Dr Sravan Chunduru in Adelaide, South Australia | Medical and health

Dr Sravan Chunduru

Locality: Adelaide, South Australia

Phone: +61 8 8212 5294

Address: Suite 11, Level 6, 55 Gawler Place 5000 Adelaide, SA, Australia

Website: http://www.adelaidecad.com.au/

Likes: 3483

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• Medical and health
• Dentist & dental surgery
• Cosmetic dentist
• Prosthodontist

21.01.2022 Stopped by at a pet store today to get some supplies, particularly for the upcoming cold snap in Adelaide. At the cashier the parrot was calm and tame and somewhat inquisitive about us, considering I had a loud and wriggly toddler on my shoulders (was up there because she wanted to see the bird).

20.01.2022 Diagnosis of 'Combination Syndrome' Although this was a case of making a lovely lower partial denture, the diagnostic process identified features of 'combination syndrome'. Because it was identified, the approach to clinical steps was altered, in particular the jaw relation to avoid overloading the anterior maxilla, and perpetuating the degenerative cycle. Features were first described by Kelly in 1976, and it includes:... - Bony loss in anterior maxilla - Flabby soft tissues in anterior maxilla - Hyperplasia of tissues in tuberosity regions These features are seen in these series of photos. It is often thought to be caused by an anterior only occlusion, either due to no lower posterior teeth or poorly fitting lower dentures. The poor fit can occur due to ridge resorption and can happen if dentures are not reviewed and maintained on a regular basis. How do you prevent it? Kelly advocated for preservation of as many posterior teeth in the mandible as possible, or use of dental implants which would reduce the impact of ridge resorption in the lower denture. Otherwise, they need to be regularly checked and optimised via denture maintenance. All denture patients need to have their dentures and tissues reviewed on regular basis. Lower distal extension partials should have a solid fit on the gums and good occlusion on the posteriors. If not, it should be relined or teeth replaced. Please like, share and comment if you enjoyed the content!

19.01.2022 Our thoughts are with those in Victoria who have had a surge in COVID-19 infections. Melbourne is my hometown with my family and many friends being there so I hope things settle down soon. I hope everyone stays safe, practicing good hand hygiene and physical distancing. The picture is of one our road trips through the Great Ocean Road in 2015. It was a notable trip because only a few days before one of the 'Apostles' had just crumbled.

17.01.2022 Maxillofacial Prosthesis A patient presented to replace an ill fitting acyrlic denture. He reports it no longer fitted after a fracture and repair. This was after a tumour removal and mandibular resection, and recontruction with a fibula bone and skin flap (note the hair). A combination of digital and analogue workflow used to fabricated a lower partial prosthesis to reconstruct a mandibular dentition. ... The digital scan produced a very accurately fitting printed chrome around the teeth but not from the lower right tissues. It is important to obtain support from both teeth and tissues. However the scan cannot replicate the compression of the tissues required. When tissues are very movable and compressible, the analogue workflow shined, with multiple layers of heavy body PVS, functional impression and alginate pickup impression in order to generate a new master cast prior to processing the acrylic. Some of the teeth required some more adjustment after processing to refine the occlusion. The patient overall is happy with his new prosthesis. Labwork by Dental Devices by Jason (SA, Australia)

16.01.2022 This was taken on our last visit to Melbourne in what seems like ages ago. We snapped our daughter feeding her little toy shark some of her babycino, after a visit to the aquarium. It brings home her nurturing nature and we hope that she continues to do so with her soon to-be baby sibling. We love you . #melbourneaquarium #melbourne #babycino #babyshark #portraitphotography #pixelphotography #mobilephotography #bigsister

14.01.2022 Our baby daughter, stalking the local birds! She didn't get to catch it, instead almost gave me a heart attack when she suddenly bolted for the bird!

14.01.2022 Full Mouth Reconstruction (FMR) Do you salivate over the FMR and think that you'll get to see lovely crown preps or porcelain work? Lets go back to the most basic of FMR, and that's the complete denture! We start with the aesthetic and functional determinants of the smile which has been set in denture literature. Then consideration of the functional determinants such as speech and vertical dimension.... Ultimately we have complete control of where each and every tooth is positioned in 3D space and its up to a combination of art and science to determine what's likely to work for each patient. If you have existing teeth, you may have a bit of a head start. The case shown is an aggressive periodontal disease cases where the patient was continuing to exfoliate teeth in recent times. We decided not to use a custom tray to take a secondary impression, as we were worried that we would exfoliate more teeth if we took too many impressions. In the maxilla we did a two part impression with alginate and bite reg material on the labial of the anterior teeth. These were super glued back together once out of the mouth ready to be casted into stone. Then the ideal positions of teeth were determined clinically and communicated to the laboratory through photographs and drawing/marking the casts. This was a collaborative effort with Dr Mandranis at @adelaidedental_ (for the dental extractions) and Toothworx @adelaidedentallab for the laboratory work and myself for the clinical stages of denture fabrication.

13.01.2022 Primary Impressions Don't be afraid to make "customise" your stock trays in order to fit the various anatomical structures you'll come across. In this example, we have a moderate to severely resorbed ridge with a steep retromolar pad. The posterior region of the tray was cut back to reduce distortion of the retromolar pads during seating. The dark blue periphery wax was positioned as tissue stops to ensure the posterior ends of the tray doesn't sink too much into the sulcuses... and miss the retromolar pads completely! The use of tissue stops also aids keeping the trays higher, so the fingers and tray handle has less distortion of the lower lip. What other modifications to stock trays do dental professionals use? Please like, comment, and share with others who may find this useful!

12.01.2022 Tips for Custom Impression of Flabby Anterior Maxilla Continuation of the Last post on Flabby Ridges! Here are some tips for getting the best possible secondary impression in an edentulous maxilla with flabby ridges.... - Mark out the flabby areas on primary impression or cast - Areas of significant mobility should have either a lot of spacer in custom tray, or no tray over it at all (open) - Encourage patient to NOT wear their old denture for a few hours before the appointment, to get the tissues more relaxed and less distorted or compressed - Border mould tissues with a slight push/pressure in apical-palatal direction - Wash impression may need to be done once or twice depending on how much of the flabby tissue can be covered with the light body material - Second light body wash can be limited to the open areas not accurately impressed by the first light body wash - If light body is thin (particularly in the open region), reinforce with a stiffer material (eg bite registration paste) to assist in pouring up the impression - Trim impressions and place back intraorally to verify retention and support, prior to pouring up the impression Please like, comment, and share if you have enjoyed these tips.

11.01.2022 Did you know that thumb sucking habit can have long-term impacts on craniofacial development? It's important to monitor this and eventually discourage them from sucking their thumb. Sometimes this habit starts really early in life! This ultrasound shows that children can exhibit this habit in-utero. This example was kindly modelled by my unborn second child, and sibling to our daughter!

11.01.2022 Watching out for flabby tissues A common sign in a maxillary impression that you may have a flabby ridge is distinct notch in the labial region of the maxillary anterior. As bone is destroyed and dentures compresses the maxillary anterior, it generates a notch, which is usually very visible on the alginate impression. In addition to flabby maxillary anterior, there is mobile hypertrophic tissues in the maxillary tuberosity regions.... All of this forms a very common appearance of a maxilla undergoing "combination syndrome" changes. Yes this patient has a poorly fitting mandibular partial denture! Only the natural anterior teeth reamain in occlusion which is the most common trigger of these changes. For this case, because this was identified, a detailed analysis of the tissues and careful marking of the impression will guide the special tray design. Will will want no pressure in the anterior and minimal pressure in the tuberosity regions. Please like, comment and share if you have enjoyed this tip. @ Adelaide CAD - Centre for Advanced Dentistry

11.01.2022 Return of the Window Denture If you remember a few months ago I posted an image about maintaining a lower tooth while still aiming for a peripheral seal. The wonderful social media community gave a lot of discussion, love and feedback when we first introduced this case many months ago (it even got plagiarised!). An update to this story is the patient involved functioned with his lower denture (and an immediate upper denture) for over 7 months. ... We decided to remake as there were a few things he wanted changed that could not be achieved in a reline. In this remake we added to hopefully improve the retention around the existing tooth. The photo and video shows how the lower denture is inserted and removed. The retention is satisfying! Please comment and like if you enjoy my videography and narration. I may make more videos if everyone finds it useful. Labwork by Toothworx, SA

11.01.2022 Importance of Posterior Support This case illustrates the role of posterior support in the management of maxillary anterior flabby ridge. In his case the patient has never had a lower denture but decided to get one because one of the lower anterior teeth had to be extracted.The maxilla has an existing satisfactory complete denture which the patient chose not to remake.... The typical characteristics of combination syndrome was first described in dental literature by Kelly in 1972. The most notable of these is the destruction of maxillary anterior hard tissues due to excess force by remaining mandibular dentition. The goal of the new lower denture is to change the occlusion to obtain stability from the posterior regions. This will hopefully halt or slow down the pathologic changes. The framework was designed to allow for tooth additions in the future. Like, comment and share if you enjoy these videos.

07.01.2022 Dahl Reconstruction Traditional reconstruction of localised anterior wear would involve either highly invasive treatment such as elective root canal treatment, post core and crown, or full mouth reconstruction with increase in Occlusal Vertical Dimension. Both has high costs, one is biological, the other being the extent of treatment/cost. Is there a way of going somewhere in between?... Composite resin rehabilitation of just the anterior region, also known as the Dahl concept of rehabilitation involved increasing the vertical dimension anteriorly and letting posterior teeth re-erupt to gain posterior contact over time. In the past Dahl rehabilitations were done by making 'palatal veneers' in chrome castings. Once posterior occlusion was re-establised, the anteriors would be restored with the clinician's restorations of choice. How long would this treatment last? It is agreed among a few authors (Hemmings 2000, Gulamali et al 2011) that this is considered a short to medium-term treatment and many of these restorations are likely require maintenance or replacement over 10 years. This patient is well aware of the discomfort invovled with not being able to chew with his posteriors as well as the short-medium term nature of this treatment. He understands he would either need to re-do or replace these restorations within the first 10 years. However we knew his self-confidence would improve, which was confirmed after doing a diagnostic mockup in composite. He also knows that in time replace these composites with ceramics in the future once the remaining teeth re-erupt. He knows his management has not finished, and that it has only just begun! Wish us luck.

05.01.2022 An intriguing piece of street art recently erected in Gawler Place/Rundle Mall junction, and very close to our surgery Adelaide CAD - Centre for Advanced Dentistry . I can imagine my front desk staff directing our patients to look for the mirrored pigeon . Credit to Paul Sloan for creating such an interesting piece for our city. #rundlemall #gawlerplace #cityofadelaide #adelaide #southaustralia #dentalclinic #pixelphotography #phonephotography #pigeon #streetart #sculptures #wherearewe

04.01.2022 It's Sani again, begging for more treats. Scruffy as ever! #animalphotogtaphy #terriersofinstagram #aussieterrier #dogsofinstgram #animalcloseups #animalportrait #inyourface #dogswithfeelings #pixelphotography #mobilephotography #dogwatching