INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.comwww.ind...
CONTENTSCONTENTS
 INTRODUCTIONINTRODUCTION
 STRUCTURE OF PERIODONTALSTRUCTURE OF PERIODONTAL
LIGAMENTLIGAMENT
 STRUCTUR...
INTRODUCTIONINTRODUCTION
 The primary function of a dental implant is toThe primary function of a dental implant is to
ac...
PERIODONTAL LIGAMENTPERIODONTAL LIGAMENT
 Synthetic cellsSynthetic cells
 Resorptive cellsResorptive cells
 Epithelial ...
PERI-IMPLANT TISSUESPERI-IMPLANT TISSUES
 3 mm tissue3 mm tissue
 2 layers - epithelial2 layers - epithelial
- connectiv...
CLINICAL PARAMETERSCLINICAL PARAMETERS
 LongevityLongevity
 PainPain
 Mobility Vs rigid fixationMobility Vs rigid fixat...
LONGEVITYLONGEVITY
 Criteria for implant success;[Albrektsson]Criteria for implant success;[Albrektsson]
1.1. An individu...
4.4. Individual implant performance isIndividual implant performance is
characterized by an absence of persistent orcharac...
PAINPAIN
 Subjective findings of pain, tenderness andSubjective findings of pain, tenderness and
sensitivity are commonly...
 The implants does not become hyperemic and is notThe implants does not become hyperemic and is not
temperature sensitive...
 Pain in implant occurs due to ;Pain in implant occurs due to ;
1.1. Soft tissue entrapment between implant andSoft tissu...
MOBILITYMOBILITY
 Natural tooth, usually anteriors moves aroundNatural tooth, usually anteriors moves around
0.1mm and mo...
Clinical implant mobility scaleClinical implant mobility scale
Scale descriptionScale description
0 absence of clinical mo...
 Natural tooth with primary occlusal trauma exhibitsNatural tooth with primary occlusal trauma exhibits
an increase in mo...
 Periotest – is a computed mechanical devicePeriotest – is a computed mechanical device
developed bydeveloped by SchulteS...
www.indiandentalacademy.comwww.indiandentalacademy.com
PERCUSSIONPERCUSSION
 It is used on teeth toIt is used on teeth to
determine which toothdetermine which tooth
is sensitiv...
CRESTAL BONE LOSSCRESTAL BONE LOSS
 Under ideal conditions a tooth or implant should loseUnder ideal conditions a tooth o...
www.indiandentalacademy.comwww.indiandentalacademy.com
RADIOGRAPHIC EVALUATIONRADIOGRAPHIC EVALUATION
 The radiographic assessment of natural teeth assists inThe radiographic a...
 Parallel periapical radiographs are more difficult toParallel periapical radiographs are more difficult to
obtain for im...
www.indiandentalacademy.comwww.indiandentalacademy.com
KERATINIZED TISSUE CONCERNSKERATINIZED TISSUE CONCERNS
 Minimum of 2mm keratinized tissue and 1mmMinimum of 2mm keratiniz...
PROBING DEPTHSPROBING DEPTHS
 The correct pressureThe correct pressure
recommended for probing is 20recommended for probi...
BLEEDING INDEXBLEEDING INDEX
 Gingival bleeding when probing correlatesGingival bleeding when probing correlates
with Inf...
PERI-IMPLANT DISEASEPERI-IMPLANT DISEASE
 Initial pellicle composition is similarInitial pellicle composition is similar
...
 The bacteria in gingivitis around a tooth may affectThe bacteria in gingivitis around a tooth may affect
the epithelial ...
 Periodontitis around teeth is caused by bacteria,Periodontitis around teeth is caused by bacteria,
characterized by apic...
BIOMECHANICAL DIFFERENCESBIOMECHANICAL DIFFERENCES
TOOTHTOOTH
 Shock absorberShock absorber
 Decreased stressDecreased s...
Biomechanical designBiomechanical design
 Greater width ofGreater width of
occlusal surface henceocclusal surface hence
l...
Sensory nerve complexSensory nerve complex
 Premature contact –Premature contact –
orthodontic migration.orthodontic migr...
 Clinical evidence ofClinical evidence of
occlusal trauma – wearocclusal trauma – wear
facets, stress lines, linesfacets,...
CONCLUSIONCONCLUSION
 Devan stated that preservation of that whichDevan stated that preservation of that which
remains an...
BIBLIOGRAPHYBIBLIOGRAPHY
 Contemporary Implant Dentistry – Carl E.MischContemporary Implant Dentistry – Carl E.Misch
 En...
Thank you
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com
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Comparision of tooth and implant/ cosmetic dentistry training

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Indian Dental Academy: will be one of the most relevant and exciting

training center with best faculty and flexible training programs

for dental professionals who wish to advance in their dental

practice,Offers certified courses in Dental

implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic

Dentistry, Periodontics and General Dentistry.

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Comparision of tooth and implant/ cosmetic dentistry training

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. CONTENTSCONTENTS  INTRODUCTIONINTRODUCTION  STRUCTURE OF PERIODONTALSTRUCTURE OF PERIODONTAL LIGAMENTLIGAMENT  STRUCTURE OF PERI-IMPLANT TISSUESSTRUCTURE OF PERI-IMPLANT TISSUES  CLINICAL PARAMETERS COMPARINGCLINICAL PARAMETERS COMPARING TEETH AND IMPLANTTEETH AND IMPLANT  BIOMECHANICAL DIFFERENCEBIOMECHANICAL DIFFERENCE BETWEEN TEETH AND IMPLANTBETWEEN TEETH AND IMPLANT  CONCLUSIONCONCLUSION  BIBLIOGRAPHYBIBLIOGRAPHY www.indiandentalacademy.comwww.indiandentalacademy.com
  3. 3. INTRODUCTIONINTRODUCTION  The primary function of a dental implant is toThe primary function of a dental implant is to act as an abutment for a prosthetic device,act as an abutment for a prosthetic device, similar to a natural tooth root and crown. Thesimilar to a natural tooth root and crown. The restoring dentist designs and fabricates arestoring dentist designs and fabricates a prosthesis similar to one supported by a toothprosthesis similar to one supported by a tooth and as such also evaluates and treat the dentaland as such also evaluates and treat the dental implant similarly to a natural tooth. Yetimplant similarly to a natural tooth. Yet fundamental differences in the support systemfundamental differences in the support system have to be recognized.have to be recognized. www.indiandentalacademy.comwww.indiandentalacademy.com
  4. 4. PERIODONTAL LIGAMENTPERIODONTAL LIGAMENT  Synthetic cellsSynthetic cells  Resorptive cellsResorptive cells  Epithelial cellsEpithelial cells  Extracellular matrixExtracellular matrix - fibers- fibers - ground substances- ground substances  Other structuresOther structures  Functions.Functions. www.indiandentalacademy.comwww.indiandentalacademy.com
  5. 5. PERI-IMPLANT TISSUESPERI-IMPLANT TISSUES  3 mm tissue3 mm tissue  2 layers - epithelial2 layers - epithelial - connective- connective  Few epithelial layerFew epithelial layer  lacks keratinizationlacks keratinization  Increased susceptible.Increased susceptible.  Sole vascular supply –Sole vascular supply – alveolar supraperiosteal.alveolar supraperiosteal.  Connective tissue rich inConnective tissue rich in collagencollagen  Acellular and avascular.Acellular and avascular. www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. CLINICAL PARAMETERSCLINICAL PARAMETERS  LongevityLongevity  PainPain  Mobility Vs rigid fixationMobility Vs rigid fixation  PercussionPercussion  Crestal bone lossCrestal bone loss  Radiographic evaluationRadiographic evaluation  Keratinized tissueKeratinized tissue  Probing depthsProbing depths  Bleeding indexBleeding index  Peri-implant diseasePeri-implant disease www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. LONGEVITYLONGEVITY  Criteria for implant success;[Albrektsson]Criteria for implant success;[Albrektsson] 1.1. An individual unattached implant isAn individual unattached implant is immobile when tested clinically.immobile when tested clinically. 2.2. The radiograph does not demonstrate anyThe radiograph does not demonstrate any evidence of periimplant radiolucency.evidence of periimplant radiolucency. 3.3. Vertical bone loss is less than 0.2mmVertical bone loss is less than 0.2mm annually after the first year of service of theannually after the first year of service of the implant.implant. www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. 4.4. Individual implant performance isIndividual implant performance is characterized by an absence of persistent orcharacterized by an absence of persistent or irreversible signs and symptoms such asirreversible signs and symptoms such as pain, infections, neuropathies, paresthesia, orpain, infections, neuropathies, paresthesia, or violation of the mandibular canal.violation of the mandibular canal. 5.5. Success rate is a minimum of 85% for 5Success rate is a minimum of 85% for 5 years and 80% for 10 years.years and 80% for 10 years. www.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. PAINPAIN  Subjective findings of pain, tenderness andSubjective findings of pain, tenderness and sensitivity are commonly seen in natural tooth.sensitivity are commonly seen in natural tooth. A natural tooth often becomes hyperemic andA natural tooth often becomes hyperemic and cold temperature sensitive as the first indicatorcold temperature sensitive as the first indicator of the problem. Tooth becomes sensitive toof the problem. Tooth becomes sensitive to heat and painful to percussion, indicatingheat and painful to percussion, indicating pulpitis.pulpitis. www.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10.  The implants does not become hyperemic and is notThe implants does not become hyperemic and is not temperature sensitive, and the early warning signstemperature sensitive, and the early warning signs and symptoms of a problems may not be present.and symptoms of a problems may not be present.  Pain is rarely associated with the implant afterPain is rarely associated with the implant after primary healing.primary healing.  Forces upto 500g are used clinically to evaluate toothForces upto 500g are used clinically to evaluate tooth or implant pain or discomfort.or implant pain or discomfort.  The persistent pain during percussion or function onThe persistent pain during percussion or function on implant- removal even in the absence of mobility.implant- removal even in the absence of mobility. www.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11.  Pain in implant occurs due to ;Pain in implant occurs due to ; 1.1. Soft tissue entrapment between implant andSoft tissue entrapment between implant and abutment- elimination of soft tissue.abutment- elimination of soft tissue. 2.2. Implant placed proximity to nerve – unthreadImplant placed proximity to nerve – unthread the implant and reevaluate.the implant and reevaluate. 3.3. Bone stress beyond physiologic limits –Bone stress beyond physiologic limits – address occlusion and parafunctional habits,address occlusion and parafunctional habits, prosthesis should be modified, or additionalprosthesis should be modified, or additional implants placed to dessipate the forces.implants placed to dessipate the forces. www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. MOBILITYMOBILITY  Natural tooth, usually anteriors moves aroundNatural tooth, usually anteriors moves around 0.1mm and molars around 56 to 73microns.0.1mm and molars around 56 to 73microns.  Implant moves less than 73 microns.Implant moves less than 73 microns.  Mobility can be tested using two rigidMobility can be tested using two rigid instruments apply a labiolingual force ofinstruments apply a labiolingual force of approximately 500g.approximately 500g. www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. Clinical implant mobility scaleClinical implant mobility scale Scale descriptionScale description 0 absence of clinical mobility0 absence of clinical mobility 1 Slight detectable horizontal mobility1 Slight detectable horizontal mobility 2 Moderate horizontal mobility upto2 Moderate horizontal mobility upto 0.5mm0.5mm 3 Severe horizontal movement greater3 Severe horizontal movement greater than 0.5mmthan 0.5mm 4 Visible moderate to severe4 Visible moderate to severe horizontal and any visible vertical movement.horizontal and any visible vertical movement. www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14.  Natural tooth with primary occlusal trauma exhibitsNatural tooth with primary occlusal trauma exhibits an increase in mobility and radiographic periodontalan increase in mobility and radiographic periodontal ligament space. Once the cause of trauma isligament space. Once the cause of trauma is eliminated, the tooth return to zero mobility and aeliminated, the tooth return to zero mobility and a normal radiographic appearance.normal radiographic appearance.  In implant, with 0.1mm horizontal mobility, onIn implant, with 0.1mm horizontal mobility, on occasion may return to rigid fixation. To achieve this,occasion may return to rigid fixation. To achieve this, implant should be completely out of occlusion forimplant should be completely out of occlusion for several months.several months. www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15.  Periotest – is a computed mechanical devicePeriotest – is a computed mechanical device developed bydeveloped by SchulteSchulte that measures thethat measures the damping effect of an object.damping effect of an object.  The recording ranges from -8 to +50. teethThe recording ranges from -8 to +50. teeth with zero clinical mobility have typical rangeswith zero clinical mobility have typical ranges from +5 to +9. implant corresponds to valuesfrom +5 to +9. implant corresponds to values ranging from -8 to +9.ranging from -8 to +9. www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. PERCUSSIONPERCUSSION  It is used on teeth toIt is used on teeth to determine which toothdetermine which tooth is sensitive to functionis sensitive to function or is beginning toor is beginning to abscess.abscess.  The ringing sound thatThe ringing sound that occurs on percussionoccurs on percussion corresponds to thecorresponds to the presence of bonepresence of bone implant interface.implant interface. www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. CRESTAL BONE LOSSCRESTAL BONE LOSS  Under ideal conditions a tooth or implant should loseUnder ideal conditions a tooth or implant should lose minimal bone.minimal bone.  AdellAdell et al, determined that successful implants afteret al, determined that successful implants after first year loading had an average 0.1mm bone loss forfirst year loading had an average 0.1mm bone loss for each year.each year.  Early loss of crestal bone beyond 1mm after prosthsisEarly loss of crestal bone beyond 1mm after prosthsis delivery is usually a result of excessive stress at thedelivery is usually a result of excessive stress at the crestal implant-interface.crestal implant-interface.  the dentist should evaluate and reduce stress factorsthe dentist should evaluate and reduce stress factors such as occlusal forces, cantilever length, andsuch as occlusal forces, cantilever length, and especially parafunction on observation of initial boneespecially parafunction on observation of initial bone loss.loss. www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. RADIOGRAPHIC EVALUATIONRADIOGRAPHIC EVALUATION  The radiographic assessment of natural teeth assists inThe radiographic assessment of natural teeth assists in determining the presence of decay, lesions of endodonticdetermining the presence of decay, lesions of endodontic origin and periodontal bone loss.origin and periodontal bone loss.  Implants do not decay and do not develop endodontic relatedImplants do not decay and do not develop endodontic related conditions.conditions.  Crestal bone loss around the implant can be evaluated butCrestal bone loss around the implant can be evaluated but radiograph only illustrates clearly the mesial and distal crestalradiograph only illustrates clearly the mesial and distal crestal levels of bone , but early bone loss often occurs on the faciallevels of bone , but early bone loss often occurs on the facial aspect.aspect.  An absence of radiolucency does not mean presence of bone atAn absence of radiolucency does not mean presence of bone at the implant interface, since 40% decrease in density isthe implant interface, since 40% decrease in density is necessary to produce a traditional radiographic difference.necessary to produce a traditional radiographic difference. www.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21.  Parallel periapical radiographs are more difficult toParallel periapical radiographs are more difficult to obtain for implants than for tooth,obtain for implants than for tooth,  Radiographs are taken and reviewed every 6 to 8Radiographs are taken and reviewed every 6 to 8 months until stable for two consecutive periods. Ifmonths until stable for two consecutive periods. If bone loss greater than 2mm is observed from thebone loss greater than 2mm is observed from the bonelevels noted from stage II uncovery to thebonelevels noted from stage II uncovery to the prosthesis delivery, parafunction on the transitionalprosthesis delivery, parafunction on the transitional prosthesis should be suspected. Night guards andprosthesis should be suspected. Night guards and stress reduction on the affected implants arestress reduction on the affected implants are indicated.indicated. www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. www.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. KERATINIZED TISSUE CONCERNSKERATINIZED TISSUE CONCERNS  Minimum of 2mm keratinized tissue and 1mmMinimum of 2mm keratinized tissue and 1mm attached gingiva.attached gingiva.  Least amount of keratinized tissue is in I PMLeast amount of keratinized tissue is in I PM  If other periodontal index are normal,If other periodontal index are normal, keratinized gingiva plays minimal rolekeratinized gingiva plays minimal role  Its not mandatory but benefit if present.Its not mandatory but benefit if present. www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. PROBING DEPTHSPROBING DEPTHS  The correct pressureThe correct pressure recommended for probing is 20recommended for probing is 20 g,g,  Sulcus depths greater than 5 toSulcus depths greater than 5 to 6 mm have a greater incidence6 mm have a greater incidence of anaerobic bacteriaof anaerobic bacteria  the probing depth next to athe probing depth next to a healthy implant is typicallyhealthy implant is typically greater than that of a healthygreater than that of a healthy natural toothnatural tooth  material from which the probematerial from which the probe should be fabricatedshould be fabricated www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. BLEEDING INDEXBLEEDING INDEX  Gingival bleeding when probing correlatesGingival bleeding when probing correlates with Inflammation and the plaque Indexwith Inflammation and the plaque Index  inflammation is typically less around implantsinflammation is typically less around implants than around teeththan around teeth  Loe and Silness gingival indexLoe and Silness gingival index www.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. PERI-IMPLANT DISEASEPERI-IMPLANT DISEASE  Initial pellicle composition is similarInitial pellicle composition is similar  They contain gram +ve bacilli and cocci.They contain gram +ve bacilli and cocci.  Supra gingival calculus is seen in implant butSupra gingival calculus is seen in implant but not subgingival .not subgingival .  Calulus around the implant is less tenaciousCalulus around the implant is less tenacious  Gingivitis is a bacteria-induced inflammationGingivitis is a bacteria-induced inflammation involving the region of the marginal gingivainvolving the region of the marginal gingiva above the crest of bone and is similar in bothabove the crest of bone and is similar in both teeth and implant- peri mucositis.teeth and implant- peri mucositis. www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27.  The bacteria in gingivitis around a tooth may affectThe bacteria in gingivitis around a tooth may affect the epithelial attachment but without loss ofthe epithelial attachment but without loss of connective tissue attachment. Because the connectiveconnective tissue attachment. Because the connective tissue attachment of a tooth extends an average oftissue attachment of a tooth extends an average of 1.07 mm above the crestal bone, at least 1 mm of1.07 mm above the crestal bone, at least 1 mm of protective barrier above the bone is left.protective barrier above the bone is left.  In contrast, no connective tissue attachment zoneIn contrast, no connective tissue attachment zone exists around an implant because no connective fibersexists around an implant because no connective fibers extend into the implant. Hence no connective tissueextend into the implant. Hence no connective tissue barrier exists to protect the crestal bone around anbarrier exists to protect the crestal bone around an implant.implant. www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28.  Periodontitis around teeth is caused by bacteria,Periodontitis around teeth is caused by bacteria, characterized by apical proliferation and ulceration ofcharacterized by apical proliferation and ulceration of the junctional epithelium, progressive loss of thethe junctional epithelium, progressive loss of the connective tissue attachment, and loss of alveolarconnective tissue attachment, and loss of alveolar bone.bone.  After prosthesis delivery, early crestal bone lossAfter prosthesis delivery, early crestal bone loss around an implant usually is not caused by bacteria.around an implant usually is not caused by bacteria.  However, bacteria on occasion may be the primaryHowever, bacteria on occasion may be the primary factor. Anaerobic bacteria have been observedfactor. Anaerobic bacteria have been observed especially when sulcus depths are greater than 5 mm.especially when sulcus depths are greater than 5 mm. www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29. BIOMECHANICAL DIFFERENCESBIOMECHANICAL DIFFERENCES TOOTHTOOTH  Shock absorberShock absorber  Decreased stressDecreased stress  Mobility to occlusalMobility to occlusal trauma, returns aftertrauma, returns after elimination.elimination.  MovementMovement 8-28 microns vertical8-28 microns vertical 56-108 horizontal56-108 horizontal  Pivot movement present whichPivot movement present which minimizes crestal bone lossminimizes crestal bone loss IMPLANTIMPLANT  no resilient interfaceno resilient interface  no force dissipationno force dissipation  irreversible bone lossirreversible bone loss  0-5 microns, 10-50microns.0-5 microns, 10-50microns.  No pivot movement, stressNo pivot movement, stress concentration at bone crest.concentration at bone crest. www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. Biomechanical designBiomechanical design  Greater width ofGreater width of occlusal surface henceocclusal surface hence lesser magnitude oflesser magnitude of stress.stress.  Cross section shapeCross section shape resists bucco-lingual orresists bucco-lingual or lateral load.lateral load.  Similar elastic modulusSimilar elastic modulus of tooth and implant.of tooth and implant.  Lesser widthLesser width  Round cross sectionRound cross section  Difference in elasticDifference in elastic modulusmodulus www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. Sensory nerve complexSensory nerve complex  Premature contact –Premature contact – orthodontic migration.orthodontic migration.  Excess tongue/oralExcess tongue/oral habits can causehabits can cause migrationmigration  Early detection ofEarly detection of occlusal load. Henceocclusal load. Hence bite force is of lessbite force is of less magnitudemagnitude  Increased occlusalIncreased occlusal awareness.awareness.  No orthodonticNo orthodontic movementmovement  Biting force is 4 foldsBiting force is 4 folds greater due to lack ofgreater due to lack of propioception.propioception.  Decreased occlusalDecreased occlusal awareness.awareness. www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32.  Clinical evidence ofClinical evidence of occlusal trauma – wearocclusal trauma – wear facets, stress lines, linesfacets, stress lines, lines of luder, cervicalof luder, cervical abfraction.abfraction.  Fatigue fracture.Fatigue fracture. www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. CONCLUSIONCONCLUSION  Devan stated that preservation of that whichDevan stated that preservation of that which remains and not the meticulous replacement ofremains and not the meticulous replacement of what is lost. Even though the implant has gotwhat is lost. Even though the implant has got more advantages compared to other prosthesis,more advantages compared to other prosthesis, ultimately, it is the natural tooth whichultimately, it is the natural tooth which remains the best.remains the best. www.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34. BIBLIOGRAPHYBIBLIOGRAPHY  Contemporary Implant Dentistry – Carl E.MischContemporary Implant Dentistry – Carl E.Misch  Endosseous implants for MaxillofacialEndosseous implants for Maxillofacial reconstruction – Block and Kentreconstruction – Block and Kent  ORBANS “Oral histology & embroyology”ORBANS “Oral histology & embroyology”  Dental Clinic of North America.-Implantology-Dental Clinic of North America.-Implantology- July 2006;50;3.July 2006;50;3.  Dental implants- the art and science- CharlesDental implants- the art and science- Charles A.Babbush.A.Babbush.  Implants and restorative dentistry- GerardImplants and restorative dentistry- Gerard M.Scortecci.M.Scortecci. www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com

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