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Welcome to periobasics.com

(Everything you want to know about periodontics and implantology)

Dr. Nitin Saroch

Dear friends,

                            Being a dental professional, i know the difficulties students face during the graduation and the post-graduation courses in our field. This website is a small attempt to create an easy approach to understand periodontology. As we know that a lot of research is going on in this field of dentistry, every attempt is being made to gather all that information and present it to the readers in an easy way. Diagrams and illustrations have been given with the text to make the topics easily understandable. The information presented in this website has been collected from various leading journals, books and websites. As no book is perfect, no teacher is perfect and no clinician is perfect, your comments are required to make this website better. You can put your comments at the end of every topic by registering on the website. Let’s contribute a little bit to our field…….Periodontology.

                                                                                                                                             Dr.  Nitin Saroch. 
M.D.S.
Periodontist and implantologist.

 

Videos……..

  • How to put continous sling suture?
  • How to put internal bevel incision?
  • Components of a dental implant
  • Modified flap operation.
  • Modified Widman flap surgery.

Recent periodontal and dental implant updates………

 

 

Common questions………..

Which is the best implant available?

 

All implants are made up of grade IV titanium. The quality of the implant depends upon the design and surface properties of the implant. Most of the commercially available implants are root form threaded implants. The implant surface is made rough with the help of surface treatments. In general terms implant surface roughness is divided, depending on the dimension of the measured surface features into macro, micro, and nano-roughness. Various treatments used to induce this roughness on implant surface include additive and ablative procedure.  Additive procedures include Plasma spraying, electrophoretic deposition, sputter deposition, sol gel coating, pulsed laser deposition and biomimetic precipitation. Ablative procedures include surface blasting, acid etching, anodic oxidation and shot/laser peening.

Although, there are many companies supplying implants presently, here is a brief description of commonly available implants and their surface treatment. Nobel active implant from Nobel Biocare is treated by anodic oxidation with phosphate enriched titanium oxide. TiXos Line implants from Leader italia are treated by laser sintering. Ankylos Plus implants from Dentsply are sandblasted, large grit blasted, and acid-etched. Zimmer screw vent implants have micro-textured hydroxyapatite surface. Laserlok surface implants from Biohorizon have laser peening surface treatment.

It is very difficult to say which implant is the best but irrespective of advertisements done by implant companies, we can study the implant properties in detail and compare them with each other to find a suitable answer.  To read in detail about basic implant design and surface treatment click on the following links…………….

Dental implant components and Current concepts in implant design

Dental implants: Surface modifications 

Which is the best available bone graft for periodontal bone grafting?

 

There are many bone grafts available for periodontal bone grafting procedure. The best bone graft is obviously autograft because; it is derived from one’s own body and has most favourable osteoconductive and osteoinductive properties. Allografts and xenografts are derived from other individual of same species and other species respectively. These bone grafts have variable osteoinductive and osteoconductive properties.

The recently introduced bone grafting materials have biologically active molecules in them which make them as good as autografts. They are named as composite bone grafts. Since, they contain growth factors and other biologically active molecules, they induce proliferation of surrounding mesenchymal cells thus promoting regeneration.

There are many factors which determine the overall regeneration in a particular bone defect which include type of bone defect, internal healing potential of the patient, operators skill and post operative care by the patient.  Generally in three wall bone defects, bone fill can be achieved easily using any bone graft, but in case of ridge augmentation procedure because of lack of support to the graft material, autogenous block grafts offer best results.

To determine the quality of the bone graft you must know the details of basic properties of a bone graft, how is it procured, its internal structure, its behaviour in biologic environment and method of its usage. Here is the link for detailed description of bone grafts……………

Bone grafts in periodontics

How practical is use of growth factors in periodontal regeneration?

 

Growth factors are biologically active molecules involved in various aspects of growth and development. They play an important role during wound healing. For more than last two decades, a lot of research has been going on the growth factors. Since then many of them have been isolated and studied for their actions at cellular and molecular level.

Available data strongly suggests that presence of growth factors in healing area promotes healing and regeneration of periodontal structures. Tissue repair studies conducted on animals provide evidence that key growth factors involved in wound healing include epidermal growth factor (EGF), TGF-α and β, platelet- derived growth factor (PDGF), acidic and basic fibroblast growth factor (FGF) and Insulin like growth factors I and II.

But, how practical is their use in periodontal regeneration? This is a very relevant question. There are multiple problems associated with using growth factors for periodontal regeneration, mainly including,

  • Need for high local concentration.
  • Non-specific activity on different cell lineages in time and space.
  • Rapid loss of topically applied growth factors.

With the help of tissue engineering, we have developed various carriers for growth factors which primarily address the above problems. Composite bone grafts, absorbable and non-absorbable matrices, cell based and gene based approach etc. are the recent advances in growth factor application for periodontal regeneration. A detailed description of the topic is available in……………..

Growth factors in periodontal regeneration

Tissue engineering in periodontics

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