Teeth To Go: Implant In An Hour

Tooth-in-an-hour technology is now a reality in India. But can the average citizen afford it, asks Jayata Sharma

Tooth-in-an-hour (TiaH) technology is providing some relief for dentists as well as patients. TiaH is a solution for replacing missing teeth by providing artificial roots called Tiunite implants and fixing teeth on top of them, all in one sitting. The technique requires careful planning and the use of software called Nobel Guide, designed by Nobel Biocare, a restorative aesthetic dentistry company. Implantation can also be done using technology from various other firms such as Bio Horizon, Alpha Bio, Zimmer, Frilayet and Dentsply.

Centres In India

Rather than hospitals, dentists with their own clinics are involved. Officially there is no record of the number of dentists currently using this technology. "Around 20-25 clinics might be using this technology," estimates Mumbai-based Dr Sandesh Mayekar, Founding President of Indian Academy of Aesthetic and Cosmetic Dentistry. "There are a few centres in Mumbai, Delhi and Chennai which are currently doing TiaH," asserts Chennai-based Dr Vijailakshmi Acharya, Implantologist.

The Procedure

TiaH is a procedure wherein, after an X-ray and CT scan, the best position for implants is planned on the computer. A small hole is drilled in the bone under totally sterile conditions and an implant of appropriate size is inserted. A prefabricated crown — temporary, but strong — is selected and placed over the titanium implant extension. The whole procedure takes about one hour. The fixture is shaped like a screw: the bone can grow around it and hold it firmly. After three to four months, the temporary implant is replaced by the permanent one.

However, things are different for implanting the whole jaw. It might take two sittings of around two hours each. Understanding the jaw relationships is what takes time. "Twelve teeth each of upper and lower arches can be replaced using this technique in two sittings," says Dr Puneet Kathuria, Prosthodontist and Implantologist, New Delhi.

Need For TiaH

TiaH is a safer and quicker alternative to the classic way of placing implants and fixing permanent teeth. The conventional way has a waiting period of three to six months after placing the implants. Also, the removable temporary dentures are uncomfortable.

The Key Role Of Titanium

Titanium is the most biocompatible metal as proved by years of research. It helps in the quick formation of bone around the extracted tooth. Also, it is capable of having a firm hold in the gums. Plus, these implants come with a special surface called Tiunite, which helps in holding on to other teeth as well.

Benefits To Dentists

"Now, we give quality on par with the West to our patients" - Dr Sandesh Mayekar Founding President of Indian Academy of Aesthetic and Cosmetic Dentistry

This is the latest development in the field of implantology. Dentists can benefit from the fact that patients coming from abroad or outstation can be treated in just one sitting. This helps in increasing the client base. "Now, we give quality on par with the West to our patients," claims Dr Mayekar. "This improves the dentists' reputation and financial status," asserts Chandigarh-based Dr Sanjay Kalra, Professor and HOD, Department of Prosthetics at BRS Dental College, Panchkula.

"This procedure is extremely predictable. It is just like a keyhole surgery" - Dr Sunil Bhoolabhai Founder and President of Academy of Cosmetic Dentistry in India

All complex procedures are done externally; only the fixing has to be done inside the mouth. "This procedure is extremely predictable. It is just like key-hole surgery," says Mumbai-based Dr Sunil Bhoolabhai, Founder and President of Academy of Cosmetic Dentistry in India. Nobel Guide takes care of all the parameters of the jaw, which helps dentists to be more accurate. With such advanced technology, doctors can now be more confident of the service they provide.

The procedure allows for total and absolute control. "Indian dentists can now promise their patients the best the world has to offer," says Dr Acharya.

With the advent of dental tourism, India needs to be updated with all procedures dentists in the West offer. "We should try to learn and master the technique as early as possible. Sooner or later, you are bound to get enquiries for TiaH," avers Dr Kathuria.

"We should try to learn and master the technique as early as possible" - Dr Puneet Kathuria Prosthodontist and Implantologist, New Delhi

Another benefit is the precision-based stent, which helps dentists to place implants without raising the gum flap of the patient.

Benefits To Patients

A major benefit to the patients is that they can walk out of the dentist's place with a tooth in their mouth, quite unlike the conventional procedure that took days to replace a tooth. "One can actually go out and eat with these teeth, plus the patient is saved from dentures," says Dr Bhoolabhai. It is a time-saving and almost painless technique, as there is no need to drill adjoining teeth to fix the missing one. The dentist can just punch the implant in the space left after extraction. "Patients are benefited by immediate better aesthetics and function; and they can be sure of better psychological security," adds Dr Kalra, who also runs an Advanced Dental Speciality Clinic in Panchkula.

Patients having an active lifestyle and requiring quick solutions can opt for TiaH. "It is safe, effective, saves time and provides maximum comfort by having almost no post-surgical recovery time," says Dr Acharya. No TiaH implants are done on diabetic patients.

The Cost Factor

The cost of these titanium implants can range from Rs 30,000 to Rs 60,000 each. Latest technology, ambience and absolute sterility play a major part in cost derivation for every dentist. But the factors determining cost for jaw implants are more varied: a bar or a framework to support them, or offering lip support and shape via the implant denture when there is a collapse of facial features. "Cost also depends on the unique requirements of the individual patient," explains Dr Acharya.

The basic cost for scanning and fabrication remains the same. What differs, is the lab cost and the dentist's professional fee. "Since it is a relatively new technology, I am sure the company will make it cost-effective to reach the masses as well," quips Dr Kathuria.

The Future

At present, these implants are only within the reach of affluent people. "The economy of our country is growing by leaps and bounds. It will not be too long before the majority of the population will have a higher standard of living, and they will be able to afford this treatment," opines Dr Mayekar. So, how long it would be take for this technology to catch on in India? "Just a few months," Dr Bhoolabhai thinks, but according to Dr Mayekar it will take around five years for this technology to be popular among the masses. "Our drawback is that we cannot advertise, and so the popularity will mostly be through word of mouth," he explains.

"With awareness not yet at an optimum, the rewards for an indigenous manufacturer can be seen only when the numbers are high. The day may not be far away," adds Dr Acharya.

"A conference like World Tour 2006, by Nobel Biocare, I am sure will leave a mark in the mind of every practicing implantologist in India to try this technique," feels Dr Kathuria.

jayata@expresshealthcaremgmt.com