Amit Gulati - Pinks Whites & Greys

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Amit Gulati - Pinks Whites & Greys

A sharing & a learning blog on some fine clinical concepts, showcasing some interdisciplinary Pinks, Whites & Greys in Contemporary Dentistry :-)

04/04/2023

Perio-Aesthetics-Restorative Module of the Fellowship in Aesthetic Dentistry & Occlusion, being conducted by Dr Amit Gulati at the DY Patil School of Dentistry.

Follow us here for our upcoming programs in Implantology, Hard & Soft Tissue Management & Implant Prosthodontics.

30/05/2021

Yesterday's case...fresh out of Oven (read SD card ;-) ). Some soft tissue management around the implants. Implants were placed in Feb 2020, just before we went into lockdown. It was a narrow ridge & after discussing options we decided to go ahead with ridge split and simultaneous Implant placement- GBR. We saw the patient after 15 months for uncovery & prosthetic rehab. To begin with as well, the Keratinized tissue was sparse plus we had shallowing of the vestibular space due to tissue mobilization during GBR. Sharing my thought process in managing this tissue deficiency.
Rest in pictures. Hope its useful.

18/04/2021

Nothing gives you more satisfaction than achieving what you envisaged & planned, especially when you are working on a Smile.
Showcasing another aesthetic case wherein our patient was not too happy with her smile. Besides midline diastema, there was something which always bothered her about her smile & she wasn't able to explain that tangibly. Such patients can be really difficult to please as they don't know for themselves too what they want.
In my experience, I have found that making picture records & sitting with the patient over them, helps both patient & the clinician converge on desires, expectations & outcome possibilities.
This was one such case.
What came really handy in handling this case was an aesthetic Treatment Planning & Simulation Software, DTS Pro.
Sitting with the patient to do treatment planning & being able to see virtual mock-ups & simulations, it wasn't too difficult to come to a conclusion that we needed to close midline diastema, create right proportions, do gingival zenith corrections & fill up buccal corridors to give this patient a satisfying smile.
On the basis of the approved smile & facial simulations, a digital treatment plan was generated & after transfering a refrence on the model it shared with the lab for creating wax-mock ups. Lab gave us quite precise mock-ups & a test drive was done with bis-acryl.
Discussing all aspects, it was decided to go ahead with with 4 LiDiSi veneers on four incisors & Direct Composite Veneers on four bicuspids to create fullness in buccal corridors, while Canines to be left untouched.
Preps were done through APT & analog impressions made.
Treatment Planning - DTS Pro Software
Test Drive - Cooltemp from Coltene
Soft Tissue Contouring - EZlase 940 by Biolase.
LiDiSi - EMax Veneers on #11, #12, #21 & #22
Direct Composite Veneers on #14, #15, #24 & #25 - Shofu Beautifil LS Composites.

🙂🙂

21/02/2021

An old case...but a one very close to my heart as it showcases the power of interdisciplinary dentistry in changing not only the smile of this young lady but the her personality, her attitude & most importantly her confidence. We felt so happy when she called up a few months later to inform us how she is excelling at her work place & is being promoted to lead a team in another country.
Orthodontics by Dr Akshay Doshi...followed by bleaching & some Minimally Invasive Contouring & Bonding.

13/02/2021

I so much wanted to a Zucchelli with CTG here and thus kept deferring to do restorations, as the patient, who was a dear friend too, didn’t want to go under the knife. Kept convincing him for the surgery until the day he threatened me of going elsewhere to have the restorations done. He was a big time smoker, but I was still good to take a chance with the surgery knowing the predictability it offered in this situation. Nonetheless…gave into his demand. Thought if the situation has to be managed restoratively…then I might as well manage it my way….with atleast some semblance of maintaining White & Pink balance.
Sorry no RubberDam here. I find that too cumbersome in such extensive lesions. My brinkers don’t reach that level plus I don’t get to see & match the Pink.
Rest in pictures.

12/10/2020

Ever wondered what happens to the soft tissue grafts over the period of time. Here is a case of a FGG done 14 years back in 2006. FGG was done to cover the recession defects with respect to #31 & #41 & to increase the zone of keratinized gingiva. Since we see a loss of facial bone(to some extent) in such defects, many of us tend to presume that soft tissue grafting here is going to be a temporary solution & eventually tissue is going to recede back again. Our presumption many a times restricts us from advising treatment options to the patient & eventually leading to more tissue loss & finally loss of tooth/teeth. So here's a long term follow up of how soft tissue augmentation fared over the period of time. The soft tissue levels not only stayed stable but improved big time with time. A perfect example of the philosophy I believe in "Human body has a tremendous healing capacity, all we need to do is to create the right environment.It repairs & regenerates"
Patient was a 25 years young female, who later moved to another country but would come in for checks whenever she would be in the city.

18/09/2020

You don't always get a good run with your implant cases. There are cases which give you lots of heartaches & this one was one of them. An old case but I distinctly remember my cardiogram ups & lows as this case progressed. Sharing my experience with this case on how we managed the situations & the thought process during this journey. He was a travelling patient based in another country & would spend couple of months in a year here, but again would travel extensively while being in India too. Rest in pictures.

25/08/2020

What is your protocol when you come across typical saucerized osseous defects like the one showcased here. Many a times, in free saddle areas (Kennedy's CI-CII), the ridge trajectory is such..that due to differences in mesio-distal osseous levels, some threads of the implants on the distal aspects may stay exposed out of bone, as seen in this case. How do you handle such situations, as granular graft materials may not stay there unless immobilised securely with membranes.
I follow some simple techniques...one of those is showcased here in this case.The graft itself is radiolucent, so what changes we see here radiographically over a period of year indicate actual regeneration of bone. The lamellar pattern of ossification is quite evident on the xrays. This is TRUE BONE...& not consolidated bone graft.

I would be talking on some simple & predictable
techniques to manage hard & soft tissues in a minimally invasive way on Sunday, 30th Aug 2020 at 12pm IST
Its a free zoom webinar. Link to register
https://zoom.us/webinar/register/WN_lJTpffsMQQWa2_uX-yVd8Q

31/07/2020

Just, a complicated looking case made simple with minimal intervention. Some soft tissue management along with slightly subcrestal implant placement to gain tissue volume for long term stability of health & easy maintenance.
Roll Flap with a modified single suture technique to roll-in as well as to approximate buccal & palatal tissues.

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Madhuli, Panchmarg, Off , Yari Road, Versova, Andheri-W
Mumbai
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Website

http://www.gumsnsmiles.com/

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