COMPUTER GUIDED STICHLESS IMPLANT SURGERY WITH IMMEDIATE BRIDGE PLACEMENT DONE FOR FIRST TIME IN JALLANDHAR.

Dr. A.S Cheema and Dr Raymandeep cheema ,  leading Implantologist’s of the city performed the first Stitch less Computer Guided / Computer Aided Implant  Placement  in a patient to replace All 32 teeth in the Patients fully edentulous jaw. The fixed restoration was inserted in minimum of one hour of the surgery.Patient was allowed to bite on food immediately.This is for the first time that such unique software has been used to plan the surgical insertion of implants.

Conventionally, the implants are placed in the jaw bone in patient’s mouth involving a minor surgery, a healing time of 7-10 days followed by suture removal .Then the patient waits for 3 to 4 months so that the implant  integrates with the jaw bone. This is followed by restoration. But the implantologist Dr Cheema is now able to virtually analyses and plan a surgery before actually performing it in the patient’s mouth. This concept is called Computer Aided / Computer Guided Implant Placement. (CAD/CAM Solution). CAD software helps the dentist to carry out a virtual surgery on the patient’s simulated jaw on the computer. CAM helps to create a surgical template to perform the surgery in the patient’s mouth as per planning on the software.

The procedure offers many advantages:

1) The guided surgery planned on the computer is more precise in placement of implants as it provides better visualization of important anatomic structures.

2) The future prosthesis (temporary/permanent Bridge) is simulated in the mouth with the help of surgical template in advance. It is time saving as the patient receives the implant and the prosthesis on the same day and can returned to active social life.

3) It has better patient compliance because surgery does not involve any incision or suturing and so there is no bleeding, faster healing, minimum discomfort, minimal risk of infection and early ambulation.

4) It can be safely performed in high risk patients such as those with coronary artery disease, diabetes mellitus,hypertention,patients on drugs like antiplatelets, anticoagulants,advanced age etc.

CASE REPORT OF FIRST EVER BLOODLESS AND STITCHLESS IMPLANT SURGERY IN THE REGION.

MR. AMARJEET SINGH JUDGE UK BASED NRI (NAME CHANGED), AGED 57 YEARS CAME WITH chief complaints of

-All Teeth Missing
-Inability to chew food

History of using denture for missing teeth.

He wanted a permanent and comfortable solution. The different treatment modalities for replacement of missing teeth were discussed.

-The patient had following risk factors

Advance age, history hypertensive for last 15 years and is on anti hypertensive and anti coagulant drugs.

He was unsatisfied with denture and no tooth was available for supporting the bridge. He is a very mobile businessman and time was a major constraint. The best option available was bloodless and a stitch less surgery to ensure faster healing, minimum discomfort, minimum risk of infection and early ambulation.

The surgery was first of its kind and since the patient was willing and co-operative, his CT scan was taken and virtual planning of case done. His surgical template was specially fabricated from Sweden through computerized machines to achieve high level of accuracy and precision. The first step took about 1 hour and 11 implants  (6 in maxilla and 5 in mandible)  were in place without a blade and suture. The next step was insertion of 32 unit bridge  (16 unit in upper and 16 unit in lower )on 11 implants  (6 in maxilla and 5 in mandible) already fabricated by the computer and the patient had solid food immediately afterwards.

Because of lack of awareness about importance of oral hygiene and need for regular dental check ups,most of the Indians start loosing their teeth as early as 35 years in urban population and even at 20 years in rural population.So,by 55-60 years,15-20% of the population is edentulous. Since the average life span of Indians has increased by 10 years, so is the need for fixed and permanent solution for missing teeth.

The technology of computer guided surgery is the latest advancement in the field of dental implants. Since it is a non invasive procedure, it reduces the risk of infection to minimum. The success rate is high and so is the cost. But cost benefit analysis proves beyond doubt that implants for missing teeth will remain the best treatment option today and tomorrow.