Please Help me Eat Roti, I am fed up of eating soft food
- drjugaljpatel
- Dec 11, 2022
- 4 min read
I got a call from Dr Kiran Kulkarni one evening. Dr Kiran is my Neighbour, soft spoken & trustworthy, his patients like him a lot. He has supported me right from day 1 of my career. He said, "I have extracted teeth last week for a lady, she needs fixed teeth on dental implants, I have her OPG & CBCT ready". We scheduled her for consultation the next day. Meanwhile I had a look at her CBCT & OPG x rays.
A lady walked in for along with her son. She looked quite depressed & old for her age. I greeted her & made her sit. Before I could even ask her problems, she said "ಕಳೆದ 1 ತಿಂಗಳಿನಿಂದ ರೊಟ್ಟಿ ತಿನ್ನಲು ಸಾಧ್ಯವಾಗದ ಕಾರಣ ನನಗೆ ಬೇಸರವಾಗಿದೆ, ದಯವಿಟ್ಟು ನನಗೆ ತಿನ್ನಲು ಸಹಾಯ ಮಾಡಿ" (“I am fed up of not being able to eat Rotti for the past 1 month, please help me Eat”).
I could see her pain. She was not able to eat for long. This is what happens when we are deprived of our basic needs of eating. She had lost weight; she was not speaking much. She had gone in a shell.
I examined her & explained to her how she will be able to start eating in one day. She asked, will it be a painful procedure? This is the most common question I get from the patients. I assured her of the comfortable procedure, showed her a few testimonials of my patients, she was ready. I could see hope in her eyes & her face said WOW!! We asked her to get her blood tests done, which turned out to be within normal limits. She was scheduled for the procedure at the earliest available time.
We started early at 8:30 in the morning. I always prefer to start early; it has many advantages. The patient & my team are fresh. We can finish the work early & have time to design the teeth & deliver the teeth to her in time. Also, studies have shown that blood pressure is low during the morning hours. It helps to finish the procedure in a comfortable manner.
The plan was to use the TD24 protocol of Dr Jugal Patel to place cortico-basal one-piece implants in the lower jaw for fixed rehabilitation & a removable partial denture in the upper. She will go for the fixed rehabilitation with upper teeth after 6 months.
Cortico-basal implants are very patient friendly, they come with the following advantages,
1. Flapless placement of implants
a. This means I don’t have to cut open the gums, place implants & then stitch it up.
b. It reduces operative time
c. No RAP
d. No post operative swelling & little to no discomfort hence comfortable patient
e. Bloodless procedure – clean field to work & comfortable for the patient
2. Polished surface of implants
a. In fresh extraction sockets or areas with less width of bone, I prefer implants with polished surface. This helps us to reduce the possibility of peri-implantitis (an infection of the bone & gums around the implants)
b. Safely engage the 2nd cortical. As this requires some part of the implant to penetrate the 2nd cortex, it is safer with polished surface to avoid any retrograde infection
3. High primary stability
a. The single drill technique, 2nd cortical engagement & corticalisation of cancellous bone, help us to have primary stability which is essential for immediate loading (having teeth on dental implants immediately without the need to wait for 6 months or more)
When she sat on the dental chair, I asked her what music she would like to listen to. She said, its Saturday, please play Lord Hanuman songs. Playing the music that the patients love helps them through the procedure, keeps them engaged & their mind soothed. We started with the placement of implants using the single drill technique. The implant placement was over in 30 mins, flapless & bloodless. We syncrystallised the implants for better force distribution & tissue health. We performed an intra oral scan & the data was sent to the lab for designing teeth. The patient was comfortable all through the procedure & she co-operated very nicely. We enjoy collaborating with such patients.
We received the design from the lab & printed it in our in-house 3D printer. The teeth were ready to be fixed. She stays in a village close to Hubli, she came back by 7 in the evening & we fixed the teeth. These are the provisional teeth on which she can eat comfortably. Having provisional teeth has many advantages for the patient.
1. They can start eating immediately
2. The healing is better because the gums are protected by the teeth
3. The patient is comfortable because of the esthetics that have been re-established.
4. Their life is back to normal in one day
5. The tongue is comfortable with nothing poking it
6. The speech is back to normal
7. The patient can go to the office or move around with friends & family without any problems.
She was incredibly happy to have her teeth back, finally she will be able to eat. The eyes spoke a lot. She left the clinic happy & content that the procedure was comfortable & she can have dinner & enjoy it too.
In the next 4 days we gave her the final prosthesis which was made from zirconia. Zirconia is a very gum friendly material & I love to use it on my implants. I love the way the gums favour zirconia.
We performed the T Scan – digital bite balancing for the teeth. This is an amazing tool which helps me see the force distribution on the teeth. By balancing the bite properly, we can ensure a long-lasting teeth for the patient with comfortable chewing.
You can see in the below video how comfortable it is to chew on balanced bite.
On the 10th Day of follow up, I was seeing a different lady altogether. She was bubbly, happy, full of energy, talkative & thankful. She is enjoying her food & life. I could stop clicking a picture with her.
TD24 has made a sea change to our patients experience of dental implants. I thank Krishna for guiding me & helping me with TD24.
This is what I as a dentist am looking at. Helping my patients get back to their life. Lucky to be blessed with this skill to be able to help people eat, put a smile back on their face & their loved once. Proud to be able to contribute towards a Healthy India & Happy India.
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