Protrusive Dental Podcast

Have you ever prepared the last molar for a crown? And just when you check the occlusal reduction, the patient bites down and as if by magic, the reduction has all DISAPPEARED?! It is the phenomenon that we call ‘The Last Tooth in the Arch Syndrome’ This episode with Dr. Mahmoud Ibrahim will give you more confidence in recognizing, screening, and managing such complications in practice. But like I say in the main episode, optimistically, this phenomenon will never happen to you AGAIN if you follow these protocols for screening. https://youtu.be/gs1r5mlefHU Check out this full episode on YouTube Protrusive Dental Pearl:  Watch out for the patient with quite flat teeth as they are more susceptible to the last tooth in the arch syndrome / bite change. They do not have good posterior coupling/stability and therefore more likely to ‘forget’ their bite as the cuspal inclines do not guide the mandible back in to maximum intercuspation. Highlights of this episode: 2:41 Protrusive Dental Pearl 6:09 Introduction to Dr. Mahmoud Ibrahim 9:34 What is Centric relation? 10:45 Last tooth in the arch syndrome 13:14 Risk assessment for Last Tooth in the Arch Syndrome 15:52 Screening patient’s CRCP and the degree of slide 17:33 Leaf Gauge protocol for screening CRCP 30:23 Communication with High-risk patients 34:35 Case Discussion 44:36 Management of space loss after preparation 46:24 Dr. Mahmoud’s top tips to prevent the ‘Last Tooth in the Arch Syndrome 58:47 Occlusion Basics and Beyond Dr. Mahmoud Ibrahim and I are currently working on a huge project called OBAB, Occlusion Basics and Beyond – it will be the best occlusion resource in the Milky Way…and that’s our mission! We want to finally demystify Occlusion and make it Tangible AF! Join the waiting list HERE! If you loved this episode, you will like If You are Not In Centric Relation, You Will Die

From the entire Protrusive Community – we wish Sanj a speedy recovery – keep smiling Sanj and stay strong! In the previous episode with Sanj Bhanderi on ‘how to extirpate properly and efficiently‘, we briefly touched on postoperative pain control. In this episode, we’re focusing more on postoperative pain and the dreaded severe pain after the obturation appointment (or in-between visits). https://youtu.be/RJzQZNhBup0 Check out this full episode on YouTube Highlight of this episode: 2:27 Post-op pain after endodontic treatment 7:43 Flare-ups 9:46 Guidelines in antibiotic microbial management 11:03 Flare up in between visits (RCT has not been finished yet)  13:40 Crown Down approach Dr Finlay Sutton is coming down South for his one-day signature RPD Masterclass on Saturday 14th of January 2023!  Limited to 12 delegates, reserve your seat now! If you enjoyed this, you might also like my episode with another talented Endodontist, Dr Ammar Al-Hourani, on Is Single Point Obturation Acceptable? 

Have you ever been planning a smile (this could be a complete denture or some veneers!) and thought ‘where do I begin’? Planning aesthetic dentistry involves more than just the teeth. A great smile is ‘facially driven’ – where do the teeth sit in relation to the face?Today we are joined by Dr. Josh Rowley to share the four rules of planning Aesthetic Dentistry (you will love them). https://youtu.be/2jbfK2WU1e4 The Protrusive Dental Pearl: Don’t start complex/comprehensive treatment on someone who is not sure or not motivated. Highlights in this episode: 2:58 The Protrusive Dental Pearl – Communication Tip 14:49 Screening for the first point of contact for Orthodontic patients 16:36 Four rules of planning Aesthetic Dentistry 35:10 SureSmile Aligners 39:35 Low trim height 41:24 High trim height 44:03 Support system for Sure Smile Check out the courses that Dr. Josh teaches through IAS Academy and SureSmile Aligners

When you Extirpate a Hot Pulp – do you need to find ALL the canals? Do you need to file to the apex? Which is the sedative of choice? In this episode, we’ve got specialist Endodontist Dr Sanj Bhanderi to talk us through the CORRECT way to extirpate teeth in acute pain WITHOUT wasting time or making things worse for future treatment. It’s packed full of gems for pain relief, diagnosis and isolation. So, what is your protocol for extirpation? This episode is all about how to get the job done right and minimize discomfort for your patient. https://youtu.be/SjYWxr1sSDc Click Here to watch this episode on YouTube. For the full notes check out the Protrusive App on iOS and Android. “I call it Ninja endodontics – get in and GET OUT – Stealth!” Dr. Sanj Bhanderi Highlights of this episode: 2:38 Dr. Sanj’s journey to Endodontics 6:30 Emergency extirpations 8:42 Diagnosis Protocol Irreversible Pulpitis 11:57 Anaesthetic for Hot Pulps 15:33 Caries and Restoration Removal Before Extirpating? 19:16 Vital pulp therapy 21:19 Isolation Protocol 25:30 Sedative Dressing for Acute Pain 28:42 Temporary restoration of choice 31:39 Post Op Medicaments Tune in for the Part 2 of this episode – next week we cover post-operative pain after endodontic treatment. If you enjoyed this, you might also like my episode with another talented Endodontist,  Ammar Al-Hourani, on Is Single Point Obturation Acceptable?

Orthodontics for the mixed dentition is not well taught at Dental School – for which malocclusions should you intervene and by what age? Dr. Amanda Wilson will show you how to identify whether early or interceptive orthodontics is right for your young patients as part of their antero-posterior, vertical and transverse development. https://youtu.be/8OksXwy_yDQ The Protrusive Dental Pearl: Prevent misdiagnosing ectopic canines by palpating the permanent canine early (from age 10 onwards). Put your index fingers a little bit apical and a little bit distal to the lateral incisors and you should be able to feel a 5-10 millimeter bulge Highlights of this episode: 1:58 Prevent misdiagnosing ectopic canines 8:55  Difference between Interceptive and Phase one 16:15 Phase 1 Interceptive Treatment Guidelines 20:20 Arch Expander Guidelines   24:07 Crossbite Tendency  24:57 Rapid versus Slow Expansion 27:42 Guidelines using functional appliances 28:21 Invisalign Mandibular Advancement 31:10 Deep Bite Guidelines 34:08 Q: Percentage of patients that would undergo Phase 2 36:43 Patient(Parent) Communication 39:51 Retention Protocol 43:36 My Phase One Smile PDF Get this My Phase One Step-By-Step PDF Checklist by Dr. Amanda to get started and help you diagnose malocclusions Check out Straight Smile Solutions for more Orthodontic Consulting and StraightSmile Solutions Orthodontic Coach for GPs for Orthodontic Educational Videos If you enjoyed this episode, you should also check out General Dentists Doing Orthodontics 

Is flapless implant placement really a solid technique? What percentage of cases are amenable to flapless implant placement? The cynic in me wondered if this is indeed a novel technique, or was it made mainstream to attract Dentists who seldom raise flaps? I brought on straight-talking Implant genius Dr. Pav Khaira on today’s Group Function to discuss flapless implant placement – ‘what’s the deal?!’ https://youtu.be/679HAttBQ1c Check out this full episode on YouTube Highlights of this episode: 4:36 The Rise of Flapless Implants 7:04 Indications for Flapless implants 9:43 Immediate implant placement 13:59 Advice to Young Dentists considering implants 18:56 Implant Mentorship 24:11 Dr. Pav’s Implantology Course 27:46 From Course to Implementation Check out The Dental Implant Podcast for information on dental implants and the Academy of Implant Excellence to learn how to place implants or upgrade your skills. If you enjoyed this episode, you will also like ‘Can I Probe This Implant?’

As a Dentist, the first years are always the hardest. You have to adjust to unfamiliar situations and people constantly. A newbie’s nerves can lead to self-doubt and hesitation whilst navigating this steep learning curve. I brought on recently qualified Dr. Saeed Cheraghi to guide you through the first few years of the ‘University of Life’. https://youtu.be/PXt3hvsV9LI Check out this full episode on YouTube “You come out of Dental school thinking you know things and then you go into the real world and you realize you actually don’t know that much at all!” Dr. Saeed Cheraghi. Highlights of this episode: 8:31 Indirect Dentistry experience  10:15 Challenges in terms of treatment phasing 12:17 Level of support being a newbie dentist 15:03 Dental training 18:07 Overcoming lack of experience 30:34 Worrying about litigations 35:05 Importance of Health 39:59 Lesson from experience This episode is not eligible for CPD but you can check out other CPD-verified episodes on our Protrusive App on a web browser or you download the iOS App or the Android App. This episode is brought to you by Enlighten Smiles, a premium brand of teeth whitening. They also run the Mini Smile Makeover Course – a composite course I really recommend. If you liked this episode, you will love How to Win at Life and Succeed in Dentistry – Emotional Intelligence

My story of coming to the UK as a refugee from Afghanistan aged 6 and my journey in to Dentistry. I share some tough times and what drives me today. I explained why I think Dentistry was mis-sold to many of us as a 9-5 job (HA!) and my top books and influences. I’m delighted to be a guest on the Soft Bites Podcast. The hosts, Manuela and Jorge, have both been guests on the Protrusive Dental Podcast in the past. https://www.youtube.com/watch?v=pznVMyEDwTE Highlights of this episode: 4:48 My Story: Refugee 1996 7:17 Life adversities 17:13 Importance of going through difficult moments 22:31 Podcasting Journey 27:38 Practicing a positive mindset 31:51 Importance of education and information 35:36 Good communication skills 45:38 Balance between the professional and personal life 55:25 Core values in life 59:30 Future goals for The Protrusive Dental Podcast and clinical dentistry Dr. Mahmoud Ibrahim and I are launching an occlusion course called OBAB (Occlusion Basics And Beyond). This course is o help you design and execute restorations from a single tooth to anterior aesthetic cases to full mouth rehab. Also, sign up for our monthly occlusion tip for you to get the kind of clinical content that we are preparing with OBAB If you loved this, be sure to watch Dentistry is STRESSFUL – this Podcast will help you

Preserve bone, be kinder to the tissues – but NOT necessarily at the expense of time. A great insight in to Atraumatic Extractions from Dr Diyari. Some say that ALL extractions should be atraumatic, and therefore this is a ‘made-up’ term by implant bods. By clarifying some misconceptions today, Dr. Diyari Abdah gives us an inside look at WHY and HOW atraumatic extractions can be efficient and effective. https://youtu.be/gS7h0L69hJ4 Check out this full episode on YouTube Protrusive Dental Pearl: Life Advice: “Never take advice from anyone who you wouldn’t switch places with” This episode is brought to you by Enlighten Smiles which is a premium brand of teeth whitening that guarantees B1 shade. If you want to know more about teeth whitening and get better results for your patients, do check out their webinar, Enlighten Online Training. Highlights of this episode: 1:28 Protrusive Dental Pearl: Life Advice 12:08 Atraumatic Extractions 15:02 Additional skill set and tools to achieve atraumatic extractions 24:24 Atraumatic Extractions Protocol 27:19 Literature regarding Piezosurgery 33:01 Collagen Plug Check out these studies regarding Piezosurgery: Clinical-Success-Bone-Surgery-with-Ultrasonic-DevicesDownload Essentials-in-Piezosurgery-Clinical-Advantages-in-DentistryDownload Learn more about Implant Dentistry with Dr. Diyari’s The Most Accelerated Practical and Comprehensive Dental Implant Course with ADDITIONAL 10% off (including the Early Bird pricing) If you enjoyed this episode, check out Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth

Half way in to a tricky extraction you hear a voice…”Maybe now is a time to raise a flap?” You ignore this voice and keep sweating with the luxator in hand, because it has been far too long since you raised a flap and you dread the nurse’s reaction. If this is you, then we got you. I brought on Consultant Oral Surgeon Dr. Sami Stagnell to share his tips and pearls in Oral Surgery, specifically WHEN and HOW to raise cleaner flaps, as well as what types of flaps to consider for each situation and when NOT to consider extending beyond an envelope flap. https://youtu.be/cx6HvrZtjcw Check out this full episode on YouTube Protrusive Dental Pearl: Nice and Clean Extraction Sites – Use the spoon end of Mitchell’s trimmer to clean the surgical site for 30 secs to 2 minutes. Highlights of this episode: 1:27 Protrusive Dental Pearl: Nice and Clean Extraction Sites 13:43 How to gain confidence in raising a flap 21:51 Envelope Flaps 30:09 Guidelines regarding relieving incisions 37:32 Raising a nice clean flap 41:45 Guidelines in lifting the papilla 44:56 Blades – 15 vs 15C vs 12 blade Improve your Oral Surgery Sectioning with this speed-increasing electric handpiece at Incidental Limited. And get 5% OFF their entire products with the code ‘onions‘! Check out the Oral Surgery Course that Dr. Sami Stagnell will be launching in 2023. If you enjoyed this episode, check out Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth