Every day we see dental clinics advocating “Dental Implants in a Day” in bold letters on various social platforms. Most of us are confused because there are also some doctors/sites which warn of high failure rates with such treatment plans. So what’s the true story. Are dental implants in a day a feasible option and are they reproducible with equal success by all doctors and in all patients.
With advanced technology and 3D treatment planning, dental implants In a day have become a reality where they can consistently be given to patients with great success rates. There are three broad categories which determine the success rate of these procedures.
1. Patient selection –
a)If a patient is a diabetic the HBa1c should be under 7.2
b)Blood pressure should be under control.
c)Smoking should be avoided during the first four months of placement.
d) A patient shouldn’t be on bisphosphonates
e) Should not have any bone disorders like osteoporosis.
f) There should be adequate bone volume and the quality of bone should be good.
2. Advanced technological aids
a) CBCT – A cbct is a volumetric analysis of the quality and quality of bone available to place implants. It gives an idea of the amount of bone available so the implants are centrally placed within the boundaries of bone without causing any damage to any vital nerves or vessels.
b) Guided surgery can be done for patients using cad cam. Various proprietary software is available today for doing this. One example is the “Noble Guide” software by “Nobel Biocare” company. This involves reverse planning the placement of implants based upon the final position of the teeth. This helps in good prosthetic planning with a good distribution of forces which further helps in the long-term success of immediately loaded teeth. The teeth which are delivered to the patients immediately after the surgery can also be fabricated/ milled using this software allowing for more accuracy and a precise fit.
When guided surgery is performed the surgical stent allows the placement of the implants without needing any extensive cutting of the gum tissue allowing the implants to be placed through small keyhole surgery. This helps in minimal postoperative inflammation and minimal pain allowing more comfort to the patients postoperatively.
c) Intraoral welding – Dentsply company has come out with a unique concept of welding the abutments (attached to the implants ) allowing for the most passive and strong immediate full jaw prosthetics. This increases the success rate of the prosthesis delivered.
d) Multiunit attachments – these attachments to dental implants allow them to be placed within a good bone volume but at the same time allowing for angular corrections up to 45 degrees. Owing to these attachments on dental implants it is now possible to place dental implants in a good bone volume but still do corrections to give immediate prosthetic results. The all on four concepts relies on this tilted dental implants concept.
3) Patient Compliance-
a) Taking medication during the healing period on time.
b) Good Hygiene maintenance is key to implant success in the long run.
c) Soft diet during the healing period – The patient is allowed to ear with the teeth but very hard food items like nuts act need to be avoided.
To summarise while immediate dental implants cannot be guaranteed to all patient but with good patient selection and following of protocols set into place for such procedures, they are a reliable treatment modality.
At Orion Orthodontic & Dental Care Centre we offer all on four dental implants at a very competitive rate. Dr. Anupam Sinha our dental implantologist has worked extensively for providing immediate Dental implants post extraction along with immediate loading protocol. Currently, we are offering a CAD CAM-based protocol for our overseas patients which makes the treatment results more predictable. With this protocol, a scan of the jaw is used to determine the exact width and length of the dental implant suitable for your case and the treatment plan is customized based upon your bone morphology and bone density on a 3D simulation software. This helps to reduce your actual chair time by half. Also as a splint is used during the surgical procedure it makes the treatment results more predictable.
Further, the immediate loading prosthesis is designed in the same simulation software and the prosthesis is delivered either the same day or within 2 days of the surgery.
At Orion, since we are located within the confines of a hospital we provide inpatient facilities in case you are interested. This would essentially mean that if you desire, we have an admission facility at the Hospital, with a monitoring post the surgery although our local patients prefer to go home.
An additional benefit we provide at Orion is the anaesthetist. This allows us to operate under conscious sedation in case you have a phobia of dental surgical procedures which allows you to be semi-conscious while the procedure is being performed. This can of course be provided only in case you desire such a facility at an additional cost of Rs 10,000. ( 138 $ U.S.D)
The charges for all on four per jaw at Orion is 3450$ U.S.D . This is not inclusive of the hospital stay(90$ USD per day) or anaesthetist charges(138$ USD). For both jaws the cost would be 6900$ U.S.D. Although there are other cheaper options available we would like to offer the best and the most predictable treatment option to our patients who are flying in for dental implants as follow-ups are limited by geographical constraints.
Usually, we request for a 2 week stay in Delhi for the procedure as the splint and temporaries require us to outsource the work and a certain amount of time in hand is always more comfortable.
Metallic braces and Ceramic labial braces work in the same manner but the Ceramic braces generally have more friction between the wire and the bracket slot due to which the movement over the treatment period can be slightly delayed. To overcome this problem the Ceramic braces can come with metal inserts in the slot where the wire sits. These Ceramic braces with metal slot/insertss have reduced friction and allow the bracket to slide over the wire much better. When we are using pure ceramic the treatment duration may get increased by a few months.
Difference between Self-Ligating brackets and regular brackets
All braces have a slot cut into their face through which the wire passes through.
In normal braces the wire is held into the slot either by using steel ligature wire or by using elastic modules. The elastic modules have the highest amount of friction as they actively hold the wire into the slot. This in turn causes the wire to bind against the bracket and leads to increased friction.
Self- Ligating brackets have a window which covers the slot which makes the slot in to a four walled enclosure. This helps to enclose the wire within the four walls and it thereby hold the wire in place.
Self- Ligating brackets are broadly of two types-
a) Self-Ligating brackets with active clips- These brackets have an active Niti clip which in although does not push the wire in actively in the initial stages but in the later stages of treatment push the heavier wires in actively and this in turn leads to a better torque expression.
b) Self-Ligating brackets with passive clips- These brackets have a forth wall which slides aver the slot and does not actively push the wire into the slot. Some believe that the torque expression suffers on this account so the final orthodontic results are not as good.
Cearmic Brackets with metal slots
My wife, Pema and myself are deeply impressed with the fine dental services and care provided by Drs. Natalia and Anupam Sinha and the Orion Orthodontic And Dental Care Center. Their professional knowledge and skills along with personal attention to details are of the highest standard. It’s rare to see dentists today who combine these qualities along with patience, concern and the latest know-how in dental science.
We at Orion Orthodontic & Dental Care Center provide complete dental and oral care solutions. By offering our services for Dental Care in India, we make sure that our patient’s safety and comforts are well taken care of. For this, we take extra measures and constantly update our dentist in Delhi with the latest treatments and techniques in dentistry. We at our dental clinic in Delhi have an experienced panel of senior dentists for providing the best treatments to our patients.