Endodontic Irrigation – How to Get Better Success – PDP203

Is Sodium Hypochlorite still the best irrigant for endodontics? Or do we have something novel and superior? How can we improve the efficacy of our endodontic irrigation? What % of NaOCl should we be using? https://youtu.be/z5h2FzHpG68 Watch PDP203 on Youtube Dr. Brett Gilbert rejoins Jaz Gulati to tackle all things endodontic irrigation after a brilliant episode on pre-emptive endodontics. Advanced activation and delivery systems could change the game—are we on the brink of a major shift in endodontics? Protrusive Dental Pearl: Before performing a molar extraction, challenge yourself to first complete an endodontic access on the tooth. This will enhance your understanding of the canal anatomy and improve your precision in sectioning the tooth. By visualizing the canals and the pulpal floor, you'll refine your angulation for more accurate sectioning. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode: 02:09 Protrusive Dental Pearl 04:23 Is Sodium Hypochlorite Still The Gold Standard? 06:54 The Role of Surfactants in Irrigation 07:58 Concentration of Sodium Hypochlorite 09:47 Chlorhexidine: Is There Still a Place? 11:32 Advanced Disinfection Technologies 21:31 Evidence-Based Techniques in Endodontics 25:22 GP Pumping This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject code: 070 Endodontics (Endodontic infections, microbiology and treatment) Dentists will be able to:  1. Gain insight into the role of sodium hypochlorite in endodontic disinfection and assess its effectiveness compared to new innovations.2. Discover the cutting-edge irrigation methods, including surfactants, ultrasonic activation, and laser-assisted irrigation, and their impact on endodontic outcomes.3. Explore emerging technologies and innovations that could revolutionize endodontic irrigation. If you liked this episode, be sure to watch the 1st Part - ‘PDP202 - Elective Endodontics? It's all about Communication’ Click below for full episode transcript: Teaser: When you use a lower percentage, you really aren't reducing or eliminating the risk of sodium hypochlorite accident. If you get 3% sodium hypochlorite out the end of the root, it's going to cause a sodium hypochlorite accident, as will 6%. If you're trying to eliminate risk using a lower concentration, I don't think it's as effective as you think, but you are taking away some of the strength that you're looking for to kill the bacteria and dissolve the tissue. So my advice would be go full. Teaser:We recognize that training our general dental colleagues on endo is paramount because we don't want the option of implant to come in place of saving the natural tooth simply because of fear or the fact that they just don't feel well enough trained to do the endo. So I believe as a dental community, the more we feel comfortable and proficient in endo, the more teeth we save and the better our patients are. Jaz's Introduction:Is sodium hypochlorite still the best thing in irrigation? If it is, what percentage should we be using? This one might actually surprise you. Is there ever a time when to use chlorhexidine. Whatever irrigant we're using, how can we improve its effectiveness? Hello, I'm Jaz Gulati and welcome to the part two with Dr. Brett Gilbert. How awesome was he? Please do check it out if you haven't already. We talked about elective endodontics or preemptive endodontics. I love the clarity and the passion in which he speaks with. And he definitely continues it on into this episode. He's so knowledgeable, he's so passionate about endodontics in general, but especially the innovation in irrigation. Because after all, endodontic success is all about killing those bugs. And Brett has so much experience in trying all the different things out there. And towards the second half of this episode,

What's the difference between radiolucency and burnout?  When's the best time to use a bitewing vs a periapical radiograph?  When should we pick up the bur for interproximal caries? Have you heard about the 4 white lines an OPG radiograph?  https://youtu.be/wCV3U8-OAvI Watch PS011 on Youtube This episode is packed full of great tips and techniques that will help you understand how to produce great radiographs as well as being able to properly figure out what they are trying to tell us. Radiographs can be tricky, whether that's due to them being flipped, upside down or due to cone cut, that's why this will help shine some light on how to get comfortable with radiographs as well as how to manage our patients after we know what we are dealing with. Need to Read it? Check out the Full Episode Transcript below! Don’t miss the special notes on Radiology and Radiography for Students available exclusively in the Protrusive Guidance app! (Join the free Students Section) This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD for Dentists waiting for you on the Protrusive App! For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. If you love this episode, check out PS003 - Routine Checkup Click below for full episode transcript: Teaser: This episode is the bare basics of radiography and radiology, i.e. the taking of the radiograph and the interpretation. How do you really know if that radiolucency you see is cervical burnout or is it actually caries? What are the four white lines on an OPG radiograph and why are they important? And why you should be really careful with radiographic interpretation? And it's really important to marry the clinical picture, because that's how you come up with a clinical diagnosis. [Jaz]Hello Protruserati, I'm Jaz Gulati and welcome back to your favorite dental podcast. This is for young dentists, students, but a lot of qualified dentists have been really enjoying this basic series, this Protrusive Student series. And so what we're going to do from the next episode is we're going to make it CE eligible. The next episode is actually on basics of extraction, but before we do that extraction, we need a radiograph. And it's a topic that you guys asked for on the YouTube comments. So there we have it. And remember, if you are a dental student, make a free Protrusive account. Go to protrusive.app and then email your username or your name on the platform to [email protected]. And you're going to get access to a secret area, which has a bit more of the premium goodies inside. Every PS episode, we have some student notes to provide you as well, made by Emma Hutchison, our Protrusive student. And the ones today are all about radiography and radiology. Hope you enjoyed the main episode, I'll catch you in the outro. Main Episode:Emma Hutchison, our Protrusive Student. Welcome back to the student's edition of the podcast. I know you've got exam results coming up and you're going on your elective soon. How exciting. [Emma]Yes, very exciting. So I'm just finishing up the last bits and bobs of my elective project and then I'm going traveling for two months. So, I should also get my exam results next week sometime when I'll be away. So, hopefully everything's good. [Jaz]We're all rooting for you. We know, you know, fingers crossed you'll do well and you'll report back to us. If anyone in Asia is a dental student or a dentist, and you happen to see Emma walking in a mall, an air conditioned mall, take a selfie with her and tag us on Protrusive. Let's see if this social experiment works. Let's see how much we're spending. That'd be cool, right? [Emma]Yeah, it would have to be an air-conditioned place because I'm from Scotland, so I'm not going to do well with the heat over there at all. [Jaz]Excellent. Well,

Does ‘elective’ or ‘pre-emptive’ endodontics have a role in Restorative Dentistry? It almost feels dirty to me as I try my best to PRESERVE pulp vitality! But sometimes this bites you, and you wish you had carried out root canal treatment before cementing that crown. At what point can pre-emptive root canal be justified in a world where MTA and biodentine exist? https://youtu.be/9Gc_yik9fDU Watch PDP202 on Youtube In this episode, Jaz sits down with renowned endodontist Dr. Brett Gilbert to delve into the intriguing world of elective or pre-emptive endodontics. Together, they explore challenging cases where teeth with uncertain pulpal health may require root canal treatment, whether due to caries or crown prep. Dr. Gilbert sheds light on patient communication strategies, the role of bioactive materials like biodentine and bioceramic sealers, and how to make crucial decisions about preserving pulp vitality. Protrusive Dental Pearl: Dr. Pav Khaira suggests using Alvogyl, commonly used for dry sockets, to treat pericoronitis! After cleaning and disinfecting the area, place a small amount under the operculum for immediate relief and to soothe inflammation. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode: 3:01 Protrusive Dental Pearl 03:55 Dr. Brett Gilbert's Journey and Philosophy 07:17 Elective or Pre-emptive Endodontics 11:06 Radiographic Measurement 11:40 Real-Life Encounters  15:29 Discussing Treatment Options and Patient Communication 20:28 Can Biodentine Prevent Root Canal? 22:45 Materials and Techniques in Endodontics 26:16 Death of Gutta-percha? This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject code: 070 Endodontics (Endodontic infections, microbiology and treatment) Dentists will be able to:  1. Learn what elective or preemptive endodontics entails and recognize scenarios where root canal treatment may be required due to caries or crown preparation, and how to approach them.2. Discover effective strategies for explaining treatment options to patients, improving trust and decision-making.3. Gain insights into the use of bioactive materials like biodentine and bioceramic sealers, and their benefits in preserving pulp vitality. If you liked this episode, you’ll love Post Operative Pain after Endodontics – Prevention and Management – GF017 Click below for full episode transcript: Teaser: I do believe in these instances, you are justified to recommend the treatment. You're not demanding it. You're not saying it's dogma, but you're having a conversation so the patient understands. Because what happens if you don't is you do your work, you're doing it in best faith. Patient winds up in pain, and they become very angry. Teaser:They become agitated, and they want to blame the dentist. And without a conversation, without a dialogue, they're clueless, and all of a sudden, they just think you did something wrong. You are a human, and you are the doctor. Speak to yourself. Let the words flow out so that you can explain all the different possibilities in a way that the patient feels heard, understood, but also nurtured, and at the same time you realize this is biology. We are not in control. Jaz's Introduction:In a world where we want to do everything to preserve pulp vitality, is it ever appropriate to carry out elective endodontics? Another terminology that our guest today, Dr. Brett Gilbert shared with me is preemptive endodontics. For example, you have a tooth with dubious pulpal prognosis. And you know that by prepping it for a crown or by removing the caries, this tooth may need root canal treatment. Is it okay to just go ahead and do the root canal so it doesn't bite you in the behind in the future? You see, I was always taught to do everything possible to preserve pulp vitality.

Are single-use diamond burs more efficient at cutting? When should we throw away a bur and pick up a fresh one? How long are they supposed to last? (it's measured in minutes!) Are expensive brands a con? Tiny, but one of the most important tools of our trade…BURS! In a world full of different identifying numbers and names, it can get confusing and even overwhelming.  https://youtu.be/Ol0_XcIbSD8 Watch PDP201 on Youtube That’s why on today’s episode, we welcome Günter and Marcela from Intensiv, a globally recognised manufacturer of dental burs, where they take great pride in bringing the latest tech to help make our dental procedures that much easier and effective. In this episode, we cover how diamonds are sourced, what the differences are in colours of burs and how the grain size of diamonds can change our results. There’s lots of amazing tips and tricks here given by the team at Intensiv, so you’ll definitely walk away from this one with something new up your sleeve. Need to Read it? Check out the Full Episode Transcript below! HIGHLIGHTS of this Episode: 01:24 Protrusive Dental Pearl 02:03 Introduction to Team Intensiv 05:40 Understanding Bur Codes 10:49 Bur Colours 15:10 When to Use Different Grit Diamonds 18:40 Single Use Burs vs Reusable Burs 24:59 Sourcing Diamonds 29:18 Fixing the Diamonds to the Metal Shank 32:40 Is my bur fit for purpose? 37:30 Drilling Zirconia 39:30 Final Tips 41:20 Contact Intensiv This episode is eligible for 0.75 CE credit via the quiz below. AGD Code: 250 Operative (restorative) Dentistry (Preparation Technology) GDC Learning Outcome:  C Learning Outcomes Identify the appropriate dental burs for different procedures, considering grit size and material composition, to ensure efficient and safe treatment. Evaluate the impact of bur selection on patient comfort and procedural outcomes, minimising trauma and maximising efficiency during dental treatments. Implement best practices for the maintenance and replacement of burs to ensure optimal performance and longevity, thereby improving clinical results and patient satisfaction. If you liked this episode, you will aslso like: PDP117 - Dental Ceramics in 2022 – Which Ceramic Should I Use Click below for full episode transcript: Teaser: Are single use burs better or really more cost effective than our traditional multi use burs? I think the answer is actually going to surprise you. And my biggest pet peeve, the thing I hate the most, is using a bur and it has like zero cutting efficiency. I work in a clinic where we share our burs and we have like different bur kits made up. Jaz's Introduction:And so sometimes I use a bur and I hadn't inspected it and I find that, oh my goodness, this is taking way longer than it should. And of course I have to ask my nurse to go to the stock room to get a brand new bur. But this is frustrating. Like when you are using a bur with less cutting efficiency. It is annoying and it's actually downright dangerous for the tooth. So how can you tell? Is there an objective way to tell and subjectively, how can you tell exactly the moment when you should bin a bur? So you avoid that horrible scenario. Hello, Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. I'm joined today by Günter Smailus and Marcella Roba who represent Intensiv. Intensiv is a Swiss based company which specializes in diamonds, so who better to find out more about the use of diamond burs and everything to do with diamonds. It's a very geeky episode, but I feel diamond burs and diamonds in dentistry, we use them so much, we rely on them so much. I think it's worth an episode, it's worth discussing about different diamonds in dentistry. I have no financial interest with Intensiv, this is not a sponsored episode. But this is very much for the pursuit of knowledge and disseminating information to Protruserati, i. e. you guys,

Last Live Occlusion Course of 2024 - Book Now: https://courses.iasortho.com/courses/gb/occlusion POV: You spend a fortune on a composite anatomy course and are excited to implement on Monday morning. However, every time you apply those concepts, you end up drilling it away because it’s proud in the occlusion! It essentially now looks like a tooth coloured version of the amalgam you just removed! Your nurse’s eyes are like pools of fire - that’s half her lunch break gone. This happens a few more times until you realise that you’re missing a trick… Enter this podcast to save your career! ;) https://youtu.be/5MVvknCNV-8 Watch PDP200 on Youtube Dr Jaz Gulati and Dr Mahmoud Ibrahim will teach you how to radically minimize adjustments on your daily restorations. Key Takeaways: Always check the patient's occlusion before starting any restoration. Utilize shim stock to ensure accurate occlusal contacts post-restoration. Pre-op visual checks are crucial for successful composite placement. Don't compromise on the anatomy of the restoration for aesthetics. Use thinner articulating paper for more precise occlusal markings. Communicate effectively with your dental nurse about new protocols. Involve your senses to assess the quality of your restorations. Document occlusal marks pre and post-restoration for reference. Adjustments should be minimal if pre-op checks are thorough. Educate patients about their occlusion to manage expectations. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode:05:24 Introduction - Dr Mahmoud Ibrahim08:42 Posterior Composite14:15 Shim Stock Foil16:35 Effects of Numbing on Occlusion18:23 Lower First Molar Example22:06 Shim Stock revisited26:22 Lateral Excursions30:32 Fissure Staining?31:56 Old Restoration as a Guide35:33 Restoration Techniques and Adjustments38:03 Tips and Tricks43:28 Event Discussion45:09 The Importance of Marginal Ridges46:25 Anatomy or aNOTomy?48:17 Post-Op Checklist: Final Adjustmentsand Polishing Tips54:19 Wrapping Up: Using Your Senses in Dentistry56:43 Outro This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance App. This episode meets GDC Outcomes A and C. AGD Code: 250 Operative (Restorative) Dentistry (Direct restorations) Dentists will be able to: Evaluate and manage occlusion during posterior composite restorations, ensuring that patient bite and interdigitation are maintained post-procedure. Effectively use shim stock foil and articulating paper to achieve precise contact points and occlusal balance, minimizing the need for post-restoration adjustments. Apply practical techniques, such as using occlusal stamps and soft flex discs, to streamline posterior composite restorations while improving the durability and aesthetics of the final result. If you liked this episode, check out: IC046 - 4 Ways and 6 Great Reasons to Document Your Dentistry Click below for full episode transcript: Teaser: The cuspal inclines and using visual references that I take before I prep the tooth. So I'll look at where the marginal ridge is compared to the base of the cavity. Where's the bottom of the fissure pattern on the adjacent tooth, for example. Use those visual references and then the angle of the cusp. The angle of the cusp is probably, for me at least, one of the most important ones. Teaser:Some patients are like princess and the pea, whereas other patients are like everything feels amazing. And the very last thing you check is how does that feel? That's like the last. Why are we getting patients to feel their bite? They shouldn't like become obsessed about their bite. We're kind of edging them closer every time we say, how does it feel? How does it feel? They're feeling their bite. Something that really should be not really present for them, if you like. Once you get quicker and slicker,

Follow THESE protocols to eliminate teeth whitening sensitivity in your practice - your patients will love you. Have you ever had a patient who had to stop whitening due to severe sensitivity? Should we be whitening when there are active carious lesions? (the answer might surprise you) https://youtu.be/IC3wMpfLo30 Watch PDP199 on Youtube In this episode, Dr. Linda Greenwall is back with another phenomenal episode as we dive into this common concern. Together, we discuss practical tips and effective strategies and protocols to help patients achieve radiant smiles without pain. Protrusive Dental Pearl: We’ve made an infographic to summarise this awesome episode. This one is available freely under the episode in our Protrusive Guidance App. Need to Read it? Check out the Full Episode Transcript below! Highlights of the episode: 03:06 Dr. Linda Greenwald's Background and Experience 07:09 Teeth Whitening: A Global Perspective 08:31 Diagnosing Teeth Sensitivity 14:28 Managing Non-Carious Cervical Lesions (NCCLs) 22:30 Using Sensodyne for Sensitivity Management 24:36 Exploring Different Sensodyne Products 26:26 Bruxism and Occlusal Forces: Mechanisms of Sensitivity 29:39 Role of Hydration and Tray Design 32:57 Whitening Limitations: Cervical Whitening and Medication Impact 36:41 Dehydration and Discoloration 42:03 Therapeutic Uses of Whitening Trays 48:53 Upcoming Events and Final Thoughts Dr. Linda Greenwald invites the Protruseratis to the "Future Dentistry" conference on November 1st at the BDA, featuring dental AI, restorative, orthodontics, and implant innovations. This episode is eligible for 1 CE credit via the quiz on the Protrusive Guidance App. This episode meets GDC Outcomes A and C. AGD code 780 ESTHETICS/COSMETIC DENTISTRY (Tooth whitening/bleaching) Dentists will be able to: 1. Understand the causes of teeth sensitivity during whitening treatments and conduct thorough diagnostics. 2. Implement pre-whitening protocols such as treating non-carious cervical lesions and recommending desensitizing toothpastes. 3. Gain insights into preventative measures for managing sensitivity in whitening treatments. If you love this, be sure to check out Dr. Linda’s other Protrusive Episodes: Finally, Some Clarity on Teeth Whitening for Under-18s with Linda Greenwall – PDP096 and ICON Resin Infiltration – Step by Step FULL PROTOCOL – PDP140 Click below for full episode transcript: Teaser: Any discolored tooth needs a periapical radiograph, really, really important, because you are looking for undiagnosed periapical lesions. And most dentists don't know, if there is an undiagnosed periapical lesion and you put whitening gel into, so you take oxygen, and you shove it into an anaerobic area, you are going to have max of sensitivity- Teaser:Because I think a lot of dentists are afraid of doing that because they're afraid of not being able to adequately bleach the cervical area. So here's another point. You can't adequately bleach the cervical area. It's never going to be the same shade. And that's a myth- The last two millimeters of the bleaching tray. So that actually tray is not rubbing on the cervical area. And they found it improved sensitivity and made no difference to the whitening effect whatsoever. So you can do that. Jaz's Introduction:Protruserati, this just might be the most actionable and impactful piece of content you'll ever consume on the topic of teeth whitening sensitivity to really help our patients to whiten better without having the horrible side effect of teeth sensitivity. I don't know about you, but for some patients it can be so bad that after about three days they don't whiten ever again. And you have to have that awkward conversation with the patient. But now, following Dr. Linda Greenwald's protocols, We can eliminate teeth sensitivity. Like, we could have spoken for like hours and hours and hours.

It’s Friday and you’re fitting the last patient’s crown. It is completely shy of the bite - but it looks good. The patient says ‘it feels great! I can hardly feel anything!’ Do you cement it (plant it low?) and let it grow? Is that acceptable? How about the 'GABS occlusal philosophy?' Is ‘centric relation’ full of unicorns and rainbows? What is an efficient protocol in ‘checking the occlusion’? https://youtu.be/Nmx1C8WDSjA Watch PS010 on Youtube Join us in this episode where we discuss some key techniques to help ensure we are managing occlusion as a primary focus when dealing with restorative treatment. This episode is packed with essential tips that are perfect for dental students and professionals alike.  Don’t miss the special notes on Occlusion, CR & All Things Confusing available exclusively in the Protrusive Guidance app! (Crush Your Exams section) Need to Read it? Check out the Full Episode Transcript below! This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD for Dentists waiting for you on the Protrusive App! For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. If you love this episode, be sure to recap PDP109 - Articulating Paper is Lying to Us Click below for full episode transcript: Teaser: Here we are, a little bit late, but this is the Protrusive Students version for Occlusion Month. We've got our Protusive student, Emma Hutchison, who once again has done a wonderful job to create these student notes. Jaz's Introduction:You can download these for free on the community, there's a special students area, and you can also catch up with the previous nine other Protrusive student notes, bespoke notes, just for students. Very visual and written by Emma herself, inspired by what she's learning at uni and also what she's learning online. Head over to protrusive. app to check that out. Hello, Protruserati. I'm Jaz Gulati and welcome back to your favorite dental podcast. This episode is huge. Like when I was a dental student, anything to do with occlusion was mega confusing. Like even down to adjusting a basic composite. Like you've just placed a composite, and you're picking up the bur, and you have no idea what you're doing. Was it just me, or is that you as well? Well, how about we cover in this episode for the benefit of students, and of course, anyone in dentistry, or dentists can actually learn something from this episode, I think. We need to talk about some specific protocols taught to me that I'm sharing with you guys, and we go deeper into what actually happens if you start leaving teeth out of occlusion, i. e. You restore a tooth and now that tooth is no longer actually touching the opposing tooth. It's no longer contributing to the patient's occlusion. Is it always a sin? Is it acceptable? And how do you actually go about avoiding that? Like, how can you actually be more precise in your occlusal adjustment? We also, of course, talk about the influence of different thicknesses of articulating paper and why you should avoid using thick papers. There's a lot to unpack here, so let's join the main interview and I'll see you in the outro. Main Episode:Okay, Emma, you just had some exams. Okay, so welcome back. How was it? How did it go? [Emma]It was okay. I think they're always going to be a bit rough. This year I had two written papers. I had one multiple choice paper, which was okay. And then the second one was like a multiple short answer, which is always the trickier of the two, I think, for me anyway. But they changed the format of our MSA short answer one this year. So it was just a wee bit different. They changed it from, I think, 20 questions worth 10 marks to 15 questions worth 13 marks or something like that. So it was just a wee bit different to what I'm used to.

“Defensive Dentistry and the fear culture is the number 1 cause of anxiety amongst Dentists” How can we instead foster a culture where we can focus on growth and supporting each other? Does Dentistry have a social media problem? https://youtu.be/wsiENbuIXcE Watch IC053 on Youtube Join us on this episode with Dr Mehy Lo-Presti as we navigate dentistry and social media, the pros and cons of using the online world as part of our portfolio and how we can remove anxiety through effective communication. 2 Events to Attend: DentoRama 18th October Treatment Planning Symposium (Hybrid Event) 16th Nov Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode:02:05 Introduction - Dr Mehy Lo-Presti06:42 Mehy Early On12:04 Dento-Rama15:30 Social Media in Dentistry20:35 Life Before Social Media21:25 Social Media is a Business 23:40 What Causes Anxiety for Dentists?29:45 Overcoming the Fear Factor34:45 Fast Tracking to Success41:20 Wrapping Up47:14 Booking the Event and Getting in Touch This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. GDC LEARNING OUTCOMES: A AGD Code 770 (Self Improvement) Dentists will be able to: Gain insights into how social media affects clinical practice, patient perceptions, and professional image, learning how to use these platforms responsibly. Manage the pressures of online validation, minimising the impact on their mental health and maintaining a healthy work-life balance. Develop stronger communication methods both online and offline, ensuring clearer patient education, reducing complaints, and fostering better relationships within the dental team. For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. This includes videos on Overlay preps and the famous 'Vertipreps for Plonkers' series. If you liked this episode, check out IC035 - Best Practices in Social Media for Dentists Click below for full episode transcript: Teaser: It depends again, what you want to show, who you want to be in social media. I always have this debate. I asked this many times in my events. Is it okay to share your personal life and your professional life at the same time? And some people will say yes. And, but there are consequences of that. And the consequences is that- Teaser:I don't believe in fast tracks. I don't believe in that things can go very quick because you're going to miss a lot of learning in the process. So I think exploring and making mistakes and allowing yourself to fail. It's something that. It will make you grow way faster. People are happy in their jobs when they feel that they are treated as adults. And this is something I learned from the employees from Google and Netflix and all these super fancy offices. They understood that people don't care if you give them free food, they have a gym, you have cinema, you have all this super cool things in their office. So if you don't treat them as adults and you don't give them this freedom, they won't be happy. Jaz's Introduction:What's the number one thing holding you back as a clinician? What's holding you back from growing as a dentist and actually sleeping well at night time? It is an F word. Me and my guest today, Dr. Mehy Lo-Presti, we believe that fear is holding us back. When all of our decision making and all of our judgments and our communications are processed through this filter of fear and our dentistry is fear driven and therefore defensive. This is what may thought was the number one contributor of anxiety for dentists. Hello, Protruserati, I'm Jaz Gulati, and welcome back to the Protrusive Dental Podcast. This is an interference cast, where we discuss more of the non clinical themes, which are super important, because we touch on communication, we touch on fulfillment, and we also touch on social media, because we can't avoid it.

JOIN US on 16th November for Treatment Planning Symposium 2024 - Online Event OR In-Person - you decide! https://youtu.be/G5ebbUl0sDg Watch PDP198 on Youtube Implants are great but they are not always the best solution for our patient. There are many times a bridge or denture may serve the patient’s goals, aesthetics and budget better. So how do we decide between bridges and dentures? Is it acceptable to use root filled tooth as a bridge abutment? Are single tooth posterior dentures risky? Or do patients love them? How do we begin to communicate aspects of replacing teeth with our patients? Join me with our guest Dr Michael Frazis as we discuss the art form of communication with our patients and some outlandish cases including roundhouse bridges. This will really help upskill you on dealing with patients with missing teeth. Protrusive Dental Pearl: Failure is inevitable for our Dentistry, but try to set yourself up for smaller failures and not giant catastrophes! The real magic is in proper case selection. Practise at the EDGE of your comfort zone, but NOT out of your depth. 20% OFF Guaranteed on RipeGlobal Fellowship Programs + Free access to their portal - Click here to register for this! protrusive.co.uk/rg20 Follow Dr Michael Frazis on Instagram This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC LEARNING OUTCOMES: A and C AGD Subject Code: 610 Fixed Prosthodontics Dentists will be able to: Demonstrate improved decision-making skills in treatment planning, particularly regarding non-implant tooth replacement options. Apply communication strategies to better explain treatment options, manage patient expectations, and gain informed consent, especially in high-risk cases involving implants, bridges, or challenging restorations. Recognize red flags and understanding the risks involved in specific dental procedures (such as implant failure or the use of root-filled teeth as abutments) and how to mitigate these risks through careful case selection and patient education. For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. This includes videos on Overlay preps and the famous 'Vertipreps for Plonkers' series. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode:00:01:37:00 Protrusive Dental Pearl00:03:51:05 Introduction - Dr Michael Frazis00:10:43:10 Growth in Dentistry00:14:10:10 Non Implant Tooth Replacement Options00:18:15:10 Treatment Planning Bridges and Dentures00:24:35:10 Ideal Treatment vs Budget00:30:15:10 Single Tooth Dentures00:36:58:10 Thin Implants vs Bridges00:39:25:10 Bridge Spans00:49:20:10 Root Filled Teeth as Bridge Abutments00:55:35:10 Failures01:05:35:10 Wrapping Up - Contact Michael If you liked this episode, check out PDP132 - Resin Bonded Bridges Click below for full episode transcript: Teaser: I'm doing that bridge 11 times out of 10. If they're a patient that has money to burn and they want their teeth to be individual, they want to be able to floss their teeth because that's just what they have as their goal. I will go crown implant- And I don't think we as dentists tell patients that. If there's something you can do as a clinician to mitigate that risk, could you use that word, tell them what it is. So to give you a concrete example, when I'm taking out a tooth, I will say- Jaz's Introduction:Implants are awesome, but they're not for everyone. Now this could be financial. This could be something to do with their medical history. And actually there are some scenarios where a bridge or a denture can be superior. And so many of these scenarios, we need to help the patient decide between a denture and a bridge. We're going to do a deep dive into decision making and treatment planning when it comes to these modalities. I'm joined by Dr.

Treatment Planning Symposium 16th November Hybrid event: https://www.protrusive.co.uk/rx Are you still afraid of raising the Vertical Dimension? You cannot break free from the shackles of single tooth Dentistry if you don’t get comfortable with vertical dimensions changes in Restorative Dentistry. https://youtu.be/Nb-LTyzRKuU Watch PDP197 on Youtube In this episode, Dr. Jaz Gulati and Dr. Mahmoud Ibrahim  simplify the complex topic of increasing vertical dimension.  What is a safe limit of increasing the vertical dimension? They cover the essentials of joint health, muscle stability, and the importance of centric relation (does it actually matter?) Protrusive Dental Pearl: Use Duralay copings for guide planes to ensure stable dentures with a single path of insertion. While eyeballing the prep can be challenging, he suggests requesting acrylic copings from the lab for precise preparation. He explains that technicians survey models to identify undercuts and determine the path of insertion, and instead of manual prepping, he advises using lab-created reduction copings and acrylic jigs to simplify and accurately guide the preparation process.  Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode:  02:05 Protrusive Dental Pearl  Acyrlic Copings for Guide Planes 03:57 Dr. Mahmoud Ibrahim’s Introduction 06:05 Personal Experiences with Vertical Dimension 08:45 Challenges and Techniques in Vertical Dimension 14:17 Clinical Considerations (Restorative Dentistry) and Research 21:15 How to Assess OVD Loss? 24:35 Factors to Consider in Increasing the Vertical Dimension 28:41 Treatment Planning: Orthodontics vs. Restorative Management 32:21 Assessing Cases for Vertical Dimension 34:39 Joint Position and Vertical Dimension 39:47 Occlusal Appliances Prior to Increasing Vertical Dimension  45:26 Joint Relationship 50:49 Reproducibility and Stability in Occlusal Planning 53:00 Summary and Final Thoughts on Vertical Dimension This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. AGD code: 180 Occlusion  (Occlusal therapy) This episode meets GDC Outcomes A and C. Dentists will be able to: 1. Explore key clinical considerations and current research in restorative dentistry related to vertical dimension, enhancing your ability to make informed decisions. 2. Understand the relationship between joint position and vertical dimension, and how to assess and manage this relationship effectively. 3. Recall the guidelines for assessing the vertical dimension and the safe limit for this in dentate patients. If you liked this, you will also like Functionally Generated Path Technique – Conforming to Funky Occlusions – PDP168 Click below for full episode transcript: Teaser: But it can also help you stage treatments, right? It's a great technique to learn because it allows you then to stage those more comprehensive cases. So one of the most useful things about opening vertical dimension is gaining space for your material without having to prep teeth that they're usually already quite worn. Now that is a huge benefit for anterior teeth, but also can come into play on back teeth. Jaz's Introduction:I used to be petrified of opening the bite, i.e any kind of treatment that would increase the patient's vertical dimension would be way out of my comfort zone and it really made me worried like, is the patient going to adapt? Are they going to get joint pain? Am I perhaps increasing the vertical dimension too much? And so for the first 18 months of my career, I was focusing on conformative dentistry. Not having to change the vertical dimension, just accepting the patient's bite for what it is and working with it. You know, a filling here or a crown there. And back then it mostly was small and large composites. I was still finding my feet, I wasn't confident with indirect dentistry,