Key benefits include -

All this is possible with high resolution CT scans converted into 3D images by special software. This is used for virtual planning of implant placements, and is then sent to a laboratory in Sweden, which fabricates the surgical guide (Nobel-guide), which reaches the clinician with in the next 6 working days anywhere in the world. This Nobel-guide is used to place implants through a keyhole technique rather than the open technique practiced earlier.

This guided implant placement was introduced only in 2005 in USA and we already use this, after its introduction in India by us, for the first time on 8th April 2006.

'TEETH-IN-AN-HOUR' TECHNIQUE

When teeth are lost, artificial teeth replacements are given as removable or fixed dentures (bridge) that are attached to adjacent teeth. The process of fixing teeth to the underlying jawbone is called implanting. These implants are made up of biocompatible titanium and have been used for more than 40 years in Europe and for almost 20 years in India.

Usually, implants are placed in the jawbone and after a healing period of 3 to 6 months artificial teeth are fixed to these implants. Over the last few years, however, this waiting period between implant placement and tooth fixing has been progressively reduced to six weeks, one week and now stands reduced to one hour, thanks to advances in computer based technology that enables better diagnosis and virtual treatment planning. This results in precise implant placement and stability, which allows the immediate fixing of artificial teeth.

'Teeth-in-an-hour' has the following advantage for the patients:

'Teeth-in-an-hour' is possible due to revolutionary advances in the implant structure and use of CT Scan technology. Scans of the patients jaw are used to perform virtual implant placement. This data is transferred to a sophisticated lab in Sweden or US from where a surgical template is prepared and sent to the different clinics. This template is then used for keyhole surgery to place implants (without stitches), thereby reducing patients' discomfort.

However all patients cannot avail the benefit of this technique. Patients wanting ' teeth-in-an-hour' need the following pre-requisites:

Good oral hygiene, satisfactory medical health, adequate bone volume and quality (no osteoporosis), good range of mouth opening, and no tobacco abuse.

This technique of 'teeth-in-an-hour' using the 'Nobel-guide' and 'key hole surgery' was being done for the first time in India at Rajan Dental Institute, Chennai in April 2006. There are very few dentists in the country who have had international training in this technique and Dr. R. Gunaseelan is one of them. He had this computer-based implant training in Europe. This advance in dental implant treatment places India on par with international standards of dental rehabilitation.

Nobel Biocare
Branemark
Zimmer

CT scan-based diagnosis and virtual treatment planning using sophisticated software (Z Corp, USA) are used here.

Traditionally implant and tooth placement has been done in two stages. But with recent advances in materials and technology, a single-stage procedure is also possible now. This is termed as "Immediate Implant loading & teeth-in-an-hour" concept.

One stage procedure

When sufficient quantity and good quality bone is available, as established using pre- operative scans and software based planning, implants and teeth can be fixed within one hour or within one week. 'Key hole surgery' can also be done to minimize tissue trauma.

In some patients where one stage procedure cannot be done, the conventional 2-stage procedure is followed.

Two stage procedure

In this technique, in the first stage, the titanium implant is placed in the jawbone and the gums are sutured around it. After a healing period of 3 to 6 months, the teeth are placed on the implants.

People start wearing dentures (artificial teeth) when they lose their natural teeth. These dentures are called ‘removable dentures’ since they are placed and removed by the patient.

These dentures can also be ‘fixed’ to the upper jawbone using titanium implants, thereby resembling the natural jaw-teeth relationship. Such ‘implant dentures’ increase the comfort and confidence of the patient.

However, many a time sufficient bone is not present in the jawbone to anchor the implants. We then need to do `bone graft` surgery i.e. take some bone from the hip region, graft it to the jawbone, wait for few months for it to heal and then do implant denture treatment.

A new technology was developed in Europe where upper dental implants could be done without the hipbone graft. This ‘graftless technique’, also called the ‘Zygoma technique’ (developed by Prof. Branemark & Nobel Biocare, Sweden) uses the cheekbone (Zygoma bone) for anchoring the implants. This has the following advantages:

• Reduced treatment time
• No need for hipbone graft (graftless technique)
• Less discomfort for patient

This ‘ZYGOMA IMPLANT MAXILLARY DENTURE’, - a type of ‘graftless implant denture’ technique, was performed for the first time in India in Chennai at the Rajan Dental Institute by Dr. R. Gunaseelan and his team on 30.3.07.