Important Info
Contact Info

Subhash Bose Rd., Kadavanthra,
Kochi, Kerala, India

Ph: 0091-484-4011133, 2206667
Mob: 0091-9446610205
Dr. Prasanth Pillai MDS, FICD

Our Websites
Site on our Dental Implant Services
Site on Oral Health, Disease & various Treatment Options
Site with details of Bad Breath and its management
Site on our Oral & Maxillofacial Surgery Services
Our Practice Site

The Treatment Sequence

The sequence of bidding Goodbye to Dentures...

1. Clinical Examination

A thorough clinical examination is essential to analyze the oral health status of the patient. It is important to evaluate the health status of the teeth present in the mouth as well as the supporting gingiva, the tongue as well as palate. Assessment of mouth opening as well as that of the jaw joint movements are essential prior to treatment planning. Assessment of occlusion (bite) and the chewing patterns are essential. Restriction in mouth opening, clicking jaw joints, existence of conditions such as neuropathies,  bruxism etc. will alter the course of treatment in a major way.

2. Medical assessment

A thorough medical history is made and basic relevant investigations are carried out. A physician's assessment may be needed in case of patients with preexisting health conditions such as diabetes, cardiac disease etc. If patients are already under medications, the drug regimen may have to be modified prior to initiation of the treatment procedures.

3. Imaging

Imaging of the jaws to assess condition of the jaw bones and status of existing teeth, if any, in addition to assessing the position of the vital structures such as sinuses and nerves. The imaging techniques employed are usually one or more of the following: OPG Xray, CT Scan, CBCT, Intra oral peri apical xray, Lateral Cephalogram etc.

4. Diagnostic Casts

Impressions of the upper and lower jaw are made to help make plaster moulds (called diagnostic casts) which will serve as study models during the course of treatment.

5. Photographs

Pre - procedure photographs are made which will provide guidelines during the course of treatment. Old photographs of the patient are also studied in detail to assess the changes in the smile and the facial shape and contours over years.

6. Treatment planning

Aim of the plan is to ensure that the patient gets a good set of upper and lower teeth which will help him both functionally as well as cosmetically for several years to come. The plan is discussed with the patient in detail.

7. Preparative Treatment

The procedures are entirely different for patients who are completely edentulous (without any teeth in the mouth) and partially edentulous (who have a few teeth retained). In the case of the former, the teeth which are to be extracted, based on the treatment plan, are extracted. Those teeth which are retained are evaluated properly and treated as needed with procedures such as scaling, fillings, root canals and periodontal surgeries.

8. Replacement of missing teeth:
This is accomplished adopting one of the following methods:

a) Crown & Bridge work
- This can be done only when patient has healthy teeth situated at a reasonable distance from each other, with the missing teeth in between. The crowns of the existing teeth are reduced in size to attain a certain form... impressions are made and the casts are sent to the laboratory for fabrication of the bridgework. The bridgework is cemented with a particular type of cement.

b) Dental Implants

The conventional dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth or bridge. Implants are placed following certain surgical techniques using special equipments and instruments. Bone buildup (augmentation) etc. and related procedures such as guided tissue regeneration, laser bio-stimulation etc. are carried out as required in addition to the implantation procedures.

c) Combinations of Dental Implant supported as well as teeth supported fixed bridgework

9. Final prosthesis delivery

In complex treatment situations such as is the case of full mouth rehabilitation etc., very often an interim fixed bridge work is delivered in the first phase which is repeatedly modified over a few weeks to ensure good fit and function. This bridgework will give the clinician an idea of how the final bridgework should be designed. The interim bridgework is often made of vitallium. The final bridgework can be made as PFM / Zirconia / Noble metal ... which are the most practical and best options available today. The final bridgework is generally cemented after a period of 3 - 6 months after the placement of the implants, after the gum and the bone contours have settled down after the implant surgery.

10. Followup and regular maintenance visits once in 6 months

This is essential to ensure that there are no untoward developments with respect to the implants and prostheses. Regular visits will help the doctor to assess the oral hygiene measures being adopted by the patient. Corrective measures / modifications in the oral hygiene practices may be undertaken to ensure that the implants and the prostheses perform well over a long term period.

The  maintenance instructions given will vary from patient to patient, based on the nature of the implants and prostheses  provided to each patient.

The golden rules are:

- Prevention is better than cure… -

- Fire-fighting is better than fire prevention… -