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Dental implants getting popular Elbow joint replacement: Blazing new entry into ortho surgeries Handling injuries in knee joint Health Notes
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Dental implants getting popular As a dentist our main objective is to restore a patient’s comfort which includes normal functioning of the teeth, aesthetics, speech and health. Implant dentistry enables us to achieve this goal successfully where conventional dentistry might not be able to do the same. What is a dental implant? A dental implant is a titanium root used in dentistry to support restorations that resemble a tooth or group of teeth to replace the missing teeth. A dental implant is used to support a number of dental prosthesis, including crowns, implant-supported bridges and implant-supported dentures. It can also be used as an anchorage for orthodontic tooth movement. Dental implants are indicated as a treatment option for the following: For replacing a missing single tooth: If a person is missing a single tooth, one implant followed by a single crown can replace it. A dental implant replaces both the lost natural tooth and its root. For replacing several missing teeth: If a person is missing several teeth, an implant-supported bridge can be the option for replacing them. Dental implant will replace both your lost natural teeth and some of the roots. For replacing all of your teeth: If the patient is missing all of his teeth, an implant-supported full bridge or implant-supported complete dentures can replace them. Dental implant will replace both his lost natural teeth and some of the roots. Why it is preferred over other treatment options Nowadays, dental implants are considered as the number one treatment option for replacing the missing teeth and preferred over other tooth-replacing modalities because of its advantages. Advantages Aesthetic benefits: Dental implants simulate (look) and feel like your own teeth. Since dental implants integrate into the structure of your bone and are well concealed inside the gums, they prevent bone loss and keep the bone intact and prevent gum recession that often accompany a bridge work and dentures. No one will ever know that you have a replacement tooth. So aesthetically it gives more superior results as compared to dental bridges. Health-related benefits: In the case of dental implants, there is no need to sacrifice the quality of your adjacent natural teeth like a bridge does (as in a bridge we need to take support from the adjacent teeth and for that we need to grind them, though minimum) because the neighbouring teeth are not altered to support the implant and the natural teeth are left untouched, doing no damage to the adjacent teeth by cutting them down to secure a tooth-supported bridge. Psychological benefits: Patients who receive dental implants are often more confident as they are benefited to speak and eat more comfortably. They feel free from the unnecessary embarrassments that they have to face from the falling down of ill-fitting dentures. In extreme cases, people who wear ill-fitting dentures may avoid social contacts, have unhealthy diets and suffer from denture sores. Reliable: Since the success rate of dental implants is highly predictable, it is considered as the closest possible replacement to natural teeth. Pre-operative considetations Before an implant is placed, the patient is examined thoroughly. He/she should be in good general and oral health. The patient’s oral hygiene is monitored. Oral examination of the teeth, gums and bones are done. Gums should be healthy and free from any periodontal disorder. The jaw-bone level should be adequate and assessed with the help of dental radiographs to support the implant. Models of the patient’s mouth may be taken to determine the best plan of treatment for your situation. Medical history is taken by the dentist to rule out any history of smoking and diabetes. After all this, a comprehensive evaluation and accurate diagnosis is made. So, nowadays, replacement of the lost teeth with implants is recognised as effective and long-lasting treatment choice. The writer is a dental surgeon at Fortis Hospital, Mohali. |
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Elbow joint replacement: Blazing new entry into ortho surgeries When one talks about joint replacements what strikes the mind first is either hip replacement or knee replacement. A relatively lesser known possibility is the elbow joint replacement. One reason that many people who might be suffering for years with an elbow joint problem do not choose the option of an elbow replacement is that these people do not find a painful or impaired elbow as crippling as a hip or a knee problem. They, however, continue to suffer the handicap, accepting the pain as a part of life or a sign of old age. Most such patients tend to resort to symptomatic relief using painkillers, going in for magic oil massages or simply ignoring the problem. Treatment in terms of elbow replacement is thought to be the last option. Causes for elbow pain: * Osteoarthritis However, like knee and hip replacement where advancements in the medical field have yielded fantastic, almost unbelievable results, elbow replacement is also now possible through a 15-minute surgery. The kind of technology now available for the replacement of elbow joints has brought hope to patients suffering from elbow joint pain. Earlier, elbow joint replacement was a very rare and complex surgical process compared to hip or knee replacement surgeries. Elbow patients had a suffering life due to restricted movements and constant pain in elbow joints even after complex surgeries and constant physiotherapy support. More than two decades of clinical research in advanced technologies have now given us simple and precise instruments that enable us to achieve greater ease-of-operation and much improved recovery rate. One of my patients, 52-year-old Mewa Singh, is a recent case of successful advanced elbow joint replacement surgery in North India. He came to our hospital with a very compromised and stiff elbow joint with only 25 degrees of motion due to an old elbow injury. We performed the simple operation in which we removed the plate and screws and fitted him with a total elbow. Now he has achieved a much higher range of motion — from zero to 120 degrees — of bending at the elbow joint and is well on the road to recovery with the help of some bending exercises. The pertinent question is: How will you know if you need the surgery? That’s a question you and your orthopaedic surgeon will have to answer together. But when elbow pain is so bad it actually interferes with the things you want or need to do; the time may be right. (The name of the patient has been changed due to the privacy clause.)
The writer is the Director and Head of Orthopaedics & Joint Replacement Department, Fortis Hospital,
Mohali.
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Handling injuries in knee joint Acute injuries affecting the knee joint cause considerable disability. These are common in all kinds of sports that require twisting movements and sudden changes of direction, especially in football, basketball and hockey. The course of events during cartilage injury when turning suddenly while walking, jogging and playing are hearing of a soft cracking sound in the knee, occurrence of instantaneous swelling, etc. The individual suffers agonising pain accompanied by swelling and discoloration of the knee. There is also loss of motion. The two cruciate (‘cross’) ligaments, anterior and posterior are often referred to as the ‘crucial’ ligaments; such is their importance in sporting activity. They are named anterior and posterior in relation to their attachment to the tibia. The role of the anterior cruciate ligament (ACL) is to prevent the forward movement of the shin bone tibia in relation to the thigh bone femur and control rotational movement. ACL ligament injuries are common among sportsman either in isolation or combined with meniscus injury. Symptoms Mild sprain (Grade-1) — Pain, mild swelling with no abnormal motion. There are minor tears of ligament fibers. Moderate sprain (Grade-2) — Swelling, tenderness, moderate abnormal motion, etc. There is stretching and tearing of ligament fibers. Severe sprain (Grade-3) indicates complete tear. There is marked loss of motion, loss of strength and feeling of giving away. TREATMENT *
Immediately after injury rest, ice treatment, compression and elevation are advised. *
Knee splint/brace is recommended to provide stability and also to prevent reinjury while allowing the healing of the ligament. *
Rehabilitation of ACL depends on the gradation of the tear. * Aerobic activity - Start with cycling/ walking in pool. When there is no pain on weight bearing, start walking/ jogging for five minutes only. Increase the distance every other day until 20 minutes of jogging can be done. After that, the speed of jogging can be increased *
Weight-bearing exercises like squats, lunges, step-up/down helps in strengthening thigh and hip muscles. Return to normal activity should only be undertaken when a patient can do one leg jump and squat 20 times. Some patients try to return to activity too soon without proper rehabilitation resulting in reinjury. Unfortunately, the resultant sprain is much more difficult to treat than the original injury. Patients suffering from ACL injury are always in a fix whether to opt for conservative or surgical management which is dependent on the following factors: Age of the patient. Degree of instability/giving away. Associated abnormalities — meniscus/medial collateral ligament tear, etc. Whether or not the patient performs pivoting sports. A patient’s occupation (serving in the army, doing a desk job, etc.) The cost of surgery and the amount of time away from work. Surgery should be recommended in grade three sprain for those athletes wishing to participate in a high-speed sport with constant change of direction and pivoting. The other cases are assessed on their merit, taking into account the above factors. Most of the patients in the age group between 20 and 30 years with complete tear undergo surgery. It is clear that one’s knee after surgery tends to remain unstable for prolonged periods of time, risking further damage to the ‘restored’ ACLs. Secondly, surgical reconstruction of the knee does not strengthen the knee; it merely puts the ACL (or a substitute for the ACL) back into position within the knee. A trial of conservative management does not rule out the possibility of eventual surgery. Patients suffering from ACL tear should be diagnosed and treated at the earliest. Delay can give rise to intra-articular damage and long-term disability. The writer is a former
doctor/physiotherapist, Indian Cricket Team. E-mail — chadhar587@gmail.com
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Health Notes WASHINGTON: A novel method using collagen — a group of naturally occurring proteins found in animals, especially in the flesh and connective tissues of mammals — can heal receding gums and exposed roots, say researchers. Receding gums often result in tooth sensitivity and can lead to decay of the root and persistent inflammation of the gum. Researchers across Germany and Switzerland led by Dr Shahram Ghanaati and Dr Markus Schlee investigated the possibility of using collagen, extracted from bovine pericardium, to form a support for mending receding gums and exposed roots. The pericardium is a thin membrane surrounding the hearts of all mammals. The bovine pericardium is principally composed of collagen. — ANI Snoring kids may have behavioural problems later in life
WASHINGTON: Young children with sleep-disordered breathing are prone to developing behavioural difficulties such as hyperactivity and aggressiveness, as well as emotional symptoms and difficulty with peer relationships. This is the finding of a study by researchers at Albert Einstein College of Medicine of Yeshiva University, who followed more than 11,000 children for over six years. “This is the strongest evidence to date that snoring, mouth breathing, and apnoea (abnormally long pauses in breathing during sleep) can have serious behavioral and social-emotional consequences for children,” said study leader Karen Bonuck, professor of family and social medicine and of obstetrics and gynaecology and women’s health at Einstein. “Parents and paediatricians alike should be paying closer attention to sleep-disordered breathing in young children, perhaps as early as the first year of life,” Bonuck noted. — ANI Vitamin E may make bones weaker
LONDON: Taking vitamin E supplements may make bones old and frail before their time, Japanese researchers say. A study found that animals fed on a diet supplemented with the vitamin had bones 20 per cent weaker than those that ate normally. More worrying is that the effect was seen after just eight weeks, the Daily Mail reported. The scientists behind the research said that given the popularity of vitamin E supplements, a larger study on people is now warranted. The vitamin, which occurs naturally in cereals, nuts, olive oil and egg yolks, is credited with helping hold back the hands of time by ‘fighting ageing from within’. — ANI
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