About

Dr. Smiti Bhardwaj is working as Senior Scientist- Implantology at Maulana Azad Institute of Dental Sciences since 2015. In her tenure she has been involved in the designing and clinical testing of indigenously developed dental implants. Her efforts have aided in the government approval and industry manufacturing of the implants. With the confluence of efforts of the Dental implant development research team at Maulana Azad institute of Dental Sciences and Indian Institute of Technology- Delhi, under the aegis of CSIR, the Dental Implant Development Project was awarded a letter of appreciation from the Prime Minister’s Office in 2019. The developed Dental implant also now possesses both U.S and India Patent.

Currently, she is pursuing research in enhancing the surface characteristics and assessing the clinical ramifications of nano-topographic dental implant surface. Alongside, she is also actively engaged in clinical training and education of graduate and post graduate students. She actively pursues and reinforces adept treatment planning. During her long-term association with the field, she has gained significant experience in addressing implant and peri-implant complications.

Dr. Bhardwaj completed her post-graduation in Periodontics and Implantology from Rajiv Gandhi University of Health Sciences with 2nd University rank and secured Ist position at her institute at Krishnadevaraya Institute of Dental Sciences, Bangalore. During her studies she completed an independent research project on peri-implant inflammation, which got published in an international indexed journal and was well received and cited. Her dissertation on the link of periodontitis and systemic inflammation got published in a high-impact factor international journal as well.

She was awarded on multiple occasions for her merit in academics during her graduation from ITS- CDSR, Muradnagar. She has been awarded with Best paper and poster presentations at Indian Society of Periodontics and ISOI conferences. Alongside she has chaired multiple paper presentation sessions. Lately, she has also presented a paper on ‘Failures in Implantology’ at IADR Asia Pacific Conference in 2022. She is a reviewer to reputed journals and has many original research publications in indexed National and International Journals to her credit. Dr. Bhardwaj serves as member of various professional bodies such as Indian Society of Periodontics and Indian Society of Dental Research.

Abstract

Table Clinic Seminar 

TITLE: Enhancing predictability of trephine-assisted explantation of fractured osseointegrated dental implants

Explantation of osseointegrated dental implants presents a challenge to the surgeons. The most non-invasive technique recommended for explantation is the Reverse Torque Technique (RTT). However, in cases presenting with fractured crest or internal channel, RTT cannot always be implemented.

Trephine assisted surgical explantation has been presented as a relatively invasive technique that may cause injury to adjoining vital structures and lead to an increased loss of peri-implant bone. Lack of real time orientation of the implants beneath the osseous crest adds to the unpredictability. Unguided use of trephines may lead to cortex perforation, vascular injuries, and consequences thereof. Considering the possibility of future implant placement, efforts should be made to minimize the bone loss around fractured dental implants during explantation. Orientation of the trephines along the length of the implant can make the explantation procedure less damaging to the bone and more predictable for the surgeons.

Use of surgical guides can best orient the trephines along the length of the implant. However, fabrication of surgical guides may not always be possible considering lack of required resources. In this presentation, various techniques are described to surgically explant osseointegrated dental implants presenting with horizontal and linear fractures. Chairside tips and techniques are also included to increase the predictability and reduce the invasiveness of trephine assisted dental implant removal. 

AUTHORS: Prof. Dr. Mahesh Verma, Dr. Smiti Bhardwaj, Dr. Harsimran Kaur