Dear Colleagues,

Firstly, wishing you and your families a very Spring 2025! Though it came a bit early this year, we are grateful for the fewer snow day related office closures this winter! We hope this message finds you healthy and prosperous! We are excited to share this newsletter with you about some information our office and a few recent cases and a few clinical pearls to help you in your practice.

Our office is staffed by 2 Board Certified Prosthodontists- Dr. Avinash Bidra and Dr. Xiao Chun Li who are committed to excellence and offer only the highest quality of dental treatment. Dr. Bidra also serves as Director of the Prosthodontics Residency Program at UConn Dental School in Farmington, CT. (Go Huskies! NCCA champions!) Our office is located right in the center of Glastonbury and we serve patients who travel from various parts of Connecticut and across the country.

As specialists, we are not only committed to helping patients with advanced dental needs, but also committed to helping other dentists who need help serving their own patients. Whether you are looking to just get some guidance on difficult cases that you want to complete on your own, or stuck halfway or need help referring patients with complex situations such as occlusal plane issues, vertical dimension challenges, multiple failing teeth, restorative space issues, or bone grafting failures or implant misangulation or implant failures, we are here to help! As an educator for 15 years, Dr. Bidra loves to teach!

We will offer complimentary consultation for your patients and refer them back to you for their maintenance after treatment is complete. We are out of network with all dental insurances but will offer your patients a very fair and reasonable price for their treatment. Our office is certified for IV sedation and we will provide a safe and comfortable “one stop” experience for their dental treatment. Please check out the cases of the month and please visit our website at for additional such cases. Thank you for your time and look forward to working with you!
 

This young rapper was referred to Dr Bidra from his general dentist from New York as he had aggressive periodontal disease from a young age. Patient had generalized mobility of his teeth and was told by 2 periodontists that he had a lot of bone loss and required major bone grafting for fixed prostheses or could only get snap-on overdentures. After CBCT evaluation and treatment planning, systematic angulation of the implants were planned. Full mouth extractions and double jaw All on 4 treatment was completed with immediate loading following the Teeth in a Day protocol. No bone grafting was done which was a significant advantage to the patient and the patient eventually received Monolithic zirconia bridges. Total time in treatment was 7 months. Patient requested the brightest shade of teeth possible to suit his esthetic desires and was ecstatic has given full permission to share his full face photographs.

The patient was referred to Dr. Li by her dentist to address her central incisors. There was decay in the central incisors, chipping and patient expressed significant esthetic concerns about her smile. Treatment was challenging due to the need for a shade match with natural incisors of subtle variations in color and translucency, as well as the patient’s high dental anxiety. Oral anxiolysis was employed and allowed the patient to remain calm and comfortable throughout the procedure. The final result achieved healthy hard and soft tissues, with well blending lithium disilicate porcelain veneer restorations. The treatment was completed within 4 weeks.

Specify custom abutment margin levels in your lab prescription!

When a screw-retained implant crown is not possible, a custom abutment and a cement retained crown is an excellent alternative. Most dentists request a custom abutment from the dental laboratory without any specifications of the margin levels. As a result, most laboratory technicians create deep margins (to avoid any margin exposure in the mouth) and then fabricate a cement-retained crown.

This can result in catastrophic problems due excessive residual cement going deep down in the peri-implant sulcus, being impossible to clean up and result in cement induced peri-implantitis. Lack of proper specification on the dental laboratory prescription (considered a legal record of medicine) can also result in medical-legal consequences. In the table below, is the suggested depth to be specified on your lab prescription. In non-esthetic regions (palatal/lingual surfaces, posterior proximal surfaces) it is best to have the margin either supra-gingival or equigingival for easy clean-up of cement. In the esthetic region, the margin depth should be no more than 0.5mm subgingival or else the residual cement clean up will become very difficult without traumatizing the delicate peri-implant soft tissues in the esthetic region.

All the best with your next crown cementation!

We offer complimentary consultations and will refer patients back to you for maintenance after treatment is complete.