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    Lanka Mahesh

    Collagen is the most abundant protein in mammals, also making it the most important component of the body structurally and functionally. Collagen provides cell occlusiveness, biocompatibility, and resorbability. It is chemotactic for... more
    Collagen is the most abundant protein in mammals, also making it the most important component of the body structurally and functionally. Collagen provides cell occlusiveness, biocompatibility, and resorbability. It is chemotactic for regenerative cells and may enhance the migration and attachment of fibroblasts through its space-making ability. Collagen also has the advantage of being a hemostatic agent with weak immunogenicity, easy manipulation, and the ability to augment tissue thickness. Additionally, upon breakdown through the resorption process, its byproducts are utilized by the host to form native tissue. Further, these proteins are elastic and enhance repair, properties that make the material useful for various biomedical applications. This review highlights and discusses some of the important aspects of collagen as a biomaterial in dentistry.
    Soon after tooth extraction the bone resorption takes place reducing the height and width of alveolar ridge. This produces an altered morphology of the bone unfavorable for implant placement and implant placement becomes impossible... more
    Soon after tooth extraction the bone resorption takes place reducing the height and width of alveolar ridge. This produces an altered morphology of the bone unfavorable for implant placement and implant placement becomes impossible without surgical correction. Socket grafting maintains and preserves ridge for implant placement.
    As placement of implants into immediate sites involves management of the remaining root structure, these residual roots may be used as a guide for the osteotomy development. This aids in implant positioning and prevents drill slippage... more
    As placement of implants into immediate sites involves management of the remaining root structure, these residual roots may be used as a guide for the osteotomy development. This aids in implant positioning and prevents drill slippage into the residual root spaces during osteotomy drilling. Following completion of the osteotomy, the remaining root structure is extracted prior to implant placement into the site.
    Kurtzman GM, Mahesh L, Afrashtehfar KI. Considerations of bisphosphonate: management in Dentistry. Final part. Rev Dent Paciente. 2012 Nov; 51:10-6. (ISSN 1405-020X) [Mexico-USA]
    This brief review is an update about adult stem cells obtained from oral tissues and their therapeutic use trough tissue engineering techniques in order to produce the tissues needed to repair/regenerate, from bone or tooth tissue lost to... more
    This brief review is an update about adult stem cells obtained from oral tissues and their therapeutic use trough tissue engineering techniques in order to produce the tissues needed to repair/regenerate, from bone or tooth tissue lost to an entire bio-engineered tooth.
    Socket grafting with a bone graft substitute immediately after extraction is essential to preserve the ridge architecture for implant placement. Several bone graft substitutes have been tested for their ability to effectively regenerate... more
    Socket grafting with a bone graft substitute immediately after extraction is essential to preserve the ridge architecture for implant placement. Several bone graft substitutes have been tested for their ability to effectively regenerate osseous tissue in the sockets. Evidence suggests that socket bone typically regenerates during a period of 6 to 8 months or longer, depending on several factors including the original ridge dimensions, type of graft, and the overall systemic health of the individual. The purpose of this study is to histologically evaluate the bone regeneration potential of a novel synthetic calcium phosphosilicate putty (CPS) graft substitute. After extraction of the involved teeth, CPS putty graft was placed, and the sockets were covered with a collagen plug. Cores were taken from 20 patients for histological evaluation prior to implant placement. Ten cores were processed decalcified with hematoxylin and eosin (H&E) stain and the remaining 10 were processed undecalc...
    The health and vitality of an osseointegrated implant depends on the surrounding supporting tissues, which not only anchor the implant to the bone but also have the important function of providing a protective seal. The aim of this... more
    The health and vitality of an osseointegrated implant depends on the surrounding supporting tissues, which not only anchor the implant to the bone but also have the important function of providing a protective seal. The aim of this article is to provide a basic understanding of differences and similarities between the periodontal and peri-implant tissues at the histologic, clinical, and immunologic levels; it is essential to know these differences and similarities during the clinical handling of these similar-looking tissues. The comparative features are of clinical relevance because it is critical to understand the behavior of the soft tissue found around the tooth and implant. This knowledge is vital from the preliminary stage of treatment planning through prosthetic rehabilitation.
    Abstract Osseointegration is the most studied and most investigated area in implantology. A thorough and complete understanding of what happens at the bone–implant interface is important for the implantologist, thereby enabling a... more
    Abstract Osseointegration is the most studied and most investigated area in implantology. A thorough and complete understanding of what happens at the bone–implant interface is important for the implantologist, thereby enabling a treatment plan which conforms to the ...
    Extraoral cementation is a technique that utilizes a stock abutment and a laboratory fabricated crown that is cemented extra orally; the advantage of this technique is that the retained excess luting agent during intraoral cementation,... more
    Extraoral cementation is a technique that utilizes a stock abutment and a laboratory fabricated crown that is cemented extra orally; the advantage of this technique is that the retained excess luting agent during intraoral cementation, which can be a source of bacterial retention and cannot be observed radio graphically and is not possible to remove with explorer all the time, does not get accumulated and can be trimmed off easily before the final placement of the crown. Thus this technique allows no retention of luting cement, providing better soft tissue contours, no soft tissue inflammation, no retention of plaque and no bone loss. In short it prevents implant failure related to retained cement around implants. This technique provides overall health of peri-implant soft tissues as compared to conventional technique of crown placement where cement retention is a common problem, leading to implant failures.
    The objective of this study was to evaluate bone regeneration in 24 sockets grafted with a calcium phosphosilicate putty alloplastic bone substitute. A core was obtained from 17 sockets prior to implant placement for histomorphometry at 5... more
    The objective of this study was to evaluate bone regeneration in 24 sockets grafted with a calcium phosphosilicate putty alloplastic bone substitute. A core was obtained from 17 sockets prior to implant placement for histomorphometry at 5 to 6 months postextraction. Radiographic analysis during the same postextraction healing period showed radiopaque tissue in all sockets. Histomorphometric analysis revealed a mean vital bone content of 31.76% (± 14.20%) and residual graft content of 11.47% (± 8.99%) after a mean healing period of 5.7 months. The high percentage of vital bone in the healed sites in combination with its timely absorption rate suggest that calcium phosphosilicate putty can be a reliable choice for osseous regeneration in extraction sockets.
    To measure implant stability using periotest values of implants placed in sockets augmented with calcium phospho-silicate putty (CPS Putty) as compared with implant stability in naturally healed sockets. Twenty two sockets were implanted... more
    To measure implant stability using periotest values of implants placed in sockets augmented with calcium phospho-silicate putty (CPS Putty) as compared with implant stability in naturally healed sockets. Twenty two sockets were implanted with CPS Putty immediately after extraction. The sockets were re-entered after a healing period at 5 to 6 months (average 5.3 months) for implant placement. Periotest values were recorded during implant insertion to assess primary stability. These were compared with the Periotest values of 26 implants placed in 22 patients, with naturally healed sockets. Periotest values were significantly lower in the grafted group, indicating better implant stability in sites grafted with CPS putty. Implant stability seems to be significantly higher in sockets augmented using CPS putty when compared to nongrafted sites. This suggests that socket grafting with CPS putty may enhance the quality of available bone for implantation.
    When performing a tooth extraction, imminent collapse of the tissue by resorption and remodeling of the socket is a natural occurrence. The procedure for the preservation of the alveolar ridge has been widely described in the dental... more
    When performing a tooth extraction, imminent collapse of the tissue by resorption and remodeling of the socket is a natural occurrence. The procedure for the preservation of the alveolar ridge has been widely described in the dental literatures and aims to maintain hard and soft tissues in the extraction site for optimal rehabilitation either with conventional fixed or removable prosthetics or implant-supported prosthesis.
    ABSTRACT
    Abstract Following tooth extraction ridge preservation procedures are employed to regenerate bone in the extraction socket, limit consequent ridge resorption and provide a stable base for implant placement. The purpose of this study is to... more
    Abstract Following tooth extraction ridge preservation procedures are employed to regenerate bone in the extraction socket, limit consequent ridge resorption and provide a stable base for implant placement. The purpose of this study is to histologically evaluate and compare bone regeneration in extraction sockets grafted with either a putty alloplastic bone substitute or particulate anorganic bovine xenograft utilizing the socket-plug technique.Nineteen patients underwent twenty tooth extractions and ridge preservation following a standardized protocol. Ten sites were grafted with calcium phosphosilicate putty (CPS group) and the remaining ten with anorganic bovine bone substitute (BO group). Patients were recalled after 4-6 months to evaluate the bone regeneration and to proceed with implant placement. A bone core was obtained during the implant procedure from each site and was used for histological analysis. Histomorphometry revealed that residual graft values were significantly higher in the BO group (25.60%±5.89) compared to the CPS group (17.40%±9.39) (P<0.05). The amount of new bone regenerated was also statistically significant higher in the alloplast group (47.15% ± 8.5%) as compared to the xenograft group (22.2% ±3.5%) (P<0.05). Both bone substitutes demonstrated bone regeneration in the healed sockets. Results suggest that ridge preservation using a putty calcium phosphosilicate alloplastic bone substitute results in more timely graft substitution and increased bone regeneration when compared to an anorganic bovine bone xenograft.
    Soon after tooth extraction the bone resorption takes place reducing the height and width of alveolar ridge. This produces an altered morphology of the bone unfavorable for implant placement and implant placement becomes impossible... more
    Soon after tooth extraction the bone resorption takes place reducing the height and width of alveolar ridge. This produces an altered morphology of the bone unfavorable for implant placement and implant placement becomes impossible without surgical correction. Socket grafting maintains and preserves ridge for implant placement.