GUM DISEASES

Gum disease is inflammation of tissues surrounding the teeth. It can range from simple inflammation to severe damage to the bone that supports the teeth.

It has 2 forms:

  • Gingivitis
  • Periodontitis

Gingivitis is mild form of gum disease in which there is only swelling and redness in gum. But if gingivitis is not treated in time it can lead to severe bone loss and pocket formation and convert into a disease called periodontitis.

HOW IT OCCURS?

A bio-film is formed on teeth which is called dental plaque. It can be removed by brushing and flossing. This is a reversible condition.  However, if it accumulates on the tooth surface for long period of time a harder deposit is formed which is called tartar or calculus. It cannot be removed by simple brushing. The bacteria in the bio-film release waste products that cause inflammation in the gum leading to severe bone loss, mobility and loss of teeth subsequently. It should be treated as soon as possible and if left untreated the bacteria in mouth can enter blood stream and spread to other parts of body causing heart and kidney diseases.

WHAT CAUSES GUM DISEASES?

  • Poor oral hygiene
  • Hormonal changes in pregnancy and menopause.
  • Some diseases like Cancer and HIV interfere with the immune system leads to gum disease.
  • Certain medications
  • Smoking
  • Genetic

 WHAT ARE THE SYMPTOMS?

 

  • Swelling of gum
  • Bleeding on brushing
  • Bad breadth or halitosis and bad taste in mouth.
  • Mobility of teeth
  • Receding gums

 

HOW GUM DISEASES IS TREATED?

If you are facing any of these problems you need to contact dentist. It needs to be treated as soon as possible. With time condition worsens leading to severe complications both on general and dental health.

Treatment depends upon the stage of the disease, and categorized as:

  • Non-Surgical

  • Scaling
  • Root planning
  • Curettage
  • Surgical :
  • Flap surgery/pocket reduction surgery
  • Bone grafts
  • Soft tissue grafts
  • Bone surgery
  • Guided tissue regeneration

Recommendation of certain antibiotic is also done to eliminate bacterial infection.

 

Laser treatment is one of the newest modality of treatment of gum disease.

 WHAT ARE THE POST TREATMENT PRECAUTIONS?

There is no any serious precaution to be carried out after treatment.All you need is to maintain good oral hygiene.

  • Proper brushing of teeth twice daily
  • Use of fluorinated toothpaste
  • Use of mouthwashes
  • Warm saline rinses

You must  visit dentist for cleaning of teeth  twice a year in order  to avoid all form of gum disease and other related serious complications on health.

 

MICROSCOPIC DENTISTRY

It is one of the newest advancement to the field of dentistry. The key to successful treatment in dentistry depends on proper accessability and visibility.

With the advancement in technology we are able to provide a better quality of dental treatment to the patient.

Dental procedures are difficult to do in the posterior area of the mouth, but with microscope we are able to carry the treatment with ease and high success rate.

WHAT TYPES OF TREATMENT WE DO WITH MICROSCOPE?

Initially reason of failure for the treatment was  lack of vision however now with advent of loupes and microscope this difficulty is overcomed.

 

In present scenario microscopic based treatment has gained popularity in almost all field of dentistry.

  • Useful in diagnosis and clinical procedures.
  • Assessing craze or fracture line
  • ENDODONTICS:

During root canal therapy, magnification provides better visibility of canals, thereby eliminating chances of any missed canals.

Surgical endodontics can also be carried out with ease.

Repairing of perforated canals can be done.

Obturation of immature open canal can be done.

  • RETREATMENT:

Performing retreatment is simplier with microscope like removal of gutta percha from poorly obturated canal.

WHY MICROSCOPE IS WIDELY USED NOWADAYS?

  • Better visualization
  • Increased quality of treatment
  • Increased precision and accuracy
  • Improved ergonomics

  • Gingival health and crevicular status can be determined
  • Any lesions in mouth can be easily assessed
  • Crown preparations can be very accurate

IMPROVED OUTCOMES

The microscope is beneficial for both dentist and the patient. The dentist can involve the patient in treatment decisions and most important is the success rate which has increased to manifold with the advent of microscope.

 

Dental Emergency

Any condition that causes discomfort in your teeth and supporting tissues can be characterized as dental emergency and require immediate concern and treatment.

Paradoxically, dental emergency does not always involve pain although it is a common signal that alarms people, some dental emergencies are painless and still require immediate management.

PAIN:

Most common issue when people seek dental treatment.

Pain originating in oral cavity can be:

ODONTOGENIC PAIN

Pain is associated with teeth and peri-radicular area. Initially, it is sharp continuous and radiating in nature.

In such condition all you need is to seek help of dentist as soon as possible. Dentist will take an x-ray and will explain you the treatment accordingly.

NON ODONTOGENIC:

Pain is associated with other oro-facial tissues.

It is generally difficult to diagnose and vary in severity.

TRAUMA:

Trauma refers to injury to hard and soft tissues in the oral cavity and the face.

Generally, more common in children but can occur at any age. It also requires immediate treatment.

OROFACIAL SWELLING:

Abnormal enlargement of facial tissue caused by infection, inflammation or trauma.

It can be intraoral or extraoral.

It should be treated as soon as possible as it can be a cause of severe infection.

CELLULITIS:

Bacterial infection in oro-facial region leads to formation of abscess and swelling.

Symptom:

  • Pain
  • Trismus
  • Cervical lymphadenopathy
  • Pyrexia
  • Malaise

It requires urgent management since it has serious systemic complications.

DRY SOCKET:

A painful infection develops following extraction if the clot forms inadequately or it is broken down. It is characterized by putrid odour and intense pain radiating to neck and ear.

HEMMORHAGE:

It can occur spontaneously in oro- facial region from gingival tissue as a result of bleeding disorder or any haematological abnormality. Trauma can also cause haemmorhage.

PERICORONITIS:

 It is inflammation surrounding partially erupted tooth, occurring most commonly around third molar.

TRISMUS:

Reduced mouth opening due to muscle spasm. Trismus can occur as a result of complicated extraction, temporomandibular joint disorder, infection or impaction.

RECURRENT APTHOUS ULCER:

Some ulcers heal on its own and does not require any treatment.   However if occurrence of ulcer is recurrent it requires immediate concern as it can be malignant also.

More common in females. It requires medical management as soon as  possible.

TEMPOROMANDIBULAR DISORDER:

It is characterized by pain and dysfunction of jaw joint and muscles that control jaw movement.

SOME OTHER COMMON EMERGENCIES:

Lost or broken filling

Broken denture

Fracture of porcelain veneer

Entrapment of foreign body in the oral tissues

Dental emergency can happen to anyone at anytime regardless of age and sex. It can be at childhood or adulthood or at old age.  There is no need to panic. All you need is keep calm and visit your dentist as soon as possible.

We are here to help you with any of these problems and any queries regarding any dental emergency.

Dental Implant: Causes of Failure

Dental implants are designed to be a permanent replacement for a missing tooth or teeth and are also growing to be popular alternative to removable dentures or fixed bridges.

Still some patients do experience some complications. The following are a few of the possible causes and reasons behind dental implant failure:

Success Rates

The majority of the problems that occur after the implant placement are generally minor and easily resolved. If something goes wrong, consult your dentist or surgeon.

Osseo-Integration

Osseo-integration is the formation of functional and structural bond between bone and an artificial implant. This process takes place over several months after the implant is placed in the bone.

The failure of the jawbone to fuse together properly with the implant is considered to be a failed osseo-integration. An implant is failed if it is mobile, falls out of bone or shows signs of bone loss of more than 1 mm even after the first year.

For patients who don’t have adequate bone height, width or length, procedures such as a sinus lift or bone graft can help in increasing space and bone mass loss.

Peri-Implantitis (Infection)

Peri-implantitis, or infection, is a condition that involves inflammation of the gum and/or bone around the implant. A form of periodontal disease, peri-implantitis can cause bone loss and implant failure.

 

Nerve & Tissue Damage

When an implant is placed too close to a nerve, patients may experience chronic pain, tingling or numbness in their cheek, gums, tongue, lips or chin.

Some bleeding and pain is to be considered normal for a couple days after the surgery, but if the pain is extreme, the bleeding excessive or they it last longer than a few days, one should contact their dentist as soon as possible

Overloading

Immediate loading is a all-in-one stage treatment method where the crown and abutment are placed on the dental implant right after the implant placement.

The normal process consists of a two stages and provides time for the implant to integrate with the bone before adding the external components.

Overloading refer to failures caused by excessive pressure or forces placed on the protruding abutment and/or crown. These forces easily disrupt the osseo-integration process.

Sinus Problems

An oral surgeon may perform a sinus augmentation procedure, to develop a strong bone foundation. The goal is to create more bone in that area in order to support a dental implant.

Sometimes if the implant protrudes into the sinus cavity, that area can become infected and/or inflamed. Patients should always inform their oral surgeon about sinus related issues prior to the implant procedure.

Other Risks & Causes Of Failure

The following are other risks and causes are:

  • Foreign body rejection–it is possible that a patient’s body will reject the dental implant.
  • Failure of the implant itself–An implant can crack or fracture if it is subjected to excessive external force impact like a blow to the face or excessive pressure over a period of time like grinding teeth or an unbalanced crown.
  • Allergic reaction–While it is quite rare, some patients can have an allergic or inflammatory reaction to titanium.

Contraindications

  • Bruxism (tooth grinding or clenching)
  • Failure to locate a primary nerve in the lower jaw
  • Uncontrolled Type II diabetes
  • Insufficient bone height, width or length
  • Oral or intravenous bisphosphonates
  • Smoking

 

Marriage: Your Smile Makeover

This Is The Moment You Have Been Waiting For. Your D Day!

A Beautiful Smile Conveys Confidence Both Personally And Professionally!

The wedding day is the most important day in a person’s life and everyone wants to look their best on Their D Day. All eyes will be on you. You are going to be photographed more than anyone on this day, with a smile that can transform your wedding photographs and videos into a memory that you’ll cherish with joy for a lifetime.

 It Is Your Day To Smile!

 

  • Are you happy with your smile?
  • Would you like to see a whiter, straighter or more attractive smile?

There has been an increase in the number of people asking for cosmetic surgery for their wedding day. We have an increase in demand for cosmetic procedures not only women, but men as well, having smile makeover in time for their wedding.

A smile makeover at Dr. Sachdeva’s Dental Institute is very easy, painless and can change your entire appearance overnight. It allows you to laugh with confidence and look more vibrant and youthful.

 Preparation Counts

Here at Dr. Sachdeva’s Dental Institute we use digital photography for our patient’s profile examinations and specialized intra-oral cameras for inside the mouth which can be seen at our in screen attached to the chair.

Some smile design cases involves a little whitening, simple reshaping and replacement of old black amalgam fillings with a white material creating a more natural look.

We can correct twisted teeth, close the gaps, align the protracted teeth, widen a narrow smile, and change the shape of your teeth. By assessing your lip line, facial shape, jaw and eye symmetry we can design a smile customized just for you.

A healthy foundation, careful planning and high quality restorations help us achieve the smile you always dreamt of.

 

Veneers Or Crowns

crown-bridges

Porcelain Laminate Veneers and Crowns are the successful and popular of all the options available for improving the look of your smile.

What Is Porcelain Laminate Veneer?

  • Porcelain-made translucent, thin laminates bonded to the front surface of a tooth are known as Porcelain laminate veneers.
  • These veneers enhance your smile with little or no discomfort to you.
  • These veneers are indistinguishable from natural teeth and are made individually according the patient’s needs.
  • Porcelain veneers are made to improve the shape, spacing, color of natural teeth.

What Are The Indications For Veneers?

  • Teeth with multiple fillings
  • Odd shaped, cracked, chipped teeth
  • Spaces between teeth
  • Discolored teeth/ crooked teeth
  • Fractured teeth
  • Unsatisfactory shape, size and form of teeth

 What Are The Advantages Of Veneers?

Advantages:

  • minimal tooth preparation
  • short span for results
  • durable
  • feel completely natural
  • highly resistant to external staining

 

What Happens When I Go For A Veneer?

  • Your dentist will analyze your smile
  • Depending on tooth shaping, anesthesia will be required.
  • Minimal shaping of your teeth is done and an impression is then taken.

 Ceramic veneers take between 1-2 weeks to be made, during which your teeth may be fitted with temporary veneers to prevent sensitivity.

What Are The Post Treatment Care Instructions?

You should:

  • Brush and Floss regularly
  • Use a non abrasive toothpaste
  • Avoid any shearing force on front teeth
  • Go for regular check-ups

 

How Is A Crown Different From A Veneer?

A crown is known for covering the entire tooth unlike a veneer which covers the front surface of a tooth only.

A crown involves more shaping and prepping of the tooth structure.

It often leads to strengthening, weakening or broken tooth.

Crowns are extremely durable, aesthetic and are mostly used for the front and the back teeth in the mouth.

 

Indications for a Crown

  • Grossly/badly decayed teeth with large fillings / root canal treated teeth
  • Fractured teeth with little tooth structure left
  • Faulty bite
  • Worn down teeth
  • Mobile teeth
  • Missing tooth
  • Over an implant

 

 

 

EXCESSIVE TOOTH GRINDING

DO YOU GRIND YOUR TEETH?

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Teeth grinding is also known as bruxism. Let’s discuss about the grinding abnormally and their ill effects on teeth:

  1. What is bruxism actually?

 Bruxism is forcible grinding and clenching of the teeth, usually happens at night, during sleep. Those who suffer from bruxism may have a habit of biting their fingernails or pencils, or chew the insides of their cheeks.

  1. How common is it?

About half of adults grind their teeth at night, and about 20% people grind their teeth in a destructive way. Children also grind their teeth mainly in response to discomfort caused by colds, ear infections or allergies.

  1. What are the causes of bruxism?

 Bruxism probably is caused by emotional factors also such as daytime stress, anxiety, anger, pain and frustration. Certain sleep disorders can trigger grinding of the teeth as well. Those people who are competitive, aggressive may also be at greater risk for bruxism. Alcohol and some types of medications also contribute in making tooth grinding more worse.

  1. Why bruxism can be a serious problem?

 The enamel may become worn during normal chewing actions so the inside of the tooth is exposed. Over time, the worn out teeth may become sensitive due to exposed dentin, and your jaws may even move out of proper balance. If bruxism isn’t treated early enough, it can lead to gum damage, loss of teeth and restorations, jaw-related disorders, soreness and fatigue in your jaw and facial muscles, and earaches or headaches.

DENTAL CROWNS: THINGS YOU SHOULD KNOW

Crowns are very important and common form of restoration which maintains our teeth appearance and functions.

People still have some questions in their mind when it comes to get a crown. We here are trying to answer most frequently asked questions about crowns.

  • What Is A Crown Actually? How It Makes A Tooth Strong?

A crown is actually an artificial replacement which restores the missing tooth by surrounding the left out/ remaining tooth structure or sometimes as a covering for dental implant.

The crown maintains the aesthetics and functions like a natural tooth. The crowns are cemented permanently on the remaining tooth or implant and only be removed by a dentist.

  • When A Tooth Needs Crowns?

 After root canal treatment. The crowns are highly recommended following a root canal treatment as after the treatment the tooth loses the resiliency to absorb the chewing forces and becomes brittle. The crown will help to regain the structure of the tooth as well as the function protecting the damaged tooth from fracture or splitting the roots.

  1. For closing spaces between the teeth like chipped, worn out, discolored or poorly shaped teeth crowns can be used.
  1. When the tooth decay involves all the surfaces of the tooth and it is not possible to restore the tooth just by filling, crowns are given.
  1. If a tooth is cracked, dental crowns are a treatment of choice.
  1. Few dental conditions where the thickness of enamel is very less or less mineralized, dental crowns can provide protection to the tooth maintaining the esthetics and function of the tooth.
  1. If a tooth has a large filling and is prone to fracture, dental crowns are given to protect the remaining tooth structure.
  1. Crowns are also used as to make a bridge where the two crowns provide support to a third crown in between them, in case of a missing tooth.
  1. An Implant also needs crowns. Implants inserted in the jaw which acts as a root and the crown is given to replicate the natural tooth. It maintains the esthetics and function in the jaw in case of missing teeth.
  • Crowns Are Made Of Which Material?

There are mainly three types of crowns used in dentistry.

  1. ALL METAL – This is the most basic crown which is used in dentistry but now its demand is reduced due to awareness of the tooth colored crowns. It looks black due to metal and gives an unpleasant look to the patient.
  1. PORCELAIN FUSED TO METAL – This is the most common used crowns nowadays. The crown is made of both metal and porcelain. The metal is on inside and porcelain is on the outside. They are generally used for the back teeth as it doesn’t fulfill criteria of esthetics for front teeth.
  1. ALL PORCELAIN – These crowns are made only of porcelain, due to the revolution in dental industry. They are also known as metal free crowns and have excellent biocompatibility with high strength and fantastic esthetics which ensures long term success.
  • How Many Visits Are Required To Get A Crown Fixed?

The time depends on the tooth which needs the crown. If the tooth is decayed or at risk of fracture or caries reaching to the pulp, then the condition should be treated first before opting for crown.

Otherwise crowns generally requires two steps

  1. Crown preparation where the tooth is prepared and impression is taken of the tooth and is sent to the lab where it will be made. For meanwhile a temporary crown is given.
  1. Second session is when the actual crown is cemented and adjusted.
  • Is The Crown Preparation Is A Painful Procedure? How One Should Prepare Himself For The Treatment?

The procedure of crown preparation is painless. After placing the porcelain crowns, few people experience sensitivity to hot and cold. Therefore it is advisable to consult your dentist to get all information about your teeth structure.

  • Does The Crown Blends With The Natural Teeth Or Stand Out?

Crowns are made after taking the shade from the shade guide to give the crown a very natural look to blend with the natural teeth of an individual. They are given to replicate the natural tooth with its functions intact, therefore not just crown look like your natural teeth, it functions like your natural teeth as well.

  • How Are The Crown Fixed To The Teeth?

Crowns are fixed with dental cement and technique of the cementation is very specific for each type of crown on what quality the crown is made of.

  • How We Should Take Care Of The Crown? How Long Does It Last?
  • There is no time limit for a crown to last. They can last a lifetime and sometime they choose to fall out or become loose.
  • The oral hygiene is very important for a long life of the crown. By keeping the gums healthy and visiting the dentist regularly for cleaning and checkups will keep the gum infections at a distance.
  • Patient with bad habits such as grinding the teeth or forcefully clenching will need to their habits in control by using the other dental appliances to save the crown as well as their natural teeth from excessive pressure.

 

IS THE BRACES TREATMENT POSSIBLE WITH CROWNS AND BRIDGES?

  • Ortho treatment or braces treatment are mainly known as corrective cosmetic treatment to align and maintain the teeth in a correct position in order to give an ideal smile and ideal occlusion of the teeth.
  • As now a majority of people are suffering from dental caries and decay so it is possible that they must have gone through treatment to get crowns to protect their teeth.
  • If you have irregular teeth and you want a corrective treatment for this situation (ortho treatment/ braces) then you must consult your dentist to know about the treatment so that the presence of crown does not hinder the ortho treatment.
  • Although every patient is different and their demands are unique therefore causing the ortho treatment a bit challenging, it’s advisable to consult the specialist to get the best solution for the individual treatment so that you get the best smile for your face.
  • Applying braces to the artificial crowns is difficult than placing braces on natural teeth. It is always advisable to consult the specialist for ortho treatment if someone wants to go for braces.

There are few questions for people going for braces;

  • The Movement Of The Tooth Is Limited When Fixed Braces Are Put On The Implant Crowns Or Crowns

As the implants are fused very solidly into the jaw, it’s impossible to move them using orthodontic treatment. People with existing bridge are given slight forces to not to cause damage to the crowns and bridges. If the crown has history of root canal treatment, the force applied to move the tooth is minimum and the restorations/crowns are monitored during the course of the orthodontic treatment.

  • There Are Chances Of Damage To The Artificial Crowns During Orthodontic Treatment.

The damage is purely esthetic in nature and there is no need to do anything about the crowns especially if they are in the back of the mouth. If the damage to the crown is in front position, the dentist may fix the restoration once the ortho treatment is done and braces removed.

  • Other Cosmetic Restorations Have To Wait Till The Orthodontic Treatment Is Finished

If a person wants to replace the crown for esthetic reasons, it is recommended to go for it after the orthodontic treatment is finished and the braces are removed.

In case if the crown is loose you may ask the dentist or the orthodontist to replace the tooth with a temporary crown before the placement of the braces.

The new crown can always be fixed after the finishing of orthodontic treatment.

Dry Socket

After Teeth Extractions

ALVEOLAR OSTEITIS or Dry socket is a complication where wound healing is altered that may occur following extraction of teeth if the initial blood clot is not formed or lost.

dry-socket

An improper wound healing results in exposed bone in the socket which is devoid of normal healing tissues (Clot), hence the name “dry socket.”It occurs three to five days after an extraction and is characterized by an increase in severe and throbbing pain.

Dry socket is treated by temporarily packing the site with eugenol, antibiotics and oral rinses. As the socket forms a new layer of the healing tissue the pain will gradually subside and the socket slowly fills in over the next 2-3 months.

  • In patients the risk for dry socket increases who smoke after extractions, too early vigorous rinses, forceful spitting, or use a straw to drink within the first 24 hour, which can disturb the initial blood clot formation.
  • Another major risk factor for dry socket is traumatic surgical procedures such as tearing the gum tissue, excessive manipulation of the extraction socket and aggressive drilling of the bone which ultimately will result in devitalized tissue with poor blood supply.

While the possible incidence of dry socket is between 1-3% data shows that no dry sockets were recorded after performing more than 150,000 extractions over the past 20 years.

THE SECRETS TO AVOID DRY SOCKET AFTER TEETH EXTRACTIONS:

  • Non-traumatic surgical techniques and procedures: This means no or minimal gum tissue flap, no or minimal removal of bone, use of irrigation, gentle handling of the tissues and atraumatic removal of teeth with ease.
  • Avoid rinsing or brushing: Any forceful rinsing or brushing immediately following a tooth extraction can cause dislodging of the blood clot leading to a dry socket. Do not rinse or brush within 24 hours of extraction then rinse gently for the next 1-2 days and more vigorously in the following days.
  • Do not use a straw: The use of a straw in the first 24 hours can also cause suction and dislodge the blood clot. Use a glass following liquid consumption.
  • Avoid smoking: Smoking creates suction in the mouth that can dislodge the blood clot. It also directly inhibits the normal healing physiology.
  • Do not spit: With blood and saliva accumulating in the mouth following an extraction you may be urging to spit that out. This action can disrupt the formation of blood clot and dislodge it. Instead of spitting let the accumulated blood and saliva drool down and wipe it gently with a gauze or tissue.
  • Keep firm pressure on the extraction site: The gauze should remain in place for at least 30-45 minutes after extraction. Constant and firm pressure helps to slow down the bleeding and stabilizes the formed blood clot.

HOW TO PREVENT DRY SOCKET

Dry socket (alveolar osteitis) is a wound healing complication that can occur following teeth extractions if the initial blood clot is lost. This results in exposed bone in the socket devoid of normal healing tissues, hence the name “dry socket.” It usually occurs three to five days after an extraction and is characterized by a sudden increase in severe and throbbing pain. Dry socket is treated by temporarily packing the site with eugenol, antibiotics, and oral rinses. As the socket forms a new layer of healing tissue the pain gradually subsides and finally the socket slowly fills in over the next 2-3 months.

The risk for dry socket increases in patients who smoke after teeth extractions, vigorously rinsing too early, spitting, or using a straw to drink within the first 24 hours—all of which can disturb the initial blood clot.

While the possible incidence of dry socket is between 1.5-2%, here at   Dr. Sachdeva’s Dental Implant Institute, Delhi, we have experienced no dry sockets after performing more than 6500 extractions over the past 13 years.

Platelet Rich Fibrin (PRF) as healing aid in extraction socket:

Platelet rich fibrin (PRF) is a fibrin matrix in which platelet cytokines, growth factors, and cells are trapped and may be released after a certain time and that can serve as a resorbable membrane, regulate inflammation and increase the speed of healing process.

It is a simple, natural and inexpensive technique for the production of leukocyte- and PRF (L-PRF) concentrates. It includes collection of whole venous blood (around 5 ml) in each of the two sterile vacutainer tubes (6 ml) without anticoagulant and the vacutainer tubes are then placed in a centrifugal machine at 3,000 rpm for 10 min, after which it settles into the following three layers: Upper straw-colored acellular plasma, red-colored lower fraction containing red blood cells (RBCs), and the middle fraction containing the fibrin clot. The upper straw-colored layer is then removed and middle fraction is collected, 2 mm below to the lower dividing line, which is the PRF. The mechanism involved in this is; the fibrinogen concentrated in upper part of the tube, combines with circulating thrombin due to centrifugation to form fibrin. A fibrin clot is then formed in the middle between the red corpuscles at bottom and acellular plasma at the top. The middle part is platelets trapped massively in fibrin meshes. The success of this technique entirely depends on time gap between the blood collection and its transfer to the centrifuge and it should be done in less time.