Friday, November 27, 2009

Top 10 Popular DSLRS

For all of you implantologists out there in the market for a DSLR here is an interesting article !
For the entire article click on the link below.

Top 10 Popular DSLRS: "
Popular-DSLRs.jpgThe question I’m being asked on a daily basis at the moment is – ‘what camera should I buy?’ Obviously cameras are on many people’s wishlists this Christmas!

I’m planning to update our Popular Digital Cameras and Gear page here on DPS in the coming week to help answer the question but thought I’d do a quick post looking specifically at what’s hot at the moment when it comes to DSLRs (as this is what many of those asking questions are focusing upon).

Note: it’s a particularly good time to buy a digital camera. Most online stores have Black Friday sales on at the moment. Here’s Amazon’s Camera sale (they’re updating it every day) and B&H also seem to have a lot of specials on at the moment.

What’s Hot in DSLRs?


The Equinox E-Commerce Site is Up and Running.

Equinox the manufacturers of Uniti(TM) implants and various other products in the Cubit, Endomax, Regenium, Lynx and InSci range of products have set up a web portal and e-commerce site for Equinox products at Equinox Sales. The portal is impressive and well designed with a variety of features that will keep a dentist coming back. You can also order Equinox products online 24 x 7 . Register on the site if you haven't already !

Luxators,Periotomes and other Magic Wands - II

Luxators are probably the best kept secret in dentistry.Luxators are manufactured by SDI Directa that makes numerous other innovative and excellent products for restorative and surgical dentistry.
The Luxator at it's simplest is a fine sharp blade and tooth elevator combination manufactured from the finest Swedish Steel .

To quote from the Directa website"Luxator Extraction Instruments are a specially designed periodontal ligament knife with a fine tapering blade that compresses the alveolar, thus cutting the membrane to enable the dentist to gently ease the tooth from its socket.
Luxator Extraction Instruments were invented and designed by a Swedish dentist to make extractions as trauma free as possible."
There are a variety of options available although I have found the standard design pictured above to be the best
Some personal observations on luxator use
  • The thin straight grey luxator is the most useful when extracting anterior teeth.
  • When using a luxator in the anterior region avoid using it on the labial. Use only on the proximal and palatal.
  • Go between the root and the socket wall wedging the luxator in an apical direction.
  • Go slow.
  • Protect against slipping of the luxator and injuring soft tissue.
  • In multirooted teeth, separate the roots with a bur and then use a luxator.
  • You can mallet the luxator with  light taps.
  • Sharpen the luxator blades when the blade becomes blunt on the sharpening stone provided.
  • Available in India from Pyrax Exports or your local distributor.
As always I have no financial interest whatsoever in this recommendation.

Wednesday, November 4, 2009

A Sample Consent Form For Implant Surgery

Here is a simple sample consent form for implant surgery. You may modify it and use it as you deem fit. Please understand that I assume no legal liability for it's use. Please take appropriate legal counsel when using it. !

Tuesday, October 27, 2009

Thought For Today !

                                                                                                 "Persistent Precision Provides Predictable Prognosis"

Optra Gate - Great Tool for Implant Surgery!

Many of you are probably familiar with the Optra Gate self retaining lip and cheek retractor from Ivoclar Vivadent and have used it for restorative procedures. But did you know that its also a great retractor when doing implant surgery specially in the posterior quadrants ? It's like having an unobtrusive extra assistant who gently retracts the lips and cheeks and doesn't get in the way. As one of my patients pointed out, it also prevents your retractors traumatizing the corner of the mouth !
Optra Gate is disposable, non-latex , hypoallergenic, highly flexible and available in three sizes - Regular, Small and Junior.
Available from N.K.Patel in Mumbai and most dental dealers.
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Saturday, October 24, 2009

Luxators, Periotomes & Other Magic Wands - 1 !

Removing teeth as atraumatically as possible preserving the maximum possible surrounding bone is a relatively new idea. It was not always so. Some 20 odd years ago when I was a student, getting the tooth and the whole tooth out was the paramount objective. Never mind if you had to destroy the surrounding bone to do it and macerate the gingiva in the process . "Compress the socket walls" was a commandment !
How times have changed !
We no longer advocate "compressing the socket walls". In fact we attempt to preserve the original anatomy of the socket as much as possible. Multirooted teeth are carefully sectioned into individual roots and extracted preserving circumalveolar and interradicular bone. In progressive practices the dreaded "bayonet" has been banished to the nether regions of the remotest drawers !
As an oral surgeon I am glad this revolution has come about.Now oral surgeons can with honesty include themselves with "conservative dentists" and oral surgery has gone some way to be seen as part of 'conservative dentistry"
Even with all this paraphernalia extracting a tooth or root piece atraumatically isn't still a simple process. There are a wide variety of tools and a number of specialised instruments that are available to make the atraumatic extraction of teeth more predictable. Over the next few posts I shall try and describe the various tricks and tools that have been developed to make extractions more predictable.

Dr.C.P.Mathai MDS
Oral Surgery, Dental Implants, Oral Reconstruction.
Restoring Smiles! Building Confidence!

Friday, October 16, 2009

Happy Diwali !

Wishing all of you out there " A Very Happy Diwali and a Osseointegrated Prosperous New Year".

Friday, September 25, 2009

New Course in Pune !

Off to Pune for a course this weekend !

Particpants Have a Super Time at the Second Module of the !st Implant Course

We just finished the second module of our first implant course last weekend (17th Sept to 19th Sept). We all had a great time. All the participants were delighted to perform second stage surgery on successfully integrated implants. The second session is more clinical in nature. Surprisingly the most popular presentation was the one on Implant Occlusion !

Immediate Temp Crown with Uniti Biotemp Abutment

Doing an immediate extraction placement using the Uniti Biotemp abutment is simple as you can see from this series of photographs here.

Callipers !

A common query in our courses is about the different kinds of measuring tools used to make measurements of distances on bone during implant surgery as well as in the planning stage. With the advent of CT Scans and Interactive planning software and the availability of computer generated surgical guides the need for such "archaic" measuring tools will probably see a fall ! But I don't foresee the demise of the scale or calliper anytime soon.

The digital calliper is the tool we use in preoperative planning to measure distances on the cast and on OPG's. It's easily available at most good hardware stores or high end stationary stores.

The Castroviejo Callipers featured alongside come in a short and long design as well as in a choice of straight and curved tips. They are very useful in measuring off distances in the mouth (the long ones are better) and I generally have both a curved and straight one available. I bought mine from A.K. Surgical here in Mumbai for a few hundred rupees each.

Featured alongside are ridge measuring callipers.
These sturdy stainless steel callipers come with sharp needle tips that can penetrate soft tissue to measure the actual width/thickness of bone. useful for bone mapping. Their large size makes them a bit unwieldy and it can be a bit difficult to read of the finely etched millimeter scale but they are a useful addition to the surgical armamentarium. The tips are replaceable if damaged. Expensive. Get them from Salvin or from Novodental in Mumbai.

This Boley's gauge can be used both on casts and intraorally since it is autoclavable. It is used in a fashion similar to the digital vernier above. Available from most dental and dental lab supply companies.

Implant placement in edentulous mandible with immediate loading - Provisional Acrylic Fixed Hybrid Conversion Prosthesis

A case I did recently. The lower denture was prepared preoperatively and then converted into an all acrylic fixed hybrid prosthesis. Therefore the name "conversion prosthesis". The ridge was literally knife-edge as can be seen from the image alongside. Follow along on the images below. The images are more or less self explanatory.

  • The edentulous ridge

  • A knife edge ridge. CT Scan

  • The knife edge ridge exposed.

  • The ridge levelled, four implants placed. Note the transosseous fixation of the flap to prevent the excessive redundant tissue left after ridge levelling from riding up and covering the healing abutments. This loose tissue can be quite a nuisance when fabricating the immediate prosthesis as well during later healing.

  • Healing abutments in place and flap repositioned and sutured.

  • the denture hollowed out

  • The hollowed out denture loaded with bite registration material

The tissue surface of the hollowed out denture relined with rigid bite registration material at the correct VDO

The denture slotted in the position of the two distal most cylinders

A piece of rubber dam placed to prevent the acrylic getting entangled with the sutures. The two distal cylinders in place.

The distal two cylinders are picked up in cold cure acrylic. The denture is stabilised by the rigid bite registration material and the posterior untouched denture base.

  • All four cylinders picked up in acrylic. Note the shortened dental arch (premolar to premolar no cantilevers)

  • the final conversion prosthesis with screw holes sealed with Fermit

  • The completed provisional restoration

Wednesday, September 16, 2009

Straumann launches Roxolid

Dental Economics-Dental News - Straumann launches Roxolid

Roxolid (Rock solid) is a new alloy of Titanium and zirconium developed by Straumann that promises narrower and stronger implants with better osseointegration. Implants in 3.3 diameter are already available for use in the USA. The possibility of using narrow diameter implants in high stress sites opens up exciting possibilities and has the potential for reducing the need for many augmentation procedures. This should increase the appeal of dental implants to patients and also induce a greater number of clinicians to begin placing implants.

Lantis Laser, Inc.

Lantis Laser, Inc.
Follow the link to learn about the newest modality in dental chairside imaging. Optical Coherence Tomography uses lasers to generate highly accurate images of oral structures in real time.

Monday, September 14, 2009

Bakers Architectural Principles

Bakers Architectural Principles

Laurie Baker was one of India's great architects. An englishman who made India his home Mr.Baker was the moving and guiding force behind the movement towards sustainable architecture and living.
In a sense we dentists are "architects of the oral cavity" ! In this age of opulence and conspicuous consumption on one side and grinding poverty on the other I believe that we as dentists too need a code to live and work by like the manifesto Laurie Baker penned to describe his philosophy of architecture. Take a look ! Read it. I was inspired by it - I hope you are too.

Implant Course gets off to great start !

I know I havent been posting to implantsutra for some days now. Have been busy with many things principally with a fresh batch of our Basic Implant Course. This group had 8 participants and was great fun ! Most all of them placed their first implants yesterday and I'm delighted to say did very well. Click on the image to enlarge.
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Monday, August 24, 2009

Class B Autoclaves

One cannot overemphasise the importance of sterilisation and infection control not just for implant surgery but for all aspects of dentistry.
Effective sterilisation can be the difference between success and failure in implant dentistry.
A Class-B autoclave is the standard of care when it comes to steam sterilisation . This is specially true when sterilising tools and instruments with hollow insides such as handpieces, drills, cannulas etc.
For the last many years my trusted Class B was a unit from Prestige Medical in the UK. In February this year it finally gave in. This, namely the lack of service and spares from foreign manufacturers or their agents has been a constant problem with many imported hi tech equipments. With a complicated , sophisticated expensive and critical device such as a vacuum autoclave it is imperative that service and spares be readily available for many years after the purchase of the autoclave. I was reasonably lucky with my Prestige. Other colleagues have not been so fortunate.
Although many imported brands are available in place of the Prestige we bought the Indian made/assembled Equitron autoclave from Medica Instruments. This is a true Class B autoclave and except for a few initial glitches has performed very well. The service from the CEO Mr.Hemant Shah has been courteous and prompt.
As usual I have NO FINANCIAL INTEREST in this product. Just a product and a company I believe deserves support and encouragement.

Thursday, August 20, 2009

Sumita Mitra named among Heroes of Chemistry for 2009

Sumita Mitra named among Heroes of Chemistry for 2009: "3M ESPE inventor of composites and RMGI technology honored."
Not strictly an implant related post but I just couldn't resist posting. Dr.Sumita Mitra of 3M has played a pivotal role in the development of glass ionomers , specially resin reinforced glass ionomers. Her accomplishments are stupendous and have revolutionised restorative and preventive dentistry. We are all proud of her !

Sunday, August 16, 2009

HEINE HRP Binocular Loupes

HEINE HRP Binocular Loupes
These are the new loupes that I've got myself. For nearly ten years I used a set of 2.5x Galilean loupes. Not the greatest. They were cheap, heavy and not very good but they served the purpose. But then advancing age (I just crossed 45) and deteriorating eyesight necessitated a more powerful set of extra "eyes". The Heines I have are 3.5x prismatics that are a joy to use. I use it for practically all implant surgery but specially when doing sinus lifts where the magnification and the additional illumination is a great help. There are quite a few additional accessories that come with the loupes in it's handsome case that make this set of loupes a joy to use. Having said this 3.5x is not the ideal first loupe to own. For that the 2.0 or 2.5x is a better choice. Not sure which loupe is best for you? Checkout this article to help you decide.

I also have a led light that goes with the loupes. I have to admit I am not as happy with the light as I am with the loupes. The light just doesn't seem to have enough intensity and the battery handle is bulky and uncomfortable to use . It's a beautifully designed little light but it's needs more power and a smaller longer lasting battery pack that easy on to carry and easy on the pocket.

I would like to add that I have NO financial interest whatsoever in this product!

Dynamic CBCT Imaging

Dynamic CBCT Imaging: "

Dr. Doug Chenin the Director of Clinical Affiars for Anatomage has announced Dynamic CBCT. According to Dr Chenin “Dynamic CBCT features allow you to create dynamic treatment simulations to be used for patient education, increasing case acceptance, and for making the most cutting edge professional presentations or CE material.” Here is an example of a surgery simulation:



Friday, August 14, 2009

EnBIO launches OsteoZip surface for dental implants

EnBIO launches OsteoZip surface for dental implants: "OsteoZip is designed to enhance the osteointegration and early bone fixation of dental implants into host bone tissue."

Tuesday, August 11, 2009

Lingual Foramen

Vascular channels are often found in the midline and lateral to the midline of the mandible. Although the lingual foramen was found in 99% of dissections it was seen in less than 49% of peripaical films . Here is patient I saw recently.One can see the lingual foramen clearly on the CT slice, as well as the periapical film and also if you look carefully at the OPG.
The lingual foramen harbors an artery that is an anastomosis of right and left sublingual arteries. This tiny vessel (0.4 to 1.5mm) has been implicated in serious hemorrhage and rarely fatalities. one should be aware of the presence of this vessel and avoid it when possible.
For the periapical and the opg image click on the title of this post

Thursday, August 6, 2009


JIACD Is a new online journal that is free. you can download the latest copy onto your desktop and read at leisure. lots of pictures and simple practical stuff !

Wednesday, August 5, 2009

A Novel Connective Tissue Graft

These are the images of a simple connective tissue graft I did recently. The advantage I think was that a second surgical site was not needed. The site did not need large volume of tissue. The pictures are self explanatory.

The Paresthesia Case

The patient with parasthesia came in this morning for follow up. The parasthesia is just a bit better (he says 5%) but otherwise adjusting quite well . I've included the postop pano so you can see the relation of the nerve to the implant.
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Sunday, August 2, 2009

Follow-Up to the Parathesia Case

I had the parasthesia patient in for a check up yesterday. The parasthesia or rather dysesthesia involves the teeth from 44 to 46. The implant was placed in the 47 region.The teeth feel "dead" to use the patient's own words. All else is fine. There is no problem with the lips, tongue or gingiva. The wound is healing well. The postop OPG shows the implant well clear of the nerve. I am puzzled. What could it be?Here are some options
  • A twist drill that damaged the nerve while preparing the osteotomy- This is most likely. Although I was as careful as could be (of course!). Hopefully given that all other sensations are normal ,sensation should return sooner or later. Once more the need for careful measurement, preop OPG's and CT Scans and the use of stops. Even better would be the use of a surgical guide with depth control.
  • Pressure on the nerve as a result of bleeding ,edema etc in the osteotomy. This too should resolve. Is it worth backing out the implant? Not in the case of a tapered implant such as this. Turning it back even a turn will more often than not result in a loss of stability.
  • An accessory canal. Not unknown but the CT Scan of the patient does not seem to show any accessory canals.
  • The loss of sensation is easier for the patient to get used to than altered sensation or pain .

Saturday, August 1, 2009

YouTube - umichdent's Channel

YouTube - umichdent's Channel

Just this morning as I was surfing the web I came across these videos on You Tube. Hundred's of videos on dentistry including lectures and tutorials from dental schools such as The University of Michigan and The University of Southern California are available for free viewing. Entire conferences are available by eminent lecturers and all for FREE !
Enjoy !

Friday, July 31, 2009

Advanced Clinical Treatment Planning for Computer Guided Surgery

Upcoming Webinar: Treatment Planning Full Arch Angled Cases for Computer Guided Surgery
Presented by: Sheldon Lerner, DMD
Course Date: Monday, August 3, 2009
Course Time: 7:00pm - 8:00pm Central time
CE Credit: 1 Hour
Tuition: No charge

Register for the 7:00 PM CDT webinar

Dr. Sheldon Lerner, will present surgical techniques to simplify and treatment plan full arch implant cases -

followed by Blue Sky Bio implant system advantages.

Download free treatment planning software

Parasthesia Following Implant Placement !

Just this morning a patient called complaining he had no sensation in his lower anterior teeth. He felt perfectly normal everywhere else lips, tongue,gingiva but his teeth felt numb and "dead". The implant in question was placed to replace 47. The postop xray shows the implant well away from the nerve. The implant was placed under infiltration anesthesia. The patient had no pain during placement but I remember him feeling the pressure of the last few turns. I'm at home today down with a bad back but I've called him in tomorrow a.m for a check up.Whew ! What would you do?
Dr.C.P.Mathai MDS
Oral Surgery, Dental Implants, Oral Reconstruction.
Restoring Smiles! Building Confidence!

Thursday, July 30, 2009

Blue Sky Plan

Dentascan and 3D ct's are now routine in dental implant practice (at least here in Mumbai). What has been missing on the implant scene has been a good affordable Implant planning software . The existing ones like NobelGuide from Nobel and Simplant from Materialise are either limited to only some implants (only Nobel Implants for Nobel Guide for example) or are too expensive (lakhs of rupees for both the above mentioned softwares) or both. I have recently been using a new planning software called Blue Sky Plan downloadable from . For users in USA and Canada it is free but for users outside these two countries there is a small licence fee. There is a 90 day fully functional free trial. It's an easy to use software and I would encourage everyone to download and play with it. I'm still learning the software as I go along and hope to have my first surgical guide planned on the software fabricated soon. I'll keep you updated !

Friday, July 24, 2009

New Domain !

Just to make it easier to remember I just registered a custom domain for this blog. The new domain is rather than the older blogspot address!

Welcome to Implant Sutra !

Hi! and welcome to the Implant Sutra blog. I began and shut down various versions of this blog over the past few years. The basic reason was that I felt that what I had to share was not significant enough. That seems to have changed a bit ! having been involved with placing,restoring and teaching dental implants for the past many years I have first hand experienced the great need for more implant dentists to share and document their experiences for others to benefit from. We need an Indian information base that helps us all here cope with the unique conditions in which we practice and enables us to deliver the highest standard of care that our patients deserve.
As I add to this blog ( I hope with some regularity) I hope to hear from all of you about what you like and dont and your opinions about what I publish and what I should. Dissenting opinions are as welcome as is praise.
I would like to see many more Indian implant dentists share their knowledge, experiences and practices with the greater dental community at large.
Once more Namaste and Welcome !