Nawal's Dental ClinicNawal's Dental Clinic
10
Jan, 2020

By Dr. Rajesh Nawal

Full Mouth Rehabilitation with Dental Implant Supported Prosthesis

Full Mouth Rehabilitation with Dental Implant Supported Prosthesis

Oral rehabilitation for a patient with severe loss of alveolar bone and soft tissue resulting from severe periodontitis presents a challenge to clinicians. Replacing loosening natural teeth with fixed prostheses supported by dental implants often requires either gingival surgery or bone grafting. The outcome of the bone grafting is sometimes unpredictable and requires longer healing time and/ or multiple surgeries. The presence of periodontal inflammation and periapical lesions often delay the placement of bone grafts as well as dental implants. Here we present a clinical case of a patient undergone full mouth reconstruction with implant-supported fixed prostheses. We believe that primary stability during implant placement may contribute to our success.

CASE PRESENTATION

Chronic advanced periodontitis can result in severe loss of periodontium, which is often associated with systemic conditions. Among these conditions, heavy smoking is linked to the degree of severity of periodontal disease Restoring the oral function and esthetics in these patients becomes a challenge and requires major bone grafting or artificial gingival tissue.

Here we present a case report of a patient, suffering from severe alveolar bone loss, who had undergone a full mouth reconstruction with dental implants

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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09
Jul, 2019

By Dr. Rajesh Nawal

Immediate Dental Implant with Crestal Approach Sinus Lift

Immediate Dental Implant with Crestal Approach Sinus Lift

The loss of tooth in the esthetic area is often a traumatic experience for the patient.
Patients may suffer real or perceived detrimental effects following the loss of one or more teeth.
Dental implant offers the most cost-effective and long-term solution for replacement of missing teeth with high average life expectancy, providing the patient with the best sense of security and well-being.
Recently, immediate implant placement after extraction of tooth with early loading has become more common.
The advantages of this procedure include fewer surgical interventions, reduction in overall treatment time, reduced soft and hard tissue loss, and psychological satisfaction to the patient.

This case report describes the procedure for immediate implant placement

 

 

 

 

 

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30
Jan, 2019

By Dr. Rajesh Nawal

Full Mouth Rehabilitation

Management of Atrophic Ridges : Full Mouth Rehabilitation

   Young female (40 yrs old) reported to our clinic with chief complaint of missing and mobile teeth.

Clinical & Radiographic examination

Since Maxilla & Mandible ridges are completely atrophic therefore quad zygomatic implants has been suggested to patient but for now patient desire denture in maxilla & dental implant supported prosthesis in mandible

Second Stage

Thank you

Dr.Rajesh Nawal

MDS, Periodontology & Oral Implantology

Nawals Dental Clinic

Jaipur (Raj)

Mobile no. 7738389814

 

 

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24
Dec, 2018

By Dr. Rajesh Nawal

Case of Anterior Teeth Trauma: Management

During any assault to the facial region, the incidence of maxillary anteriors, being injured, is 37% as they are most anteriorly placed in the arch and their protrusive eruptive pattern, followed by maxillary laterals (16%) and mandibula rcentral incisors. Coronal fractures can be classified as simple or complicated depending on the extent of fracture and involvement of the pulp. The incidence of complicated crown fractures ranges from 2% to 13% of all dental injuries. An injury to the maxillary anterior region causes significant disfigurement of the patient’s appearance as well as function which in turn imparts deep psychological impact. Such aesthetically demanding critical scenarios require quick and logical clinical actions to restore the lost structures.

CASE REPORT

A 25‑year‑old young male patient reported to our clinic (Nawal’s Dental Clinic) with the history of trauma, the previous day, and complained of broken front teeth. After thorough clinical and radiographic examination, it was diagnosed as complicated crown‑root fracture, extended subgingivally in palatal region with respect to 12 (maxillary lateral on right side and with fractured crown with respect to 11(maxillary central). The fractured fragments were mobile and indicated for extraction.
  Pre-operative
Pre-operative RVG
As the patient was young and conscious esthetically, he demanded immediate correction of the fractured teeth.
The treatment options were explained to the patient, and Root canal treatment with fiber post was planned with the consent of the patient.
After administration of local anesthesia, the fractured fragments were extracted atraumatically. The pulp was removed with respect to both 11 and 12. One important finding of this case was the subgingival extension of the fractured margins on the palatal area of both teeth.Upon probing this area, it was determined that the biological width was not encroached, but the fracture lines were subgingival; hence, 1 mm of gingivectomy was done with electrocautery to expose the fracture lines.
    
Fracture Segment Removed
POST RCT X-RAY
The rest of the radicular space  was prepared for fiber post of size 2 (Radix Fiber post‑DENTSPLY). The length of the
post was adjusted accordingly and was 6 mm into the root. The corresponding coronal pulp chamber was prepared for the post attachment. The fiber post was luted using dual cure resin cement (Relyx‑3M) and cured followed by core build up on fractured crown to receive full crown on both teeth fig.4,5.
Crown preparation has been done to receive metal free crown(Superlucent crown -Dentcare lab) to restored highly aesthetic anterior zone.
    
Teeth Preparation after Core Build-up
   
Restoration of prepared teeth with superlucent crown (DENTCARE LAB)
    
Beauty of Highly Lucent Crown
   Pre-Operative Picture
Post-Operative Picture
    Thank you
                       Case by :
             Dr. Sangeeta Nawal
                  Nawals Dental Clinic
                  J L N Road, Jaipur
                   7738389814
                    9828099950
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03
Jul, 2018

By Dr. Rajesh Nawal

Prosthetic Driven Dental Implants

Time Is Valuable For Doctors—and Patients

The demand for implant treatments is on the rise and so are expectations. Patients are now more

informed about the procedure, and they demand results that are both highly functional and

aesthetic—in the fewest number of appointments possible. That’s a real challenge for the dental

professional. On the one hand, less chair time is a cost reducer. But on the other, meeting those

expectations for high-quality outcomes in a shorter amount of treatment time is a tall order.

The pressure is on to improve the process.

In this increasingly cosmetic-focused environment, there are also highly experienced oral health

professionals who might not immediately see the value in changing anything about the way they place

implants. They are satisfied with their success and their patient outcomes. Why should they stray

from their proven approach that they find so comfortable and familiar?

The answer is time savings. That’s the first benefit that clinicians will find when they embrace

prosthetic-driven implant planning and digital implant workflow, and the implications of this time

savings should not be underestimated.This paper examines the value that prosthetic-driven planning

brings to the implant placement process—benefitting the clinician and the patient.

BENEFITS OF PROSTHETIC-DRIVEN PLANNING

  1. Time savings

  2. More predictable,higher quality outcomes

  3. Enhanced collaboration with treatment network

  4. Increased case acceptance rates

  5. Greater patient satisfaction

 

All About the Outcome

The traditional methodology behind the implant workflow has involved first placing the implant in

the available bone. At that point, the clinician then determines where the crown should be positioned.

Prosthetic-driven planning, however, reverses this process with a crown-down approach. With

prosthetic-driven planning, the outcome lies at the heart of the workflow, driving the process from

start to finish. And by taking this approach, there are no unwanted surprises at the restorative end of

the process.There’s no need to courageously step in and salvage a situation with extensions, custom

abutments and other compromises when it’s time to place the restoration. Instead the clinician has

more predictable—and often higher quality—outcomes.

Clinical Case

      A female patient age 45 reported to our clinic with missing teeth in right upper posterior region

Dental implants has been planned at both sites with indirect sinus lift due to insufficient bone height

SECOND STAGE :- WELL FORMED GINGIVAL MARGIN

 

FINAL PROSTHESIS

 

  THANK YOU

Nawals dental clinic & Implant surgery Hospital

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09
Apr, 2018

By Dr. Rajesh Nawal

Dental Implants

Implant dentistry is one of the fastest-growing areas of dentistry today as more and more patients realise the benefits of dental implants far outweigh their cost.
Dental implants can replace a single missing tooth, or can be used as an anchor for a bridge to replace multiple missing teeth. Because the implant is secured deep into your jawbone, the final tooth replacement usually lasts longer and is more solid and secure than traditional dentures. Not only that – dental implants offer a wide-range of other benefits too.

In this post( clinical case), we provide a step-by-step guide to the dental implant procedure.

Step 1: Assessing and preparing the dental implant site

Because dental implants are fitted into your jawbone, your dentist will need to check the condition of the bone site and make sure there’s enough bone to hold the implant securely. Your dentist will also use x-rays to check for nearby blood vessels and nerves.
If you don’t have enough bone in your jaw to accommodate the implant successfully, your dentist will discuss options with you. This may involve bone-grafting, using synthetic bone, or a process called ‘bone distraction’ – a special procedure which will help your body create new bone on the implant site. If this is necessary, it will simply take a little longer before your new implant can be fitted.
At your first surgical visit, your dentist will anaesthetise the implant site before removing gum tissue to expose the bone underneath. This may be done either with a scalpel, or, in some cases, a special ‘punch’ which is a less invasive way of accessing the bone.

Case presentation

A female patient age 24 years reported to our clinic for replacement of her missing teeth.

C/E :- Bilateral missing lower first molar

   

 

 

 

 

          CBCT ANALYSIS

OPG

DIAGNOSTIC CAST

Step 2: Positioning the Dental Implant

Your dentist will make a pilot hole in the bone of the implant site. The hole will initially be drilled just half-way, and an alignment pin will be used to make sure the hole is at the right depth and angle to accommodate the new dental implant. Once the dentist is satisfied with the alignment, a series of increasingly larger drills will be used to widen the hole to the correct size.
During this stage, the drilling will be slow and the implant site will be flushed regularly with either water or saline solution. This is to prevent the bone from overheating during the drilling process, which can affect the fusion of the implant to the bone.

 

After Anesthesia full thickness flap reflected

 

 

 

 

       Pilot Drill

 

 

 

 

 

PARALLELING PIN

 

 

 

Step 3: Placing the Dental Implant

 

Because the implant is screwed into the bone, a special instrument will be used to create a ‘thread’ in the bone which matches the thread on the implant. Some implants are ‘self-threading’, which means they create their own thread as the implant is inserted.

Once the implant is screwed into place, a special collar, or ‘implant cap’ is used to seal the implant site from the rest of the mouth. This will protect the implant site and help the gum to heal around the new implant safely.

 

 

Dental Implant placed at prepared site.

 

 

 

 

  Suturing done

Step 4: creating your new tooth

The final step is split into two parts. After osseointegration, (fusion) has occurred, the implant cap will be removed and an ‘abutment’ will be attached to the top of the implant.
Then, depending on whether you’re replacing a single tooth or multiple teeth, either a crown or bridge will be fitted on top of the abutment. The crown or bridge will be carefully prepared to match the colour, shape and size of your natural teeth. These stages may be carried out either together or separately, depending on the complexity of your treatment, but your dentist will be able to advise.
Your dentist will also explain exactly how to care for your implant, and will schedule future appointments to monitor your new implant regularly.
Dental implants are a reliable, long-lasting solution for missing teeth which bring a range of benefits. If you would like to find out more about the costs of the procedure, or why we recommend implants as a first choice solution for missing teeth, please contact us today for a no-obligation discussion.

 

 

Second stage done by laser

 

 

 

 

IMPRESSION MADE

                                        ABUTMENT PLACED TO HOLD FINAL PROSTHESIS

 

      FINAL FIXED  PROSTHESIS

 

 

FROM NO TEETH TO FIXED TEETH

 

 

Dental implants are a reliable, long-lasting solution for missing teeth which bring a range of benefits. If you would like to find out more about the costs of the procedure, or why we recommend implants as a first choice solution for missing teeth, please contact us today for a no-obligation discussion.

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25
Dec, 2017

By Dr. Rajesh Nawal

PERIODONTAL PLASTIC SURGERY- FREE GINGIVAL GRAFT

Periodontal Plastic Surgery Procedures

Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, a periodontist may be able to help.

Long Teeth/Exposed Roots

Sometimes gum recession causes the tooth root to become exposed, which makes your teeth look long and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal diseases.

Gum graft surgery and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay

ONE OF THE CASE OF EXPOSED ROOT DONE AT OUR CLINIC

A Female Patient reported to our clinic with chief complaint of exposed root of lower teeth which makes her conscious during smile. we as advised her for Free Gingival Graft ( Periodontal Plastic Surgery) so that we can cover her exposed root with soft tissue.

She agreed for the treatment and result is in front of you.

       PREOPERATIVE VIEW SHOWING RECESSION WITH LOWER LEFT CENTRAL INCISOR

                                                                                                                     RECEPIENT BED PREPRATION

FREE GINGIVAL GRAFT OBTAINED FROM PALATE


GRAFT SUTURED TO RECEPIENT BED

RECESSION COVERAGE SEEN

                                                              

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25
Dec, 2017

By Dr. Rajesh Nawal

LINGUAL FRENECTOMY / ANKYLOGLOSSIA / TOUNGE TIE

Ankyloglossia, also known as tongue-tie, is a congenital oral anomaly that may decrease mobility of the tongue tip and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth. Ankyloglossia varies in degree of severity from mild cases characterized by mucous membranebands to complete ankyloglossia whereby the tongue is tethered to the floor of the mouth.

Ankyloglossia can affect eating ,speech and oral hygiene as well as have mechanical/social effects.Ankyloglossia can also prevent the tongue from contacting the anterior palate . This can then promote an infantile swallow and hamper the progression to an adult-like swallow which can result in an open bite deformity. It can also result in mandibular prognathism ; this happens when the tongue contacts the anterior portion of the mandible with exaggerated anterior thrusts.

 PRESENTING ONE OF THE CASE OF Ankyloglossia DONE AT OUR CLINIC FOR YOUR BETTER UNDERSTANDING

     A Female child patient reported to our clinic with difficulty in speech due to her tongue tie ( Ankyloglossia).

Lingual Frenectomy has been planned to release her tongue so that she can speak clearly

PREOPERATIVE VIEW

 

                         

 

 

 

 

 

 

 

SURGICAL INTERVENTION

 

 

                                                                                SUTURING DONE

 

 

                                 COMPARISION BETWEEN PREOPERATIVE AND POST OPERATIVE VIEW

 

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25
Dec, 2017

By Dr. Rajesh Nawal

IMMEDIATE IMPLANT

   IMMEDIATE IMPLANT

45 year old Patient came with pain in Lower Left posterior region .On clinical and X-ray examination second molar was grossly decayed and left with root stumps only , so it was decided to extract root stumps and do immediate implant in second molar area.

 

 

 

 

 

 

  Pre-operative X-ray

                Extraction site

Final Dental Implant

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25
Dec, 2017

By Dr. Rajesh Nawal

Immediate Dental Implant

           Immediate Implant

42 year old Male Patient came with pain & swelling in Lower Left posterior region.On clinical and X-ray examination second molar was grossly decayed, so it was decided to extract the tooth and do Immediate Dental Implant (OSSTEM 5 * 10 )  in second molar area.
Thank you
Nawal’s dental Clinic
For Happy & Healthy Smile

Pre-Operative

Pre-Operative X-Ray

Parallel Pin

 

 Implant (Osstem 5 * 10 )

         Primary closure of surgical-site

 

Will wait for three months before delivering final prosthesis…..final prosthesis picture and X-ray will uplaod after three months

Thank you

Nawal’s dental Clinic
For Happy & Healthy Smile.

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SMILE SPOILERS like improper alignment of teeth, spacing between teeth, broken teeth, old fillings, attrition or wearing of enamel of teeth, smoking stains, yellow teeth, black gums, protruding teeth, jaw size discrepancies, gummy smile, fluorosis etc can be corrected and mended using a host of treatments like braces, veneers, bleaching and depigmentation.

Technological advancements are slowly decreasing the need for unsightly braces. Invisible aligners like INVISALIGN have done away with fixed wires and made the treatment invisible. Aligners are removable, transparent, do not cause food lodging, easier to maintain and patient acceptance is also better. Wilkodontics can decrease the duration of alignment treatment to as short as three months. VENEERS are instant smile correction techniques to make your smile radiant with the shape and size to suit your facial structure.

Anti-ageing treatments – restoration of lower facial height lost due to loss of enamel. LASER tooth whitening procedures are long lasting.

Most cosmetic problems also indicate an underlying functional problem – corrections will offer a better quality of life, early detection in childhood can simplify treatment.

BAD BREATH AND BLEEDING GUMS indicate gum disease which will soon lead to tooth loss. It may be due to aging, diabetes, pregnancy or genetics.

Technological advancements like LASERS ensures faster healing, less bleeding. Microscopic Dentistry improves precision. Nowadays targeted treatments and growth factors from one’s own body are also used for rapid healing. Cell culture technology are the latest developments.

Gum disease is usually due to plaque and calculus accumulation around the teeth. If addressed early, the tooth can be saved. Delay in treatment will result in tooth fall.

Sensitivity is usually an early symptom of decay, gum recession, over-zealous brushing or hard clenching or grinding habit.

Technological advancement like LASER Desensitisation, Dental loupes assisted root coverage procedures, tooth coloured fillings can cure sensitivity and save the teeth.

Before blindly following what the advertiser in the television tells, it is mandatory to check for the underlying reason and treat the same. In gum recession covering of the exposed, sensitive part of the root by gum treatments is done. Ignoring the symptom or resorting to over the counter relief measures – almost always leads to tooth loss.

PAIN in the tooth or mouth is usually due to deep decay in the tooth, wisdom tooth eruption, food collection inside gum pockets, ulcers or cracked tooth. The dentist will examine you and may need to take an x-ray to check the spread of infection.

Technological advancements like apex locators, flexible rotary tools, laser root canal, microscope assisted dentistry, have reduced the duration of treatment and the discomfort involved. Precious Metal Crowns improve durability and ensure zero allergies.

Do not use over the counter medication to treat dental pain. Clove oil cannot stop the spread of infection. If the cause of the pain is found early, the tooth can be restored to normal function.

Treatment Option

Root Canal Treatment

With luxurious ambiance, A-star hospitality, the Nawal’s Dental is a completely inimitable experience in Dentistry. Everything from the quality of the smiles that greet you to the smiles that leave the place is of a much higher stature.

With sophisticated technology and finest dentist in the world we practice almost painless procedure for a precise outcome. Our specialist in smile designing, laser dentistry, and sedation dentistry are determined to restore confident smile and to offset pain from dental procedures.

Now it is time for you to move over ordinary dental care, to get over your fear of dentists, to forget about cramped dental offices, painful treatments, and fear of catching infection due to a non-sterile atmosphere, inadequate infrastructure, and ill experienced dentists. It is time for you to Come and experience the dental care beyond the ordinary.

Fast Dental Treatment

Keeping up with changing times and tight schedules of patients, we have endeavored to keep treatment time and visits minimal. This in no way has been by virtue of compromising treatment quality. On the contrary, the best of machinery and materials have been sourced to ensure faster and more efficient working with the best possible end result.

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    Full Mouth Rehabilitation with Dental Implant Supported Prosthesis
    Immediate Dental Implant with Crestal Approach Sinus Lift
    Full Mouth Rehabilitation
    Case of Anterior Teeth Trauma: Management
    Prosthetic Driven Dental Implants
    Dental Implants
    PERIODONTAL PLASTIC SURGERY- FREE GINGIVAL GRAFT
    LINGUAL FRENECTOMY / ANKYLOGLOSSIA / TOUNGE TIE
    IMMEDIATE IMPLANT
    Immediate Dental Implant