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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