Wednesday, May 26, 2010

A Comparison between Alloderm and Free Gingival Graft

Alloderm and Free gingival grafts are placed on either apical or coronal region at the recessed gingival margin, where these grafts are used to enhance the smile and reduce tooth exposure which gives unpleasant appearance. A free gingival graft is used to increase the zone of attached gingival tissue. In this procedure, the tissue is obtained from the patient itself and used on the site of gum recession. The tissue obtained can be either from the palate of the patient or some other oral tissues from the patient’s mouth. It is then placed on the area where there is exposed root surface or wall defects, and which can have single or multiple defects. There is hardly any damage to the donor due to tissue removal.

The main function of the free gingival graft is to increase the thickness of the gum tissue. This process is indicated when there is gingival recession or a part of the soft tissues is displaced due to trauma. It also covers root surfaces exposed due to severe gum recession. In this technique, an incision is made at the mucogingival junction without touching the periosteum. An Aluminum foil template at the recipient site is used as patterns, and the graft is placed directly on the bone tissue and is allowed to heal for two weeks.

An Alloderm or acellular derma matrix is a processed graft obtained from donated human tissues which is later processed to be used in any patient. Alloderm is made up of a matrix of collagen which helps in cell production and also contains elements which provide blood supply to the surrounding areas. It can be used for root coverage for multiple teeth. And it has very good epithelial tissue which helps in maintaining the esthetics. The cells produce and cause pigmentation like the natural tissues, and give good contour. We can also treat several defects in a single surgery with alloderm graft as there are no limitations on the amount of tissue obtained unlike the free gingival graft obtained from the palate which has limitations.
There are several advantages of the alloderm against free gingival margin graft. Firstly, no palatal tissue is required from the patient. Secondly, multiple surgical procedures can be performed on the patient without any limitation on the tissue requirement. Irrespective of the age of the patient and the medical fitness of the patient, the surgery can be performed as the palatal tissues are not required from the patient. With Alloderm, the height of the mandible over denture is maintained. Alloderm was previously used in major body burns for plastic surgeries, but today it is extensively used in dentistry as well.

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Sunday, May 09, 2010

Significance of Esthetic Buccal Flap (EBF) in Implant Surgery

Although dental implantology has tremendously advanced in the last decade, there are still a few flaws and backdrops in the procedures when it comes to perfect esthetic appearance, especially for those who want to have natural appearance immediately after implant surgery. For such people, a flapless implant surgery has come into being recently. It was discovered in order to rectify the flaws of other implant procedures and to deal with those factors which flap designs in implant surgeries. But these procedures are not able to correct the vertical and horizontal wall defects of one wall or more, and are also not able to correct dehiscence or fenestrations without disturbing the esthetics.
Hence, a new Flap design was introduced in the implant surgery which aimed at maintaining maximum esthetic appearance while rectifying other defects as well at the same time, and this flap design is known as Esthetic Buccal Flap (EBF). It is best preferred for single missing tooth or multiple missing teeth where the adjacent soft tissues and bony structures are intact. And is more preferred in the anterior region so as to achieve perfect harmony with the implant position, bone level, soft tissue esthetics and tooth form and color. It can satisfy all these factors and give good esthetics without any scar tissue formation.

When a prosthesis or implant is inserted in the jaw bone, after a gap of 6 months or more, a clinical assessment is done to check for the progress and regeneration of bone, and its adaptability to the surrounding structures. An assessment of mid buccal probing height is also done together with the detection of any present signs of scar tissue, based on which a soft tissue adaption is preferred.

The height of the soft tissue remains the same before and after the surgery, the papillae and the probing dept also appears to be the same after the surgery, and there will be no sign of any scar tissue. Thus, Esthetic buccal flap along with rightly guided bone augmentation allows perfect esthetics in implant surgery which also rectifies any wall defects as well. The esthetic buccal flap in implant surgeries helps to get a normal gingival appearance after the implants are placed.

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Friday, April 09, 2010

Alloderm - The solution for gingival esthetic problems

Alloderm is a product which is used in human implants gingival grafts, periodontal grafts, gingiva recessions etc etc.

It is made out of real human tissues. Unlike other membranes, Alloderm is natural and they slowly get integrated into the tissue of an individual. Alloderm is used in various oral grafting procedures like augmentation of soft tissue, lip augmentation, gingiva defects around dental implants etc.
It is of more use for people having harvestable tissue deficiency. These grafts have minimal side effect as compared to the various other methods.

For processing Alloderm, a buffered salt solution is used to remove the epidermis. The multiple cells that are present inside the dermis are then washed away with the help of a non-denaturing detergent wash. The tissue matrix obtained after extraction is preserved with the help of a special freezing drying process.

The major advantage of using Alloderm is that you can create multiple sites in a single surgery. Another advantage of Alloderm is that it removes cells that cause infection or rejection in an individual.
Shrinkage poses the only major threat while using Alloderm, the signs of shrinkage may take quite some time to appear. Alloderm is safe, natural and effective and these are the qualities which makes it highly popular. The fact that these products become an integral part of an individual may sound scary, but it is not so.
It is true that Alloderm offers a lot of benefit. However, there are also some side effects associated with its use. Some of the most common side effect of Alloderm is swelling, redness, bruising, excessive pain etc. Bruising caused due to its use can also last for a couple weeks.

Despite its few disadvantages, this product is being widely used in various implant and periodontal surgeries.

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Wednesday, April 07, 2010

All Ceramic Crown VS Esthetic composite Restoration

All Ceramic Crowns and Esthetic composite are both dental restoration methods. Both are equally popular but they differ widely from each other. This article will give you a brief insight on both these methods.

An all-ceramic crown completely encircles or caps a tooth or a dental implant. Dental cement is used of bonding crown with the tooth.
Crowns not only impart strength to the fixed tooth but also it gives a pleasant appearance. Inlays, crown lays, porcelain veneers and various other varieties of crown can be made out of ceramic materials, also using CAD/CAM systems. The advantage of using ceramic crowns is that they are higly esthetic, durable and easy to maintain. Also, since these are made up of solid porcelain, their color matches the shade and color of the teeth.
These crowns are made up of either pressed ceramics or feldspathic porcelains. These restorations require wider shoulder margins and a small reduction across the chewing surface of the teeth. The major disadvantage of using ceramic crowns is that these involve risk of fracture. Also, it has been noticed in some cases that the patient who have ceramic crowns on their teeth grinds their teeth excessively.

On the other hand, Esthetic composite restorations are used as adhesives or restorative materials in dentistry. These are used in dentistry because these are insensitive to dehydration and are esthetic, inexpensive and insoluble. These can also be manipulated easily. These are commonly composed of Bis-GMA monomers, a photo initiator and a filler material like silica. The scientific knowledge and artistic ability produce strong, esthetic, and long-lasting restorations. However, this method too has some disadvantages. It is said that composite restoration causes craze lines, stains, dentin exposure, chips, cracks, surface defects, and developmental defects.

However, despite of their various shortcomings both these methods are widely used for dental restoration.

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Thursday, March 25, 2010

What are Lumineers ?

Lumineers are a kind of thin veneer by Cerinate, to keep it simple.

Just like regular veneers, the Lumineers can change your like completely if you have esthetic problems like discolored teeth, teeths with large unestethic restorations, flourosis discolored teeth, teeth with gaps etc etc.

The difference between regular veneers and Lumineers is that Lumineers are made from a special patented Cerinate porcelain that is so strong than traditional laboratory-fabricated veneers but thin as contact lenses.

The main advantage of the Lumineers is that minimal tooth preparation is necessary. To keep it simple, very little - if any - of your natural tooth enamel needs to be removed before bonding the Lumineers over your natural teeth.

In the end, Lumineers are often reversible, since your tooth structure is left almost intact, unlike traditional veneers, where a significant amount of your tooth structure may need to be removed, almost everytime the drilling reachsthe dentin.


Sunday, March 21, 2010

Careful with Internal bleaching

If you have a tooth that had a previous root canal treatment and it's getting discolored, sometimes with a range of colors from grey to brown, sometimes even pink when the dentist left some live pulp inside the tooth, there's a good option to put that tooth with again, and that is Internal Bleaching.

So what do you do?

You drill the tooth through the same it was drilled to do the treatment and you protect it 2mm under the CEJ line with Glass Ionomer. You put the Hidrogen Peroxide in the pulp chamber and you close it for 3 to 5 days. Check the results and repeat if necessary.

So... All seems pretty easy and pretty good, and in fact the tooth get much whiter but the problem is that in clinical trials have showed that this kind of treatment has a recidive rate of aobut 50%, which means that after 3 years half the internal bleachs get back to dark again... Although it's never as the original dark color but it gets darker and you may need to internal bleach the tooth again so...

Should you go for internal bleaching? Or just solve the problem with a Ceramic Crown?

I don't have the answer to that, it depends on many factors, so you should be aware of this before choosing the treatment you want...

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Friday, March 19, 2010

Dental XP

Everyone interested in Cosmetic Dentistry already should know DentalXP, but if you are one of those that went on vacations to the moon just click the link above and browse that great webpage dedicated to dentistry.

You will find everything there, great works from the best of the world in their fields.

You can learn a lot from there by becoming a premium user also.