cause wetting of lower lip & chin, which might further lead to the formation of rash around the lips. This should be cleaned or wiped away as and when required.
Piece of ice wrapped in a towel placed on gum over the erupting teeth for 1-2 min of time.
Teething rings: Teething rings can provide relief for some time, rings are best when they are chilled to freezing temperature. Teething rings are attached to the child’s clothes.
Solid silicone rings are preferred over fluid-filled rings as they may leak.
Massaging the child’s gum: Parents asked to massage with their clean fingertips or very soft finger toothbrushes for 1-2 min.
Frozen fruits and vegetables or even chilled spoon can also be used to relieve pain.
Topically applied gum soothing gels can be used. Around peanut-sized amount of gel should be taken over a clean finger or cotton bud and applied by gently massaging on painful gum region for about 15 – 20 min, 4-5 times a day.
Sugar-free plain paracetamol syrup is another choice for teething infants. The dose can be repeated every six-hourly intervals with a maximum of four doses a day.
Things to remember about Teething of Babies
Sugar-free medication should only be used, the presence of sugar might cause tooth decay.
Only inert teething objects are recommended.
Medicines should not be added to feeding bottles because it is difficult to monitor the dose.
If you are wondering what is the correct age to start brushing your kid’s teeth, you might be surprised to know that you should start brushing you baby’s tooth as soon as the very first tooth comes out; usually starts with the lower front tooth by 6 to 9 months of age.
Benefits of Introducing Early Brushing in Kids
1st reason: Initiating brushing at early ages help the kid to get used for brushing, they never resist form brushing in their later life thereby it helps to maintain healthier teeth. 2nd reason: As soon as the tooth comes into the mouth, the tooth gets exposed to n number of things like the stuff we eat, drink, bacteria itself in mouth and saliva all together forms smear layer on the tooth which is called plaque. Plaque provides shelter for bacteria their by helps in multiplication and activity of bacteria leads to tooth decay and gum problems. So brushing helps to remove tenacious plaque on teeth their by healthier teeth.
Are there any special toothbrushes available for kids?
Yes, till baby turns one and half years of age use baby toothbrushes they are good enough to remove plaque from teeth other than baby brushes finger toothbrushes and silicon tips are available but they are not as effective as baby toothbrushes in removing plaque.
From 18 months of age shift from baby brush to junior brush with little bigger head & soft bristles.
Battery operated brushes are as good as manual brushes and they are recommended from 6 years of age.
How to do brushing in kids
While performing brushing on a baby who is under 2 years of age take a knee to knee position flip the lip up processed on upper teeth for lower teeth flip the lower lip out, for back teeth use the index finger to pouch inside the cheek pull it little outwards.
Position for brushing toddler 2 to 3 years take the baby on lap, rest their head on your upper body, secure their body with one hand then start brushing your toddler’s teeth.
From what age kids can brush by their own
Till 6 years of age parents or primary caregivers should brush for their kids. From the age of 6 to 10 brushing should happen in the supervision of parents or caregivers.
Toothpaste recommendations for kids
Fluoride is one main ingredient in toothpaste to look for its presence as it helps in preventing loss of calcium from the tooth.
Based on fluoride toothpaste are of 3 types:
No Fluoride: Contains 0 fluoride, used in under 1 year of age
Less Fluoride: Contains 500 ppm fluoride. Recommended in 1 to 3 years age, provided baby has good oral health. Presence of any cavitated tooth indicates baby at high risk of dental caries, advised to use regular toothpaste.
Regular Fluoride: Contains 1000 ppm fluoride. Recommended from 3 of age onwards
Amount of Toothpaste to use for brushing
1 to 3 years of age use smear of toothpaste which is pressed into the bristles. From 3 to 6 years of age peanut-sized amount of toothpaste is used.
When to Brush
Tooth brushing should happen twice daily. Once in the morning and once at nights.
Brushing at nights before going to bed helps to remove the plaque from teeth and prevents dental caries and gum problems. Brushing in the morning helps to provide fresh feel or fresh breath as we all know at nights body reflexes are relaxed that’s where even our saliva production gets little reduced that helps the bacteria to active in mouth whole night leads to bad breath once we get up in the morning.
When it comes to brushing your kid’s teeth, remember –
Introduce early brushing as soon as the first tooth comes in mouth
Perform twice daily brushing
Less intake of sugars in diet followed by regular dental visits will help your kid to maintain good oral health entire their life.
Did you know that the oral health effects the health of your whole body? The same bacteria that infect the mouth can travel into your blood system. The spread of this infection into the rest of the body has been directly linked to heart attack, stroke, diabetes and numerous other serious conditions.
What is a Tooth Abscess?
A tooth abscess is a pocket of pus that’s caused by a bacterial infection. The abscess can occur in different regions of the tooth for different reasons.
A periapical abscess occurs at the tip of the root, whereas a periodontal abscess occurs in the gums at the side of a tooth root. A periapical dental abscess usually occurs as a result of an untreated dental cavity, an injury or prior dental work.
Symptoms of Dental Abscess
Signs and symptoms of a tooth abscess include:
Severe, persistent, throbbing toothache that can radiate to the jawbone, neck or ear
Sensitivity to hot and cold temperatures
Sensitivity to the pressure of chewing or biting
Swelling in your face or cheek
Tender, swollen lymph nodes under your jaw or in your neck
Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief, if the abscess ruptures
Difficulty breathing or swallowing
When to see a doctor
See your dentist promptly if you have any signs or symptoms of a tooth abscess.
If you have a fever and swelling in your face and you can’t reach your dentist, go to an emergency room. Also, go to the emergency room if you have trouble breathing or swallowing. These symptoms may indicate that the infection has spread deeper into your jaw and surrounding tissue or even to other areas of your body.
Causes of Tooth Abscess
A periapical tooth abscess occurs when bacteria invade the dental pulp — the innermost part of the tooth that contains blood vessels, nerves and connective tissue.
Bacteria enter through either a dental cavity or a chip or crack in the tooth and spread all the way down to the root. The bacterial infection can cause swelling and inflammation at the tip of the root.
Risk Factors Involving Dental Abscess
These factors may increase your risk of a tooth abscess:
Poor dental hygiene: Not taking proper care of your teeth and gums — such as not brushing your teeth twice a day and not flossing — can increase your risk of tooth decay, gum disease, tooth abscess, and other dental and mouth complications. A diet high in sugar: Frequently eating and drinking foods rich in sugar, such as sweets and sodas, can contribute to dental cavities and turn into a tooth abscess. Dry mouth: Having a dry mouth can increase your risk of tooth decay. Dry mouth is often due to the side effect of certain medications or ageing issues.
Treatment of Tooth Abscess
Dentists will treat a tooth abscess by
draining it and getting rid of the infection.
root canal treatment,
If it’s not restorable, the tooth may need to be pulled.
Antibiotics: If the infection is limited to the abscessed area, you may not need antibiotics. But if the infection has spread to nearby teeth, your jaw or other areas, your dentist will likely prescribe antibiotics to stop it from spreading further. He or she may also recommend antibiotics if you have a weakened immune system.
Leaving a tooth abscess untreated can lead to serious, even life-threatening, complications.
Complications from Tooth Abscess
A tooth abscess won’t go away without treatment. If the abscess ruptures, the pain may decrease significantly — but you still need dental treatment. If the abscess doesn’t drain, the infection may spread to your jaw and to other areas of your head and neck. You might even develop sepsis — a life-threatening infection that spreads throughout your body.
If you have a weakened immune system and you leave a dental abscess untreated, your risk of a spreading infection increases even more.
Do’s and Don’ts at Home
If you have to wait before your dentist sees you, these home remedies can give you some relief from your pain. But remember, these remedies are not a replacement for your treatment with the dentist.
Warm saltwater mouth rinse thrice a day can ease your pain and swelling.
Clove oil. The active ingredient in clove oil, eugenol, has helpful anaesthetic and antibacterial properties. Applying a small amount of a clove essential oil to the site of a dental abscess inside your mouth (not over your cheeks or outside your lips)can temporarily numb the area, easing your pain.
Do not apply any balms like Zandu balm, Moov or Volini spray over your face or cheeks on the abscess area as you may get severe and rapid swelling.
Prevention of Tooth Abscess
Avoiding tooth decay is essential to preventing a tooth abscess. Take good care of your teeth to avoid tooth decay:
Use fluoridated drinking water.
Brush your teeth at least twice a day with a fluoride toothpaste.
Use dental floss or an interdental cleaner to clean between your teeth on a daily basis.
Replace your toothbrush every three or four months, or whenever the bristles are frayed.
Eat healthy food, limiting sugary items and between-meal snacks.
Visit your dentist for regular checkups and professional cleanings.
Consider using an antiseptic or a fluoride mouth rinse to add an extra layer of protection against tooth decay.
If you pass on hot or cold drinks because you know they’ll make your teeth hurt, it may be time to talk to your dentist about the possibility that you have sensitive teeth. Sometimes other things can aggravate them, too, like sweet and sour foods or even cold air.
Why does tooth sensitivity occur?
Tooth sensitivity occurs when the layer of a tooth underneath the enamel (called the dentin) or the layer covering the root (called cementum) is exposed along the gum line causing receding gums.
The dentin contains microscopic channels called tubules, which are pathways to the nerve. When dentinal tubules are exposed, due to receding gum tissue or enamel loss, nerves are more easily triggered by heat, cold, sweet or sour foods and cause sharp shooting pain in your teeth.
Causes of Tooth Sensitivity
Sensitive teeth can be caused by the following dental issues:
Worn tooth enamel from using a hard toothbrush and using a hard grip while brushing aggressively.
Tooth erosion due to highly acidic foods and beverages.
Gum recession that leaves your root surface exposed.
Grinding your teeth at night.
Post dental treatment sensitivity – common, but temporary, especially with procedures such as crowns, fillings and tooth bleaching.
Treatment for Tooth Sensitivity
We at The Dental Specialists will evaluate your teeth thoroughly and assess your-grade of sensitivity.
Treatment may be as simple as fixing a cavity or replacing a worn filling. However, if your discomfort comes from gum loss exposing root surfaces, our periodontist may suggest a gum graft to protect the root surface and support of the tooth.
Desensitizing toothpaste: This contains compounds that help block transmission of sensation from the tooth surface to the nerve, and usually requires several applications before the sensitivity is reduced.
Laser treatments to fuse (close) the tunnels.
Fluoride gel:An in-office technique which strengthens tooth enamel and reduces the transmission of sensations.
A crown, inlay or bonding: These may be used to correct a flaw or decay that results in sensitivity.
Surgical gum graft: If gum tissue has been lost from the root, this will protect the root and reduce sensitivity.
Root canal: If sensitivity is severe and persistent and cannot be treated by other means, your dentist may recommend this treatment to eliminate the problem.
8 ways to relieve and prevent tooth sensitivity
Use a soft-bristled brush and brush with gentle strokes
Consider using desensitising paste
Cut down on acidic foods and soft drinks
Do not rush to brush after having citrus juices
Avoid grinding your teeth ( ask your dentist about mouth guard)
Take a break from teeth whitening a.k.a bleaching
Warm saline mouth rinses could relieve your sensitivity
Dr.Narendra, famous periodontist at The Dental Specialists talks about common gum and teeth diseases and how to prevent them. If you are suffering from gum disease, please check out the video and also how we are treating patients with gum problem.
Taking care of your children’s teeth is a critical aspect of their health and well being and while as parents we try to do our best, we often miss out on small and simple stuff that can help make our little ones smile brighter. Here in this video, Dr.Sarika, one of the top pediatric dentist in Hyderabad shares her tips about common teeth problems that children and how to take care of them.