ESTHETIC AND THERAPEUTIC CROWN LENGTHENING USING LASER

A healthy periodontium and incisal wear with adequate tooth structure for restorations may require only restorative treatment. A sound, intact dentition with gingival hyperplasia may require only periodontal treatment. A tooth that has been damaged by caries or trauma to the extent that there is less than 3 mm of sound tooth structure coronal to the alveolar crest will require periodontal and perhaps orthodontic treatment prior to fabrication of a definitive restoration. When significant discrepancies exist in face height, lip length or lip thickness, periodontal and restorative treatment may need to be coordinated with orthognathic and/or plastic surgery procedures If the patient is unwilling or unable to obtain this additional care, then he or she must be informed that limited improvement may result from periodontal and restorative treatment. It is absolutely essential that a complete, comprehensive diagnosis be developed in order to plan treatment that will predictably produce optimal results with long-term stability. It is important to keep in mind that excessive gingival display, often referred to as the ‘‘gummy smile’’ may be the result of several factors, including gingival enlargement, altered or delayed passive eruption, insufficient clinical crown length, vertical maxillary excess and a short upper lip.

Following the formulation of a complete and accurate diagnosis, a comprehensive plan for treatment is developed. When full-coverage restorations are indicated, it is preferable to avoid placing margins subgingivally; however, in anterior areas margins frequently must be placed within the sulcus for aesthetic reasons. In order to minimize colonization of the sulcus by microorganisms associated with periodontitis, it is important to avoid overhangs and to reproduce the original contours of the tooth as closely as possible

Therapeutic crown lengthening for better crown adaptation 

              In anterior areas where aesthetic considerations are highly significant, surgical crown lengthening alone may have an unacceptable result and the use of Lasers gives the patient a comfortable, painless and bloodless experience to achieve what they want both esthetically and with therapeutic indications.

Esthetic crown lengthening

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FLAPLESS KOS DENTAL IMPLANT PLACEMENT

FLAPLESS KOS DENTAL IMPLANT PLACEMENT in left side premolar region.. Provisional Restoration given in 2 days..

                       

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WHAT IS IMMEDIATE DENTAL IMPLANT PLACEMENT ?

Dental Implants are rapidly becoming  a routine procedure  in today’s dentistry..

Dental IMPLANTS are placed immediately after extraction of the teeth  ie, Implants placed into fresh Extracted site..  This procedure is known as IMMEDIATE IMPLANT Placement.

There are many advantages in this immediate placement technique:

In a traditional two piece implant system, we have to wait for 6 months after the tooth has been extracted  for  the new bone to build up in the site.  And a second  surgery  for uncovering the Implants and again wait for few weeks for the teeth to be restored.

But in IMMEDIATE  IMPLANT , we use single piece Implants.

Implants placed immediately after extraction of teeth.

There is no waiting period of 6 months. Healing process of Implants ( osseointegration ) occur as   naturally process, ie,  the body builds up the new bone in the extracted site where the Implant is placed.

There is no second surgery as in conventional method, we give  temporary teeth on same day and permanent teeth of ceramic or zirconia on 3^rd day.. ( fixed teeth in 3 days )

It is convenient for the patient since the surgical treatment is completed in one intervention.

No multiple appointments.

Cost effective since there is no multiple visits.

No complications of crestal  bone loss or screw loosening as commonly seen in two piece Implants.

In the present scenario, this procedure is highly standardized, as it prevents change in  shape of  bone and gums surrounding the extracted teeth.

                                        Patient came with loose, mobile lower front teeth

                                                Extraction of  shaky, mobile teeth done.

                          single piece BCS IMPLANTS  placed Immediately  after  Extraction

                               

                                                   Next  day after Implant placement

 

                                                   Ceramic Bridge cemented in 3 days

                                           Patient happy with good, appealing esthetics

To know more about Immediate Implants,

click this link: http://drmurugavel.in/immediate-implant

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dr_mrgvl@yahoo.co.in

chinthamanidental@gmail.com

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Contact: 91-9283786776

FLAPLESS DENTAL IMPLANT IN INDIA

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LASER TREATMENT FOR SUBMUCOUS FIBROSIS

Oral Submucous Fibrosis(OSMF)

OSMF  is a pre- cancerous condition and it occurs predominantly among Indians and even those settled outside India. The causative factors for the occurance of this disease are attributed to areca nut chewing, consumption of hot chilies and genetic predisposition of people of Indian subcontinent. There are more evidences to suspect that areca nut chewing is the main causative factor. OSMF can occur in all parts of oral mucosa.

Diode Laser in Treatment of OSMF

Laser stands for Light Amlification by Stimulated Emission of Radiation. Laser rays are coherent beam of rays that pack lot of energy compared to ordinary light. But the energy delivered can be controlled . There are many applications of Lasers and the characters of Laser rays find many application in surgery. The properties of lasers like reflection, absorption, transmission and scattering are all used for beneficial results in surgery. The Laser can reflect off a surface of the tissue depending on the tissue surface properties and can be absorbed in the tissue cells. In scattering it causes to diffuse the absorption over the large surrounding areas and because of this it is not possible to get precise incision by using this property. 

Because of developments in Diode Laser technologies, it  has found great applications in surgery due to improved  power and precise controllability. It has found great applications in oral surgery practice as well as in other areas. By changing the wavelengths we can control the energy levels and other desired properties that determine incision quality and coagulation parameters. 

Diode lasers built with semiconductor materials are portable and very compact in size and can be used in different modes such as pulsed or continuous mode. Diode laser surgery can be successfully used in surgical treatment of OSMF.

LASER PROCEDURE:

The operating team and patient are required to wear the protective eye wear. Ideally 0.3mm diameter cable is used to deliver the beam. Laser hand pieces are used to place the incision at required sites. Incisions are made from the retromolar area to premolar area. These incisions are of 2mm depth to reach the muscle layer while incising only fibrous mucosa and submucosal layer. The same type of incision is done in the region inferior to this starting at a distance one third of the superior incision in the third molar area upto earlier incision made to form the shape of inverted "Y". 

Laser beam ideally 5 Watt power is directed. The excision of fibrous bands was followed by forcible separation of mucosa. Bilaterally placed incision was made and then the mouth forced open using Fergusson's mouth gag.

Venier calipers were used to measure the mouth opening. The mouth opening was measured for maxillary and mandibular incisors. The patients are trained on physiotherapy excercise ten days after surgery. 

The clinical examination after surgery shows precision in incision and less postoperative edema and pain in patients of all age groups and varying degree of the condition.

The follow up examinations after surgery showed significant improvement in forced mouth opening and later after 10 days and three months these improvements are sustained for spontaneous mouth openeings. 

 There is no doubt that diode laser surgery is very effective and less invasive technique to treat OSMF and offers great relief to the terrible state the patients suffer because of this disease.

Before Laser Treatment, The limited mouth opening and fibrous buccal mucosa

After Laser Treatment, improved mouth opening and less fibrous buccal soft tissue 

       

 

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Please watch our video for treating OSMF patients using Laser in  http://www.youtube.com/watch?v=4NH5elqgPZ8

GINGIVAL DEPIGMENTATION

GINGIVAL DEPIGMENTATION

Gingival hyperpigmentation is more of a esthetic procedure rather than a medical problem. Black gums are of esthetic concern for not only fair skinned individuals but almost all people of all age groups. Various treatment modalities have been practiced for gingival depigmentation, such as scalpel, cryosurgery, electrosurgery, abrasion of the gums using diamond burs, free gingival grafting procedures lasers.

Melanin pigmentation, is a brown pigmentation of the skin and gums that occurs in all races. Gingival depigmentation is a perioplastic surgical procedure, whereby the gingival hyperpigmentation is removed or reduced by various techniques. The use of Lasers compared to other surgical procedures have been proven to be more palliative despite fulfilling the requirements of the patient.

Advantages of  Laser  over other surgical procedures:

1.      Dry and bloodless procedure.

2.      Instant sterilization of the surgical site.

3.      Reduced bacteremia.

4.      Reduced mechanical trauma.

5.      Minimal postoperative swelling.

6.      Faster healing time.

7.      Minimal postoperative pain.

8.      No need for periodontal dressing (usually used for protection of the wound created by scalpel)

Visit us at:
  http://www.chinthamanilaserdentalclinic.com/

email us at:          dr_mrgvl@yahoo.co.in

                                          chinthamanidental@gmail.com