LASERS IN ENDODONTICS

  • Endodontic procedure carried out by conventional methods may not be successful in spite of utmost care.
  • Despite the mechanical removal, irrigation and disinfection of canals, the bacteria can still persist which cannot be reached by conventional techniques.
  • As the technology has advanced, now lasers are used in endodontic procedures to improve the prognosis of the treatment of tooth.
  • Laser light penetrates upto >1000 micrometre into the dentin and provides a distinct advantage since the bacteria can immigrate upto 1000 micrometre into tubules.
  • When in contact with laser, cell membrane gets destroyed due to the impact of direct heat and this damage is enough to stop the growth of the bacteria depending on the wavelength and frequency of laser irradiation used by the dentist.
  • It is a very effective tool for disinfecting the root canal after mechanical root canal treatment as it has sufficient penetration depth.
  • It is effective in curved canals also and the energy is transported by thin flexible fibres which have diameter of only 200 micrometer.
  • Laser eradicates the microbial flora of root canal and also has same effect on surrounding dentin without affecting the surrounding tissue and has good disinfection mechanism without causing pain and improving the prognosis of the endodontic treatment.

If you want to consider being mentored by Dr Rajat Sachdeva contact him directly on 01142464041 for an informal chat.

PERIODONTAL LASER THERAPY

Periodontal Care for Gum Disease in India

Dr.Prof. Rajat Sachdeva is proud to offer the latest technology available for periodontal therapy: laser treatment in India. There are numerous advantages to using laser therapy as opposed to the traditional methods requiring a scalpel and sutures.

Benefits of using laser technology in dentistry :

Comfort:

With laser treatment, there is reduced or no bleeding, minimized swelling, no charring, and no drill noise or vibration. The stress and anxiety often associated with dental work is therefore eliminated when you experience quick, effective, and essentially pain-free laser procedures. Also, postoperative sensitivity is greatly limited by laser dentistry, and recovery time is much quicker than with traditional methods. In fact, due to the less-invasive nature of the laser technique, the mouth begins to heal immediately after work is completed!

Reduced Risk of Infection:

The laser’s high-energy light beam acts as a sterilizer on the area it is working, thereby reducing the risk of bacterial infections and relapses.

Anesthesia Limited or Eliminated:

Because laser dentistry is virtually painless, no longer will you suffer with fear of injections and numbness. Often, only a light anesthetic spray is required. Laser treatment eliminates the complications and cost associated with anesthesia.

Uses:

Dr.Sachdeva can perform a variety of procedures using laser technology, such as a frenectomy, osseous surgery, gum grafting and treatment of gummy smile.

Dr. Rajat is also able to use laser technology as a way to regenerate healthy gums and remove diseases areas in a virtually painless way. This method also encourages healthy gum to regenerate and attach to the teeth. There is a much lower chance of gum disease returning when laser therapy is used as opposed to traditional surgery.

Piezosurgery

Dr.Rajat Sachdeva utilize advanced technology to make your dental surgery more effective and comfortable for you.

What is Piezosurgery?

The piezosurgery system uses ultrasound waves to cut bone without damaging soft tissue. Whereas traditional methods of bone-cutting, such as drills and burs, result in some tissue and bone loss regardless of the dentist’s precision, piezosurgery technology eliminates this risk. This means Dr. Rajat Sachdeva is able to perform procedures such as tooth extractions, crown lengthening, ridge expansion, periodontal therapy, and implant site preparation with increased accuracy and minimal discomfort.

Benefits of Piezosurgery:

Accuracy Hard tissue is surrounded by soft tissue including arteries, nerves, and sinus membranes. In traditional surgery, there is great risk of damaging this precious tissue, but with piezosurgery, the system is so accurate and specific to the surgery site that this risk is eliminated.

Comfort If you fear the trauma associated with drills and burs, piezosurgery eliminates this problem as well. The procedures completed with piezosurgery technology result in minimal bleeding and swelling, and reduced pain.

Healing Time Healing time is accelerated when piezosurgery technology is used. Not only will you heal faster than with traditional surgery, but you will experience minimal post-operative pain or discomfort.

Safety Piezosurgery techniques are extremely safe.

MAXILLARY SINUS LIFT

The tendency of the alveolar ridge to progressively resorb after tooth loss & typically poor quality of posterior maxillary bone, rehabilitation of this region with implant supported prosthesis has been challenging.

Anatomically maxillary sinuses are largest paranasal air cavities limited by six walls, separated from the nasal cavity, containing the neurovascular bundle & covering the tooth root by a Schneiderian membrane. The blood supply of the maxillary sinus is derived from the branches of maxillary artery, posterior superior artery, infraorbital artery & descending palatine artery. Anatomical knowledge of sinus vascularization is necessary to prevent bleeding complications during the sinus lift procedure.

Therefore, the surgical procedure of maxillary sinus lift has undergone considerable development & different variations with autogenous bone regarded as the preferred option.

Factors to satisfy the criteria for sinus augmentation are:-

-residual bone <10mm in height

-absent pathological condition/fibrous scars

-absence of multiple maxillary teeth & need for strong sinus floor for multiple implants

Preexisting local pathological conditions is an absolute contradiction to sinus lift procedure as grafting procedure can lead to fluid stagnation & exacerbated sinusitis.

At present there are two surgical approaches for maxillary sinus floor lift procedure.

First the lateral antrostomy (traumatic) being classical one described by tatum.The transcrestal approach has less morbidity but nevertheless it requires enough residual bone height for primary stability of implants i.e. prerequisite residual bone height should be >6mm to enable placement of implant 10mm in height. It is indeed a one stage procedure & less time consuming but as every procedure has its own pros & cons, its drawback is that only 2-4mm of bone height can be increased & its highly technique sensitive.

More recently, second approach i.e. crestal one (atraumatic or conservative) has been advocated by Summers using osteotomes.It includes same procedure as that of lateral approach with a crestal incision followed by full thickness flap raised & implant site prepared 1-2mm shorter than the subantral bone height using drills & osteotomes while in lateral approach antrostomy is performed using a round bur to create a U-shaped trapdoor on a lateral buttress of the maxilla.

The main advantage of this approach being less invasive procedure, improves the density of the maxillary bone allowing greater stability of implants which can be unproven if the residual bone height is <6mm.

Restoring edentulism with dental implants needs careful treatment planning especially in the posterior maxilla where the pneumatized maxillary sinuses can limit the amount of alveolar bone for implant placement. Hence maxillary sinus floor lift offers the most common & predictable preprosthetic procedures to address this problem.

Regards: Dr. Prof. Rajat Sachdeva

Director & Mentor

Dr.Sachdeva’s Dental Institute

www.sachdevadentalcare.com 

www.dentalcoursesdelhi.com

+919818894041, 01142464041

Occlusion is the key in Implants

Osseo integrated implant being the most sought after modality of treatment, optimal occlusion plays a key role in implant supported prosthesis. The probable reason for peri-implant disease or crestal bone loss & failure of implant prosthesis is occlusal overloading of implants.

This is a review to discuss the clinical guidelines for various occlusal schemes like balanced, group function, mutually protected occlusion. Appropriate occlusion is the foremost mandatory for long term survival of implants in absence of sound clinical situations. This is because poor occlusion increases the magnitude of mechanical stress & strains at the crestal bone.

Misch proposed implant-protective occlusion which states that by decreasing the occlusal forces increases the clinical success of implants & its prosthesis.

Keeping aside the conventional occlusal concepts, refinements proposed to reduce stress at the implant interface are

Ø Mutually protected articulation

Ø Implant body angle to occlusal load

Ø Crown height

Ø Quality of implant crowns

Ø Timings of Occlusal contacts

The biggest question of the hour is why occlusion is the most important factor? Since the periodontal ligament – mediated proprioception doesn’t occur with implants as in natural teeth; occlusal forces are to be carefully accomplished in order to regulate mandibular displacement.

Each of the prosthesis i.e implant supported prosthesis, tooth or tissue supported prosthesis exerts different range of forces in both the functional & resting movements. The implant supported prosthesis is designed as that of tooth supported single fixed partial prosthesis with an adequate interarch space with bilateral stability in centric occlusion & no interferences between retruded & centric position. In terms of posterior fixed implant prosthesis reduced inclination of cusps, narrow occlusal table, and increased proximal contacts provides stability to the restorations.

The current accepted paradigm shift is mid retrognathia-flat lingual incisal platform in skeletal class II div II, raise vertical dimension at occlusion to flatten anterior guidance in skeletal class II Div II, to slightly disocclude posterior or mild anterior disocclusion in skeletal class III.

In cases of natural dentition little degree of flexibility is acceptable but in implants the flexibility degree is supposed to be decreased to zero for the success of prosthetic rehabilitation.

Dr. Prof. Rajat Sachdeva

Director & Mentor

Dr.Sachdeva’s Dental Institute

I-101 Ashok Vihar Phase 1 Delhi 110052

www.sachdevadentalcare.com

www.dentalcoursesdelhi.com

+919818894041,01142464041

FROM NO TEETH TO CHEWING WITHIN 72 HRS

Nowadays increase in patient’s demand in terms of good quality of life & appearance makes it necessary for the dentists to aim for a dental prosthesis which restores the speech, health, functional, esthetic requirements. Dental implants have surfaced as a promising option for this objective.

Firstly introduced into the market evolving from conical to cylindrical surface, self drilling to sand-blasted and acid etched surface treatments, immediate implants and loading in fresh sockets after extraction has a success rate proportionate to that of implants introduced under mainstream protocols, if the surgical site meets the prerequisites.

 Immediate implants prefer precise preparation of the osteotomy site. The required primary stability allows vital  bone  to  be  in  contact  with  the  implant  surface  facilitating  immediate  loading. With new age advancements in implant designs and surface modifications treatment time have been reduced.

Henceforth the beau ideal has thus repositioned from “No load on implants during osseointegration” to “No micro movements of implants”. Immediate loading loads the implant with a provisional crown at the same appointment or shortly later eliminating the second stage implant surgery. The advantages of placement of a temporary restoration as an immediate loading of dental implants include:  greater acceptance of patients, better esthetics, function, most importantly reduced treatment time. Immediate loading of implants refers to a superstructure being attached to the implants no later than 72 hours after implant placement. Misch stated immediate occlusal loading within 14th days of implant insertion. The terminology ‘non-functional immediate loading’ and ‘immediate restoration’ are used when prosthesis is fixed to the implants within 72 hrs without establishing full occlusal contact with the opposing tooth.

 The criterion for success of Implants includes primary implant stability, quality & quantity of cortical & trabecular bone, surgical technique, occlusal factors, implants design surface textures & design.

As per the procedure at the time of first stage of surgery, the implant is inserted into the socket.  After implant insertion the final abutment is positioned. Final abutments are formulated intraorally for appropriate height & parallelism. The transitional prosthesis is accessed for harmonious occlusal contact in centric occlusion. This is followed by impression with additional silicone to record implant body position. After the impression, the abutments are removed from the implant body and replaced with gingival former/healing abutment/healing cap. The laboratory inserts the implant body analogs into the impression, pours the impression with die stone, and prepares the abutment to fabricate a transitional prosthesis.

Further, the surgical procedure can be accomplished without flap, decreasing morbidity and surgical procedures patients require reducing undermining esthetics.

Regards :

Dr. Prof. Rajat Sachdeva

I-101 Ashok Vihar Phase 1 Delhi 110052

http://www.sachdevadentalcare.com/institute.html

PRP in Dental Implantology

Platelet-rich plasma therapy can be used to accelerate the healing process for dental implant treatments.  PRP procedures use the body’s own regenerative abilities to enhance the growth of bone and soft tissue.  They jumpstart the process and reduces the time between implant placement and crown fitting.

The patient’s own blood is used and centrifuged to separate the platelet growth factors from the red blood cells.  The platelets help improve the rate of growth of new bone and soft tissue.  There is minimal risk because the healing process of the body is completely natural.  Since the patient’s own blood is used, an allergic reaction or infection is unlikely.

In dental surgery, PRP is mixed into gels and applied to treatment sites and tooth sockets.  It is effective in supporting the integration of implants with bones. The grafts become bonded faster with the patient’s bone thanks to the growth factors in PRP.  Implant dentistry can be a more natural and effective process with the professional use of plate-rich plasma growth factors.

Regards:

Dr. Prof. Rajat Sachdeva 

Director & Mentor : Dr.Sachdeva’s Dental Institute

I-101 Ashok Vihar Phase 1 Delhi 110052

 

http://www.sachdevadentalcare.com/institute.html

Classification of Molar Extraction Sites for Immediate Dental Implant Placement

Dental implants may be successfully placed immediately into fresh extraction sockets when primary implant stability can be attained. This article presents a new classification system for molar extraction sites that describes extraction sockets based upon the bone available within the socket for stabilization of an immediately placed implant. Three categories–types A, B, and C–are employed: the type A socket, which allows for the implant to be placed completely within the septal bone, leaving no gaps between the implant and the socket walls; the type B socket, which has enough septal bone to stabilize but not completely surround the implant, leaving gaps between one or more surfaces of the implant and the socket walls; and the type C socket, which has little to no septal bone, thus requiring that the implant engage the periphery of the socket. Treatment protocols and relevant clinical examples are presented based upon the characterization of the socket according to this classification system.

Dr. Rajat Sachdeva
Dr. Sachdeva’s Dental Aesthetic &amp; Implant Centre
I – 101, Ashok Vihar,
New Delhi -110052
Mobile: +919818894041

Clinic: 011-42464041, +918527017175

http://www.sachdevadentalcare.com/institute.html