D e n t a l    F o l l i c l e               

             The        Monthly   Dental   E-Journal                 Vol - I I      Number-  V I   November  2007

In this Issue:

  • Editorial

  • News

  • Laughter - The best Medicine

  • Ranks at Number 5 on Google

  • Delayed Implant Placement in an esthetic zone - MarcoIorio , Italy

  • IDEM SINGAPORE online registration open


Editorial :


      William Addis of England is credited with creating the first mass-produced toothbrush in 1780. In 1770 he had been placed in jail for causing a riot. While in prison, he decided that the method for teeth brushing of the time – rubbing a rag on one's teeth with soot and salt – could be improved. So he took a small animal bone, drilled small holes in it, obtained some bristles from a guard, tied them in tufts, then passed the bristles through the holes on the bone and glued them.

The first patent for a toothbrush was by H. N. Wadsworth in 1850 in the United States, which was mass produced in USA in 1885. The rather advanced design had a bone handle with holes bored into it for the Siberian Boar hair bristles. Boar wasn't an ideal material; it retained bacteria, it didn't dry well, and the bristles would often fall out of the brush. It wasn't until World War II, however, that the concept of brushing teeth really caught on in the U.S. cause the US troops had it as part of daily duty to clean their teeth.

Natural bristles (from animal hair) were replaced by synthetic fibers, usually nylon, by DuPont in 1938. The first nylon bristle toothbrush, made with nylon yarn, went on sale on February 24, 1938. The first electric toothbrush, the Broxodent, was introduced by the Bristol-Myers Company (now Bristol-Myers Squibb) at the centennial of the American Dental Association in 1959.

In January 2003, the toothbrush was selected as the number one invention Americans could not live without, beating out the automobile, computer, cell phone, and microwave oven, according to the Lemelson-MIT Invention Index.

The Information technology revolution did also take the good toothbrush in the swing

Tech savvy guys always come up with some new stuff. Something innovative. The new one to add to the rack is  a USB tooth brush. I guess all of you know what is USB, Universal Serial Bus (USB) is a serial bus standard to interface devices. USB was designed to allow peripherals to be connected using a single standardized interface socket and to improve plug-and-play capabilities by allowing devices to be connected and disconnected without rebooting the computer (hot swapping). Other convenient features include providing power to low-consumption devices without the need for an external power supply and allowing many devices to be used without requiring manufacturer specific, individual device drivers to be installed.

AKIBA PC HOTLINE has shown intel executive  Jason ChipZiller's dream and vision to make USB 2.0 "truly ubiquitous" . The USB tooth brush  box contains  a battery-powered pin to USB cable directly linked to the structure, and will not use batteries.

APPLE the leader in IT world has something to give to dentistry too .  The Apple Toothbrush will include the first user-friendly application of DRM—dental rights management. Using its patented FairBrush technology, each Apple Toothbrush will be locked to a single Apple ID. The device will be wildly popular because nobody likes it when someone else uses their toothbrush

The other tooth brush innovation latest to add up is a "Solar powered tooth brush" that does not require a toothpaste .

This Proton Toothbrush  will brush without a toothpaste. In 1822, an Estonian physician named Thomas Seebeck inadvertently discovered that the junction between two dissimilar metals will generate a voltage between the metals which depends on the temperature. The electric potential created by combining precious and base metals in this  Toothbrush  helps provide better plaque removal than conventional toothbrushes. The magnesium copper metal combination generates a voltage of 0.8 – 1.8 and an electric current of 2 – 1200 mA in water, in addition to H 3 O 2 - negative ions. Bacteria in the mouth may be sterilized by voltage over 1.3, which creates an electric sterilization effect. This electron activity helps remove dental plaque from areas where conventional toothbrushes cannot reach.

So keep advising proper brshing to your patients and enjoy this issue.


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Yours truly

Dr. Syed Nabeel

Editor of Dental Follicle & WebMaster

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News :




Laughter - The Best Medicine :

A man went to his dentist because he feels something wrong in his mouth. The dentist examines him and says, "That new upper plate I put in for you six months ago is eroding. What have you been eating?"

The man replies, "All I can think of is that about four months ago my wife made some asparagus and put some stuff on it that was delicious...Hollandaise sauce. I loved it so much I now put it on everything --- meat, toast, fish, vegetables, everything."

"Well," says the dentist, "that's probably the problem. Hollandaise sauce is made with lots of lemon juice, which is highly corrosive. It's eaten away your upper plate. I'll make you a new plate, and this time use chrome."

"Why chrome?" asks the patient.

To which the dentist replies, "It's simple. Everyone knows that -- there's no plate like chrome for the Hollandaise!"


DentistryUnited Ranks 5 on Google  for key word "Dentistry"



Delayed Implant Placement in an esthetic zone



MarcoIorio,   DMD, DDS, private practice in Castelletto Ticino (NO) Italy

Via G.Barberis 1

28053 Castelletto Ticino (NO)


Tel. +39-0331-973311+39-0331-973311

Fax +39-0331-968300


Initial presentation

The patient is a healthy 35 years-old Caucasian man, asking for replacement of tooth 2.4.





Three different treatment options were proposed to the patient:

1. Maryland Bridge

Limited tooth preparation

Acceptable esthetics (reduction of lightness of adjacent teeth)

Poor long-term prognosis

2. FPD

Good esthetics

Good long-term prognosis

Technically demanding (canine involved)

Extensive tooth preparation with unacceptable sacrifice        

of healthy adjacent tooth

3. Implant-supported single crown

Good esthetics

Good long-term prognosis

No tooth preparation

Surgery needed        

The patient chose the implant-supported treatment option.        





Implant placement

Under local anesthesia a buccally-based full

 thickness flap was raised. 

Primary incision started from the disto-palatal angle of the

canine and ended at the mesio-palatal angle of the second premolar.                            2

This incision continued intrasulcular to the mesio-buccal angle of the

 canine and to the disto-buccal angle of the second premolar,

where vertical releasing incisions were placed.

One 4x11,5 mm Nanotite Certain implant (Biomet-3i, West Palm Beach, FL, USA)

was placed in slight subcrestal vertical position.

No dehiscence or fenestration defects were present.






Image 3

Bone augmentation

Since buccal plate was less than 1.5 mm thick,

 a bone augmentation procedure was performed.

This GBR was NOT carried out for long-term implant

\ stability reasons, but only to obtain soft tissue stability.


A Bio-Oss (Geistlicht, Wolhusen, Switzerland) particulate

 graft was placed to increase buccal bone thickness.

The long-term resorption time of bovine hydroxylapatite

 ensures support to soft tissues in the long term.


Image 4

Membrane placement

A collagen membrane was placed over the

mineralized graft and over implant cover screw.

The membrane was fixed with two titanium tacks

(Frios, Mannheim, Germany) on the buccal aspect.


A periosteal releasing incision was performed to

 allow for tension-free suturing of the flap.




Image 5


This image shows site status three months

 after implant placement and GBR.

Note the modification of normal mucogingival

anatomy of the augmented site, with a subsequent

esthetic alteration.



Image 6

Second stage implant surgery

Occlusal view showing the position of mucogingival

 line, located near the crest of the ridge.

The incision to expose the implant should run from

 distal to mesial, tangent to the most palatal point of

implant’s cover screw.



Image 7

Provisional restoration

A standard provisional crown was relined on a

provisional titanium post during stage 2 surgery (left).

The crown was contoured with an ideal emergence

profile, both on palatal and buccal aspect.

A slight concavity was made on the buccal aspect,

to avoid soft tissue recession (right).



Image 8

Flap mobilization

Two short vertical incisions, together with a

 split-thickness elevation on the buccal aspect,

allow an apical reposition of the flap and

provide a stable periosteal bed for suturing.





Image 9


Single sutures anchored to the periosteum

allow apical repositioning of keratinized gingiva.





Image 10

Healing at 10 days

Clinical situation at suture removal.





Image 11

Healing at 2 months

The healing process was completely uneventful.

Note the papillary regeneration and the

 position of mucogingival line.





Image 12


It is impossible to transfer the anatomy

of the subgingival portion of the crown using a

standard transfer, in fact once the provisional

crown is removed, the unsupported gingiva

tends to collapse.

To precisely reproduce the emergence profile,

it is mandatory to build a custom-made transfer

coping. To do so a lab analog is connected to

the provisional restoration.



Image 13


Polyvinilsyloxane is used to take an

extraoral impression of the provisional restoration. 

The mixed impression material is wrapped

around the crown-analog complex and left to set.






Image 14


Once the material is set the provisional

 crown is removed from the analog.



Image 15


A standard impression coping is connected to the lab analog.







Image 16


Self-curing acrylic resin is poured in the

space between the coping and the

 impression material and left to completely set.


Image 17


It is possible to make an exact replica of the

emergence profile of the provisional restoration.

Image 18


The modified transfer is connected to

the implant, providing soft tissue support.



Image 19


An open-tray pick-up impression is taken,

sing polyether material

(Impregum F, 3M Espe AG, Seefeld, Germany).

Once the impression is poured, the dental

technician only needs to fill in the space left by

the transfer with the ceramic of the definitive crown.


Image 20

Final restoration

A collarless PFM single crown on a milled

 zirconium abutment

(ZiReal, Biomet-3i, West Palm Beach, FL, USA)

was made.


Image 21

Healed gingiva

Occlusal view of mucous canal

immediately before the delivery

of the final crown.


Image 22

Abutment connection

Zirconium abutment is placed on the

implant and the connection screw is torqued

 at 20 Ncm.


Image 23

Final restoration

Buccal appearance of the

final crown in place.




 IDEM SINGAPORE online registration open



One of the biggest events of dentistry "IDEM" singapore now opens online registraions.The IDEM sinpgapore which is scheduled for April 4-6/2008  . Click here to register