Protrusive Dental Podcast

Can adults really expand their maxilla? Is treating sleep apnea with a CPAP or mandibular advancement device only MASKING the problem? How does craniofacial anatomy influence airway health, and what should dentists look for? Dr. Dave Singh joins us to dive into CranioFacial Sleep Medicine. He breaks down how structural issues—like a narrow maxilla, high-arched palate, or limited tongue space—can be root causes of sleep-disordered breathing, rather than just treating symptoms.  The episode also touches on controversies in orthodontics and presents evidence supporting interventions once thought impossible in adults. https://youtu.be/WUyeOjKquJU Watch PDP253 on Youtube Protrusive Dental Pearl: Obstructive Sleep Apnea is NOT just a “fat old man disease.” If you’re not screening every patient for sleep and airway issues, you’re missing a huge piece of their overall health. Snoring, bruxism, and craniofacial anatomy are all connected, and understanding these links can transform the way you approach patient care. Key Takeaways: Mandibular advancement appliances are not a universal solution. While effective for some patients, they often fail to address the underlying causes of airway collapse. Craniofacial sleep medicine focuses on airway etiology, not just symptom control, by identifying why the mandible, tongue, and airway behave as they do during sleep. The cranial base plays a foundational role in facial growth, jaw position, and airway size, directly influencing sleep apnea risk. A retruded mandible is frequently due to developmental and epigenetic factors, rather than being an isolated mandibular issue. Sleep apnea has multiple endotypes—including craniofacial, neurologic, metabolic, and myopathic—requiring individualized treatment planning. Bruxism is not a reliable airway-opening mechanism and may be a primitive physiological response to hypoxia rather than a protective behavior. Tooth wear can be an early indicator of sleep-disordered breathing, and should prompt clinicians to screen beyond restorative concerns. Upper Airway Resistance Syndrome (UARS) can occur even when the apnea-hypopnea index (AHI) is low, particularly in non-obese patients with fatigue, pain, and poor sleep quality. Palatal expansion should be understood as a 3D craniofacial intervention, aimed at improving nasal airflow and airway function—not merely widening the dental arch. Effective care depends on an integrated, multidisciplinary approach, involving dentists, orthodontists, sleep physicians, ENTs, and myofunctional therapists. Youtube Highlights: 00:00 Teaser 01:01 Introduction 02:56 Pearl: Debunking Myths About Sleep Apnea 04:27 Interview with Professor Dave Singh: Journey and Insights 13:23 Craniofacial Development 18:53 Epigenetics and Orthodontic Controversies 25:52 Diagnosis and Treatment of Sleep Apnea 32:49 Understanding Upper Airway Resistance Syndrome 34:17 Midroll 37:38 Understanding Upper Airway Resistance Syndrome 39:45 Diagnosing Sleep Disorders and Treatment Modalities 43:58 Exploring Bruxism and Its Hypotheses 45:19 CPAP and Alternative Treatments for Sleep Apnea 48:12 Managing Upper Airway Resistance Syndrome 55:11 Integrative Approach to Sleep Disorder Management 57:17 Diagnostic Protocols and Imaging Techniques 01:02:25 The Importance of Proper Device Fit and Function 01:07:16 Upcoming Events and Further Learning Opportunities 01:09:56 Outro ✨ Don’t Miss Out: Practical, anatomy-based approaches to sleep and airway management for dentists and specialists 📅 Event: Introduction to Craniofacial Sleep Medicine 📍 Location: Marriott Hotel, London Heathrow 💷 Course Price: £2,495 🐦 Early Bird Registration: £1,996 🎟️ Discount Code: Use “earlybird20” at checkout 🌐 Learn More: Visit REMA Sleep for details on courses, devices, and craniofacial sleep medicine resources. 🚀 Try Protrusive AI aka AskJaz today: Explore clinical reasoning and educational support directly within the Protrusive Guidance App! If you loved this episode, watch 5 Airway Patients In Your Dental Practice Right Now with Dr Liz Turner – PDP226 #PDPMainEpisodes #OcclusionTMDandSplints #BreadandButterDentistry This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcome C. AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Sleep medicine) Aim: To understand the craniofacial and dental considerations in managing sleep-disordered breathing, including the role of mandibular advancement, palatal expansion, and integrative dental approaches in sleep medicine. Dentists will be able to – Describe the craniofacial factors contributing to sleep-disordered breathing and upper airway resistance syndrome (UARS). Explain the mechanisms, indications, and limitations of mandibular advancement devices and palatal expansion in dental sleep medicine. Integrate diagnostic findings, craniofacial assessment, and interdisciplinary collaboration to formulate individualized treatment plans for patients with sleep-disordered breathing.

Happy New Year, Protruserati ✨ As 2025 comes to a close, we wanted to pause and reflect by revisiting the moments that genuinely shaped how we practise, think, and show up in the clinic. This Best of 2025 episode starts with restorative and aesthetics, moves through digital workflows, endo, paediatrics, surgery, communication, and finishes with what sustains us over a long career. These are the clips that made me pause, rethink, and quietly adjust how I work – and I hope they do the same for you. Some of the ideas you’ll hear in this episode include: Predictable ways to manage wear and space without over-treating Small restorative and material choices that have a big impact long-term Practical digital workflows that genuinely improve accuracy and efficiency Endo fundamentals that reduce stress and increase consistency Clear clinical judgement for paediatrics, surgery, and medical emergencies Communication habits that build trust without using jargon Simple, sustainable ways to protect your body, health, and curiosity https://youtu.be/rsOxnzlYUkc Watch the Best of 2025 on YouTube Also, AskJaz is here!📢 AskJaz (JazAI) is built to solve a simple problem: knowing what to do next without digging through endless content. Need quick guidance on a tricky case? Not sure which cement to use? Need help with a lab prescription? AskJaz has you covered.😉 It provides 24/7 support, allowing you to ask questions at any time and receive clear, direct responses. You can even talk to Jaz in your own language, making the guidance easier to understand and apply—especially in fast-paced clinical situations. AskJaz is available by upgrading to the Ultimate Clinical Education Plan, where it’s currently included. This gives you full access to AskJaz alongside premium masterclasses, CPD features, and advanced clinical resources inside the app. If you join or upgrade on or before January 11, AskJaz is included with your Ultimate membership for as long as your account remains in good standing. From January 12, a new Ultimate+ Plan will launch at a higher price—and that will be the only way new members can access AskJaz. So if you’ve been thinking about upgrading or joining the app, this is a very good moment. A Heartfelt Thank You To every guest who sat down with me this year and shared their knowledge, their stories, their hard-won wisdom — thank you. You made us all better clinicians. And to you — for listening, for questioning, for caring enough to keep learning even when you’re exhausted, even when the day’s been long, even when it feels like there’s always more to know. You’re the reason this podcast exists. You’re the reason I keep doing this. Thank you for being here. Thank you for being part of this community. Thank you for showing up, year after year. Here’s to 2026. Here’s to more conversations. Here’s to all of us getting just a little bit better. Until next year, keep learning, keep caring, and keep doing the dentistry that makes you proud.

Do your patients really have two bites? Does their bite change when they lie down? When they sleep? And how can you explain centric relation, posture, and deprogramming in a way that patients actually understand? Dr. Bobby Supple joins Jaz for a powerful episode unpacking one of the most misunderstood topics in occlusion: the daytime chewing bite versus the nighttime airway bite. After spending days with Bobby in his New Mexico clinic, Jaz saw firsthand how simply and elegantly Bobby communicates concepts that usually leave patients — and dentists — confused. Together, they explore why bite discrepancies exist, what happens when the condyles fully seat, and how aligning Bite One and Bite Two over time can transform patient comfort and restorative outcomes. https://youtu.be/EC_qxUF7GxI Watch PDP252 on YouTube Protrusive Dental Pearl  When assessing abfractions, always check the patient’s bite in two positions: seated upright and lying back.  Posture subtly shifts the condylar position and can change how forces load the tooth. Want more gems like this? AskJaz — your on-demand dental brain, will be soon baked right into the Protrusive App. Key Takeaways: Every patient has two bites — their upright chewing bite and their horizontal airway bite. Posture changes the condylar position more than we realise. Clear communication can make complex occlusion concepts instantly understandable. Aligning Bite One and Bite Two over time leads to healthier joints and more predictable dentistry. Highlights of this episode: 03:36  Pearl – Assessing Abfractions  06:47 Dr. Bobby Supple’s Journey to Dentistry 10:46 Confusion Around Centric Relation 13:22 Exploring T-Scan Technology 21:40 The Evolution of Digital Occlusion 27:05 Effect of Sitting vs. Reclined Position 32:03 Airway and Skeletal Asymmetry 37:19 Bite Philosophy and Treatment 42:10 Orthotics and Long-term Care 52:13 Preventive Dental Care 58:18 Ask Jaz AI (Beta Launch) 🎓 Join the world’s leading organization dedicated to occlusion, temporomandibular disorders (TMD), and restorative excellence — the American Equilibration Society (AES). 🗓️ AES Annual Meeting 2026 – “The Evolution of the Oral Physician”  📍 February 18–19, 2026 · Chicago, Illinois Papers & Literature: Dr. Bobby’s Top Picks Evolving digital patterns Introduction to force scanning 5 ways to use T-Scan Digital Occlusion–From paper marks to digital force mapping Discover Dr. Robert Kerstein’s guide to Measured Digital Occlusion and T-Scan technology.  Dive deeper into occlusion with Dr. Bobby Supple on Occlusion Wars II: Beyond Teeth – PDP101 #PDPMainEpisodes #OcclusionTMDandSplints #BestofProtrusive This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C AGD Subject Code: 180 OCCLUSION Aim: To enhance clinicians’ understanding of the “two bites” concept, the role of condylar position in occlusal health, the use of T-Scan in diagnosing occlusal force patterns, and the long-term prevention-based approach to managing occlusal stress, abfractions, and TMJ remodeling. Dentists will be able to – Explain the concept of patients having “two bites” (MIP bite vs. airway/postural bite) and describe how posture influences mandibular position. Identify occlusal stress patterns using clinical examination and digital tools (e.g., T-Scan) to recognise overloads that may contribute to abfractions, cracks, or TMJ symptoms. Apply a long-term, preventive approach to occlusal management that aims to harmonise daytime and nighttime bites while supporting joint remodeling through appropriate orthotic therapy.

How do you balance a high-performance dental career with being an effective parent? What strategies help you stay sane amidst the organized chaos of family life? How can showing up as your best self benefit both your patients and your children? Dr. Shandy Vijayan and Dr. Raabiha Maan join Jaz in this nonclinical episode to share their experiences of parenthood in dentistry. From the unique perspectives of two dentist-moms and the dad viewpoint, they discuss the real-life challenges of raising children while maintaining personal well-being. They also share practical tips, book recommendations, and actionable strategies for self-care and emotional regulation—helping you create a balanced family life while thriving in your career. During the episode, Jaz also mentions KARRI — a fun, screen-free voice messenger that helps kids stay safely connected with parents and friends, without social media or internet access. Loved by kids. Trusted by parents. Get 50% off via: www.protrusive.co.uk/karri https://youtu.be/F-Tp83_tuco Watch IC065 on Youtube Key Takeaways Life comes in “seasons”; early parenting (~0–8 yrs) is intense but temporary. Reduce clinical load early to focus on children; career focus increases after ~12 yrs. Prioritize time with kids over tasks; coordinated parenting schedules help. House help significantly reduces stress, frees energy for quality interactions. Support networks (family, in-laws, professional communities) are essential. Grandparents: allow flexibility; avoid micromanaging childcare. Returning to work: stress, costs (GDC, indemnity, childcare), skill gaps, guilt. Dentistry = high-performance + emotional labor; manage energy carefully. Quick mental reset between work/home recommended; part-time can boost longevity. Parent happiness + strong parental relationship = major factor in kids’ emotional regulation. Run family like a small business: systems, schedules, clear roles. Self-regulation, EQ, and self-care benefit family, patients, and professional life. Highlights of this episode: 00:00 Teaser 01:00 Intro 02:50 Shandy’s Story: Juggling Multiple Clinics 08:11 Raabiha’s Story: Managing a Practice and Family 08:58 Interjection 16:03 Raabiha’s Story: Managing a Practice and Family 18:17 Life Seasons and Reducing Clinical Commitment 21:05 The Value of Help and Support Networks 27:00 Financial and Emotional Challenges in Dentistry 33:03 Midroll 36:22 Financial and Emotional Challenges in Dentistry 36:24 Balancing Work and Home Life 42:26 Time Management and Setting Boundaries 46:51 Self-Care and Emotional Regulation 53:53 Upcoming Wellness Event 59:01 Final Thoughts and Future Ideas 59:49 Outro Ready to take the next step? Check out this great resource for new dentists and trainees: Dentistry in a Nutshell Join the community at the Dental Mums Network to connect with dentist‑parents balancing clinical work and family life. Revive 2026 – A Wellness Event Like No Other (6 hours CPD) 🗓 Saturday 24th January 2026 📍 Leonardo Royal Hotel, St Paul’s, London Revive 2026 is your invitation to pause, breathe, and reconnect- a full-day experience designed for women in dentistry who are ready to start the year with purpose, calm, and clarity. Loved this? Dive deeper into Parenthood and Dentistry – IC025 (Even If You’re Not a Parent!) #InterferenceCast #BeyondDentistry #Communication This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcome: B AGD Subject Code: 770 SELF IMPROVEMENT Aim: To explore strategies for managing work-life balance in dentistry, focusing on early parenthood, emotional regulation, and professional sustainability. Dentists will be able to – Describe key challenges dentists face balancing clinical practice with early parenthood. Identify practical strategies for maintaining emotional energy, setting boundaries, and creating support networks. Apply approaches to integrate self-care, household management, and EQ development to enhance personal and professional well-being.

Thinking of moving to the USA as a dentist? Wondering what exams, applications, and documents you’ll need to practice or specialize there? Curious about how much it costs — and what life as a dentist in the States is really like? Dr. Hazel Kerr and Dr. Dorrin Reyhani join Jaz for a deep dive into everything you need to know about moving to America as a dentist. Both UK-trained and now faculty at UPenn, they share their personal journeys and break down the full pathway — from exams like the INBDE and TOEFL, to transcripts, personal statements, and application timelines. They also discuss what it’s like working in the US compared to the UK, including earning potential, patient culture, and training opportunities. Whether you want to complete an advanced standing program, pursue a specialty, or bring your skills back home, this episode gives you a clear roadmap to make it happen. https://youtu.be/Ro9dljETKpc Watch IC065 on YouTube Key Takeaways The journey to becoming a dentist varies significantly by country. Specializing in dentistry can open more opportunities than general practice. Board certification enhances professional status and may offer insurance benefits. International dentists have specific routes to practice in the US. Scholarships can significantly reduce the financial burden of dental education. Teaching positions can provide pathways to practice without additional costs. Faculty primarily teach and supervise dental students in clinics. Early preparation for the INBD exam is crucial for success. Clinical experience and a strong portfolio are essential for applications. Networking and externships can enhance application prospects. Understanding the application process can alleviate stress for international students. Cultural differences impact how dental care is valued and perceived. Highlights of this episode: 00:00 Teaser 00:55 Introduction 04:15 Journey to Specialization 12:49 Understanding the Certification and Board Process 15:35 Exploring Different Routes for International Dentists 18:17 Financial Considerations and Scholarships 25:48 US Difficulty and Competitiveness 29:35 Choosing Between General and Specialty Routes 31:11 Navigating State-Specific Licensing 33:28 Teaching and Clinical Responsibilities 35:03 Midroll 38:24 Teaching and Clinical Responsibilities 43:01 Application Process and Exams 52:07 Residency and Career Pathways 57:39 Application Portals 01:00:35 Work Experience Before Specialization 01:03:22 Why Dentists Choose to Work in the US 01:09:36 Finishing the Program and Looking Ahead 01:12:01 Outro If you enjoyed this episode, you’ll definitely be inspired by The American Dental Dream – PDP002. #InterferenceCast #CareerDevelopmentThis episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan.

You’re doing a routine exam when you spot it – a stained hairline crack snaking across the marginal ridge of a molar. Your patient hasn’t mentioned any symptoms… Yet. Should you sound the alarm? Monitor and wait? Jump straight to treatment? Cracked teeth are one of dentistry’s most misunderstood diagnoses. Colleagues debate whether to crown or monitor. And that crack you’re staring at? It could stay dormant for years—or spiral into an extraction by next month. So what separates the teeth that crack catastrophically from those that quietly hold together? In this episode, I am joined by final-year dental student Emma to crack the code (pun intended) on cracked tooth syndrome.  We break down the easy-to-remember “position, force, time” framework to help you spot risk factors before disaster strikes, and share a real-world case of a 19-year-old bruxist whose molar was saved by smart occlusal thinking. If you’ve ever felt uncertain about diagnosing, explaining, or managing cracked teeth, this episode will change how you think about every suspicious line you see. https://youtu.be/mU8mM8ZNIVU Watch PS019 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Risk factors include large restorations and bruxism. Occlusion plays a significant role in tooth health. Diet can impact the integrity of teeth. Every patient presents unique challenges in treatment. Communication about dental issues is key for patient care. Certain teeth are more prone to fractures due to their anatomy. The weakest link theory explains why some patients experience more dental issues. Patient history is crucial in predicting future dental problems. The age and dental history of a patient influence treatment decisions. Understanding occlusion is essential for diagnosing and treating cracked teeth. The location of a tooth affects the force it experiences during chewing. Bruxism increases the risk of tooth fractures. Tooth contacts and forces play a critical role in diagnosing issues. Opposing teeth can provide valuable insights into tooth health. Effective communication is essential in managing cracked teeth. Stains on teeth can indicate deeper issues with cracks. Monitoring and documenting cracks over time is crucial for patient care. Highlights of this episode: 00:00 Teaser 00:49 Intro 03:25 Emma’s Dental School Updates 07:18 What is Cracked Tooth Syndrome (CTS)? 10:02 Crack Progression and Severity 12:45 Risk Factors 14:54 Position–Force–Time Framework 21:53 Which Teeth Fracture Most Often? 25:32 Midroll 28:53 Which Teeth Fracture Most Often? 30:37 The Weakest Link Theory 34:05 Diagnostic Tools 37:56 Treatment Planning 39:42 Case Study – High Force Patient 47:27 Communication and Patient Management 51:03 Key Clinician Takeaways 53:03 Conclusion and Next Episode Preview 53:42 Outro Check out the AAE cracked teeth and root fracture guide for excellent visuals and classification details. Literature review on cracked teeth – examines evidence around risk factors, prevention, diagnosis, and treatment of cracked teeth. Want to learn more about cracked teeth? Have a listen to PDP028 and PDP098 – both packed with practical tips and case-based insights. #BreadAndButterDentistry #PDPMainEpisodes #OcclusionTMDandSplints This episode is eligible for 0.75 CE credits via the quiz on Protrusive Guidance.  This episode contributes to the following GDC development outcomes: Outcome C   AGD Subject Code: 250 – Operative (Restorative) Dentistry Aim: To help dental professionals understand the causes, diagnosis, and management of cracked teeth through a practical, evidence-based approach. It focuses on identifying risk factors using the Position–Force–Time framework and improving patient outcomes through informed communication and tailored treatment planning. Dentists will be able to: Explain the aetiology and progression of cracked tooth syndrome Identify high-risk teeth and patient factors—such as restoration design, occlusal contacts, and parafunctional habits—that predispose to cracks Communicate effectively with patients about the significance of cracks, prognosis, and monitoring options, improving patient understanding and consent.

Are you confident in spotting a child at risk of neglect? Do you know what to do if you witness abuse in your practice? How can you raise concerns safely while protecting both the child and your team? This episode with Dr. Christine Park provides tangible actions, practical scripts, and clear guidance for managing challenging scenarios—like seeing an adult hit a child in the waiting room or recognizing neglect in the dental chair. These are situations dental school rarely prepares us for. Every practice needs clear protocols for safeguarding. This episode acts as a North Star, helping you stay compliant while ethically doing the right thing. If you treat children, you must listen to this episode and share it with every colleague who treats children. https://youtu.be/-kYs23Xa4Ls Watch PDP251 on YouTube Protrusive Dental Pearl: Find the phone number of your local child safeguarding board / social services. Verify it, then display it where you and your team can quickly access it. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Dentists are trained observers of family dynamics. Recognizing normal behavior is key in dental care. Unconscious observations can guide professionals. Feeling uncomfortable about a situation is a valid signal. Empowerment comes from trusting your instincts. Dental care professionals see many aspects of families. It’s important to act on uncomfortable feelings. Observation skills are crucial for effective care. Children’s interactions reveal much about family health. Awareness of discomfort can lead to better outcomes. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:40 Pearl – Child Protection Hotline 05:23 Dr. Christine Park’s Background and Expertise 08:37 The Role of Dentists in Safeguarding Children 11:19 Practical Scenarios and Guidelines for Safeguarding 15:35 Recognizing Silent Cases of Neglect 17:29 Team Collaboration and Support in Safeguarding 21:58 Guidelines and Policies for Effective Safeguarding 22:03 Midroll 25:24 Guidelines and Policies for Effective Safeguarding 28:32 Handling a Tough Safeguarding Scenario 32:18 Dealing with Poor Oral Hygiene and Neglect 39:12 Managing Parental Reactions and Consent 43:08 The Importance of Safeguarding in Dentistry 45:34 Further Guidance and Resources 46:10 Outro 📢 Safeguard your young patients with confidence! Catch Dr. Christine Park at the Scottish Dental Show in June or via her NES webinars. Check out the BSPD guidelines on dental neglect —an essential resource for any dentist treating children ✉️ Get in Touch with Dr. Christine: General: [email protected] Patient-info: [email protected] If you loved this episode, don’t miss How to Manage Children in Dental Pain – Paediatric Emergencies – PDP159 #PDPMainEpisodes #Communication #CareerDevelopment This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and D. AGD Subject Code: 430 PEDIATRIC DENTISTRY (Identification and reporting of child abuse) Aim: To equip dental professionals with practical knowledge and skills to recognize, respond to, and appropriately escalate safeguarding concerns involving children in dental practice. Dentists will be able to – Identify key signs and red flags of child neglect, abuse, or welfare concerns in dental patients. Apply clear communication strategies to discuss concerns with parents/caregivers and involve relevant authorities. Follow practice-based and multi-agency procedures for safeguarding, including documenting observations and escalation.

Let’s be honest – the occlusion after Aligner cases can be a little ‘off’ (even after fixed appliances!) How do you know if your patient’s occlusion after aligner treatment is acceptable or risky? What practical guidelines can general dentists follow to manage occlusion when orthodontic results aren’t textbook-perfect? Jaz and Dr. Jesper Hatt explore the most common challenges dentists face, from ClinCheck errors and digital setup pitfalls to balancing aesthetics with functional occlusion. They also discuss key strategies to help you evaluate, guide, and optimize occlusion in your patients, because understanding what is acceptable and what needs intervention can make all the difference in long-term treatment stability and patient satisfaction. https://youtu.be/e74lUbyTCaA Watch PDP250 on YouTube Protrusive Dental Pearl: Harmony and Occlusal Compatibility Always ensure restorative anatomy suits the patient’s natural occlusal scheme and age-related wear. If opposing teeth are flat and amalgam-filled, polished cuspal anatomy will be incompatible — flatten as needed to conform. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Common mistakes in ClinCheck planning often stem from occlusion issues. Effective communication and documentation are crucial in clinical support. Occlusion must be set correctly to ensure successful treatment outcomes. Understanding the patient’s profile is essential for effective orthodontics. Collaboration between GPs and orthodontists can enhance patient care. Retention of orthodontic results is a lifelong commitment. Aesthetic goals must align with functional occlusion in treatment planning. Informed consent is critical when discussing potential surgical interventions. The tongue plays a crucial role in orthodontic outcomes. Spacing cases should often be approached as restorative cases. Aligners can achieve precise spacing more effectively than fixed appliances. Enamel adjustments may be necessary for optimal occlusion post-treatment. Retention strategies must be tailored to individual patient needs. Case assessment is vital for determining treatment complexity. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:53  Pearl – Harmony and Occlusal Compatibility 05:57 Dr. Jesper Hatt Introduction 07:34 Clinical Support Systems 10:18 Occlusion and Aligner Therapy 20:41 Bite Recording Considerations 25:32 Collaborative Approach in Orthodontics 30:31 Occlusal Goals vs. Aesthetic Goals 31:42 Midroll 35:03 Occlusal Goals vs. Aesthetic Goals 35:25 Challenges with Spacing Cases 42:19 Occlusion Checkpoints After Aligners 50:17 Considerations for Retention 54:55 Case Assessment and Treatment Planning 58:14 Key Lessons and Final Thoughts 01:00:19 Interconnectedness of Body and Teeth 01:02:48 Resources for Dentists and Case Support 01:04:40 Outro Free Aligner Case Support!Send your patient’s case number and get a full assessment in 24 hours—easy, moderate, complex, or referral. Plus, access our 52-point planning protocol and 2-min photo course. No uploads, no cost. [Get Free Access Now] Learn more at alignerservice.com If you enjoyed this episode, don’t miss: Do’s and Don’ts of Aligners [STRAIGHTPRIL] – PDP071 #PDPMainEpisodes #OcclusionTMDandSplints #OrthoRestorative This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A and C. AGD Subject Code: 370 ORTHODONTICS (Functional orthodontic therapy) Aim: To provide general dentists with practical guidance for managing occlusion in aligner therapy, from bite capture to retention, including common pitfalls, functional considerations, and case selection. Dentists will be able to – Identify common errors in digital bite capture and occlusion setup. Understand the impact of anterior inclination and mandibular movement patterns on occlusal stability. Plan retention strategies appropriate for aligner and restorative cases.

Do you have a “hopeless” retained root you’re ready to extract? Think implants, dentures, or bridges are the only way forward? What if there’s a way to save that tooth — predictably and biologically? In this episode, Dr. Vala Seif shares his experience with the Surgical Extrusion Technique — a game-changing approach that lets you reposition the root coronally to regain ferrule and restore teeth once thought impossible to save. Jaz and Dr. Seif dive into case selection, atraumatic technique, stabilization, and timing, all guided by Dr. Seif’s own SAFE/SEIF Protocol, developed from over 200 successful cases. https://youtu.be/2TyodqgAP9w Watch PDP249 on YouTube Protrusive Dental Pearl: When checking a ferrule, consider height, thickness, and location of functional load. Upper teeth: prioritize palatal ferrule. Lower teeth: prioritize buccal. Tip: do a partial surgical extrusion, rotate the tooth 180°, then stabilize. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Surgical extrusion is a technique-sensitive procedure that requires careful planning. Case selection is crucial for the success of surgical extrusion. A crown-root ratio of 1:1 is ideal for surgical extrusion. Patients are often more cooperative when they see surgical extrusion as their last chance to save a tooth. Surgical extrusion can be more efficient than orthodontic extrusion in certain cases. The importance of ferrule in dental restorations cannot be overstated. Proper case selection is crucial for successful outcomes. Atraumatic techniques are essential for preserving tooth structure. The ‘Safe Protocol’ offers a structured approach to surgical extrusion. Patient communication is key to managing expectations. Flowable composite is preferred for tooth fixation post-extraction. Understanding root morphology is important for successful extractions. Highlights of this episode: 00:00 Surgical Extrusion Podcast Teaser 01:07 Introduction 02:38 Protrusive Dental Pearl 05:53 Interview with Dr. Vala Seif 08:57 Definition and Philosophy of Surgical Extrusion 15:30 Indications, Case Selection, and Root Morphology 21:37 Comparing Surgical and Orthodontic Extrusion 25:54 Crown Lengthening Drawbacks 28:39 Occlusal Considerations 33:53 Midroll 37:16 Definition and Importance of the Ferrule 43:07 Clinical Protocols and Fixation Methods 01:00:01 Post-Extrusion Care and Final Restoration 01:05:04 Learning More and Final Thoughts 01:09:29 Outro Further Learning: Instagram: @extrusionmaster — case examples, papers, and protocol updates. Online and in-person courses in development (Europe + global access). Loved this episode? Don’t miss “How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique” – PDP061 #PDPMainEpisodes #OralSurgeryandOralMedicine #OrthoRestorative This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C. AGD Subject Code: 310 ORAL AND MAXILLOFACIAL SURGERY Aim: To understand the biological and clinical principles of surgical extrusion as a conservative alternative to orthodontic extrusion or crown lengthening for managing structurally compromised teeth. Dentists will be able to – Identify suitable clinical cases for surgical extrusion, including correct root morphology and crown–root ratios. Describe the step-by-step SAFE Protocol for atraumatic surgical extrusion, fixation, and timing of endodontic treatment. Evaluate the advantages, limitations, and biomechanical considerations of surgical extrusion compared with orthodontic extrusion and crown lengthening.

Are you confident in replacing a single missing central incisor? When is a denture the right option — and when should you consider a bridge or implant instead? Why is the single central incisor one of the hardest teeth to replace to a patient’s satisfaction? In this Back to Basics episode, Jaz and Protrusive Student Emma Hutchison explore the unique challenges of replacing a single central incisor. They break down when each option — denture, resin-bonded bridge, conventional bridge, or implant — is appropriate, and the biological and aesthetic factors that influence that decision. They also share key communication strategies to help you manage expectations, guide patients through realistic treatment choices, and avoid disappointment when dealing with this most visible and demanding tooth. https://youtu.be/czjPQxKpwPw Watch PS018 on YouTube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways:  Replacing a single central incisor isn’t just about technical skill — it’s about communication and case selection.  Success comes from helping patients understand that a restoration replaces a tooth’s function and appearance, not nature itself.  Clear conversations about expectations, limitations, and maintenance are what turn a difficult aesthetic case into a satisfying long-term result. Highlights of this episode: 00:00 Teaser 00:28 Intro 01:56 From Dental Nurse to Final-Year Student 07:38 Challenges and Considerations in Replacing Central Incisors 12:51 Patient Communication and Treatment Planning 18:33 Discussing Treatment Options and Enamel Considerations 21:16 Communicating Options and Guiding Patient Decisions 25:51 Choosing Between Fixed and Removable Options 27:10 Midroll 30:31 Choosing Between Fixed and Removable Options 31:05 Handling Old Crowns and Patient Communication 34:17 Conventional vs. Resin-Bonded Bridges 37:57 Occlusal Load, Function, and Implant Considerations 43:40 Digital Workflow in Dentistry 45:54 Managing Aesthetic Expectations 48:34 Final Thoughts and Recommendations 52:59 Outro 🎧 Want to feel confident with prosthodontics? Explore these essential follow-ups to this episode: Dentures vs Bridges with Michael Frazis Crowns vs Onlays with Alan Burgin Dentures with Finlay Sutton RBB Masterclass on the Protrusive Guidance App Quick, practical lessons to sharpen your planning, communication, and anterior aesthetics — all in your pocket. #ProsthoPerio #OcclusionTMDandSplints #Communication #BreadandButterDentistry This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes C. AGD Subject Code: 610 – Fixed Prosthodontics Aim: To provide a clear, clinical overview of replacing a single missing incisor — focusing on when to choose a denture, bridge, or implant, and how to communicate realistic expectations. Dentists will be able to – Identify the key biological, functional, and aesthetic challenges in replacing a central incisor. Compare the indications, advantages, and limitations of dentures, resin-bonded bridges, conventional bridges, and implants. Communicate realistic outcomes, limitations, and maintenance expectations effectively to patients.