Protrusive Dental Podcast

We’ve now come to the last bit of this 3-part Oral Surgery Complication series with Dr. Chris Waith. I’m going to be honest, I have a lot of concerns about Tuberosity Fractures – they scare the bejeebers out of me! We all know that it can be a really nasty complication. Fear not! Dr Waith will teach you how to prevent and manage maxillary tuberosity fracture. https://youtu.be/ZQuDeViQiX4 Check out this full episode on YouTube “If there’s a really tight contact between those three molars, the two teeth you’re extracting, just spend a minute skimming the contact points.“ – Dr Chris Waith In this episode, we discussed about: Risk factors of tuberosity fractures 1:40 How to manage when you hear the crack of the tuberosity 3:57 High risks patients 6:35 Leaving a loose bone as a space filler in soft tissue 9:07 Join us in our Telegram group! Let us help each other out! If you loved this episode, be sure to check out the first part! Dry Sockets – How to Prevent and Manage Them?

“Wait, Dentists still carry out Equilibration?!”, that was the reply in our recent discussion on the Protrusive Telegram group when I announced this episode. Yes, Saranga, they still do! The topic of occlusal equilibration is a very controversial one. In this episode you’ll realise the WHY and HOW an equilibration is carried out by one of the best Dentists I ever had a pleasure of shadowing (and also one of the most precise and OCD Dentists I know!) Dr Koray Feran. https://www.youtube.com/watch?v=0CjKu24R5GU Check out the full episode on the Protrusive YouTube Channel! Let us learn more about the potential benefits and challenges of equilibration with Dr. Koray Feran, who is a wet fingered practitioner of the highest calibre. Protrusive Dental Pearl: When you have a patient who has a crowding and they want veneers, and you want to convince them to have some orthodontics first….. Instead of saying, “Oh, I have to remove this part of the tooth.” You could instead say “I don’t want to have to remove your healthy body parts to be able to achieve this goal.” Language is powerful! “Equilibration is one bit of the pie, it’s a tool. It’s not a magical process. It’s to resolve a situation that you’ve diagnosed.” – Dr. Koray Feran In this episode, we talked about, Does equilibration matter? 9:38 What is equilibration? 11:59 What are we trying to achieve in equilibration? 21:12 When should finding centric relation be a part of examination protocol? 29:18 We discuss full mouth comprehensive dentistry and preventing failure 33:32 Orthodontics is full mouth rehab! 49:26 Risks and Benefits of Equilibration 46:00 Fundamental rules of Occlusal Equilibration 52:33 Protocol after equilibration 57:09 Why is equilibration not routinely practiced by Dentists?  1:02:12 To learn more about equilibration, check out Dr. Koray’s occlusion course! If you loved this episode, you will definitely like If You’re Not In CR, You Will Die with Dr Kushal Gadhia!

After the last group function where a juicy bit of dry socket has been tackled, I was again surprised by Dr. Chris Waith that managing OACs was such a simple matter of using your existing tools – there is some super real-world GDP-friendly advice in this episode. https://youtu.be/aHV15R0SNaw Check out this full episode on YouTube “If the OAC is bigger than 5mm, you really get into the point where I don’t necessarily think we should be expecting GDPs to do something super courageous at that point.” – Dr. Chris Waith In this group function we talked about: The Classic OAC regimen  1:31 Oro-Antral Communication Management 6:37 Medications for an OAC 8:55 If you loved this episode, be sure to check out the first part! Dry Sockets – How to Prevent and Manage Them?

When did they change the ingredients of Alvogyl?! It’s the return of Oral Surgery Specialty Dentist and sensible man Dr. Chris Waith – this time to answer our Oral Surgery Complication questions starting with Dry Socket prevention and management! https://youtu.be/QiOJAwxAZE8 Check out this full episode on YouTube “It will be better no matter what we do, whether we dress it or not, it’s just whether you can live with that timeframe.” – Dr Chris Waith In this group function we discuss: How can we prevent dry sockets? 3:54 Can suturing help in preventing dry socket? 10:43 How to manage patients in pain with dry socket 15:39 Does Irrigation and Alvogyl actually help in managing dry sockets? 19:09 Click for ->Chris Waith’s Oral Surgery Course If you enjoyed this episode, check out Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth

I think we owe it to our patients to a know some fundamentals of full arch implant Dentistry, even if you do not currently place or restore implants. Make a big cup of coffee because this is one of those longer episodes! I am joined by Restorative Specialist Dr. Harpal Chana to breakdown FP1 to RP5 and exactly what GDPs should know about full arch implant prostheses. https://youtu.be/QY_3SZKdc0U Check out this full episode on YouTube Protrusive Dental Pearl: Instead of booking patients for a ‘fit appointment’ for crowns or bridges, rebrand it to ‘try-in appointment’. This takes the pressure off of you and your technician – in the small chance that things are not perfect, you can correct it and book their fit. If everything is good at the ‘try-in’ you can go ahead and fit your work definitively. It’s just a good way to manage expectations and reduce the chance of disappointments and surprises. As Promised! Infographic summarising FP1 – RP5 classification In this episode we talked about: Dr Harpal Chana’s journey to full arch dentistry 8:19 The initial stages of full arch complex implant reconstruction 15:18 What determines a terminal dentition? 23:52 Implant Reconstruction Options for GDPs to know + Classification 31:03 Difference between Implant retained and Implant Supported 37:10 How many implants? 40:56 Research about the quality of life that impacts clinician’s decisions 48:40 Learning how to place the first implant 56:56 Advice for dentists who wants to learn implants 1:08:00 If you liked this episode, you will love to listen and learn about Implant Assessment for GDPs: from Space Requirement to Ridge Preservation Implant Overdenture and All-on-4 course Sponsored by Nobel Biocare 12-13th March 2022 at Elmfield House Dental Education, Teddington, London. Hosted by – Harpal Chana, Harjot Bansal, Pynadath George, Manish Patel, George Xirogiannis, Hannah YoungSummary: Beginners course for fixed and removable implant retained and supported bridges and dentures. Cover implant planning, bone grafting, prosthetic planning and execution, dealing with failures and maintenance of appliances and implants. Register your interest by emailing: info@elmfieldhousedental.co.uk

All of the Protruserati clan get 15% OFF the third molar experience with the code ‘protrusive‘! A brilliant course by Dr Nekky Jamal A tricky Third molar surgery can humble even the most experienced of Oral Surgeons. Surgical removal of Wisdom teeth has become somewhat of a post-graduate discipline, with many Dentists lacking the confidence or even the appetite for their removal. We have today the very enthusiastic Dr Nekky Jamal who is a GDP that lives and breathes third molar surgery. He shares with us his top tips for the planning and execution of M3Ms surgery! Protrusive Dental Pearl: When you are sectioning a mesio-angular impacted tooth, start your section 1-2 millimeters more mesial to where you think the furcation is – you will have a tendency to drift distally and therefore more likely to HIT that furcation which is when the magic begins. https://youtu.be/Cc_dp2ktt2w Check out this full episode on YouTube (Regarding disto-angular third molars) “If you lose your crown, you almost lose your ability and your orientation of where that tooth is.” Dr Nekky Jamal Click Here to visit Nekky’s Third Molar Experience Course – coupon code is PROTRUSIVE. In this episode, I asked Dr Nekky about: What clinical and radiographic features suggest an easier third molar? 9:51 Main features that identify a tricky third molar worthy of referal 15:15 The two characteristics to determine the difficulty of third molar removal 16:37 Things to look out to determine a high risk of inferior alveolar nerve damage 20:15 Does CBCT help in planning tooth removal for Wisdom Teeth 24:19 When to consider a coronectomy? 26:37 Tips and Tricks on how to get cleaner flaps 30:54 The Hydraulic flap Technique 32:34 Armamentarium for wisdom tooth removal 35:30 Three magic Nekky tips 38:33 Join us in our Telegram Community, where we can always help each other out! If you enjoyed this episode, check out Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth with Dr Chris Waith

Building on from Basics of Occlusion Part 1, I am joined Dr Mahmoud Ibrahim who takes us on his journey from hating Dentistry to eventually loving occlusion and aesthetic Dentistry. We geek out over occlusal contacts, the occlusal examination and freedom in centric! https://youtu.be/emfAS95VARU Check out this full episode on YouTube Protrusive Dental Pearl: When you’re checking occlusion after placing your restoration, check on the contralateral side with the articulating paper (19 microns, for example) to see if it is ‘passing through’. If it does pass through, double up the articulating paper (now 38 microns). You can keep doubling-up if you need to, until the paper holds. How does this help? You’ll know right away if you need to adjust anything, and if so, you’ll get a better idea of how much adjustment is likely. “Keep everything nice and smooth, the patient has nothing to grab hold of and push against. That’s probably going to make sure your restorations last a lot longer.” – Dr. Mahmoud Ibrahim Jaz Edit to the above quote: By ‘Smooth’ we don’t mean highly polished or glazed. We refer to the movements of the mandible being smooth, rather than jerky or abrupt. 3-minute Occlusal Examination PDF – Click here In this episode, we talked about: 7:59 Mahmoud’s journey in Falling in love back to Dentistry 13:16 Tripodized Contacts 19:55 How to maximize cusp to fossa 26:54 Bonus little trick on avoiding high restorations 28:40 What do we check in a basic occlusal examination? 38:15 Freedom from Centric/Freedom in Centric 49:11 Relevance of the Centric Relation Contact Point 56:41 Disadvantages of doing MIP vs Centric Relation Contact Point Join us in our Telegram Community, where we can always help each other out! If you loved this, be sure to watch the Part One of the Basics of Occlusion!

Dr Jane Lelean will teach us how to implement ‘Hypnodontics’ techniques so that we can calm our patients, create a positive environment and even reduce post-operative clinical complications! https://youtu.be/oesEIRfJvdE Check out this full episode on YouTube “Hypnodontics isn’t just for patients, many dentists are using it to reduce their stress levels and their anxieties too” – Dr Jane Lelean In this episode, we discuss: Is there an official qualification before practicing hypnodontics? 8:24 Two general types of hypnotherapy 9:13 Evidence-Base of hypnodontics in Dentistry 11:57 How can we incorporate hypnodontics in our practice 15:45 Reducing post operative complications and pain with hypnodontics 26:43 Changing the post operative instructions 30:02 Help from Hypnotherapist regarding Bruxism 36:28 Check out The Institute of Dental Business to learn more about Hypnodontics and Hypnotherapy with Jane Lelean. If you loved this episode, please do check out What Every Dentist Should Know About Managing Dental Anxiety with Dr. Mike Gow

What is Occlusion? Canine Guidance…..Group Function…that’s all right?! If only it was that simple! I hope to simplify Occlusion no matter where you are in your journey starting with this back to basics episode. Occlusion is the backbone of complete dentistry and full mouth rehabilitations. https://youtu.be/nCRepLglJBk Check out this full episode on YouTube Protrusive Dental Pearl: If you think your patients are in Canine Guidance, check again. This time check while the patient grinds really hard. You will notice that most people are really group function and even have non-working side guidances! “It’s very difficult to say that one occlusion is perfectly correct for all individuals. And I don’t think we’ve identified an ideal occlusion for a specific person.” – Dr. Ed McLaren In this first episode on Occlusion I shared: Canine Guidance vs Group Function 5:54 Evidence base about Occlusion and TMD 10:34 Challenges in researching Occlusion and TMD 13:13 Different Schools of Thoughts about Occlusion 19:42 Centric Relation 23:27 Centric Occlusion 30:34 What is Occlusion? 35:29 Occlusion vs Occluding 37:12 Test driving the changes 46:11 Check out my 9 point checklist to never have high restorations again on YouTube: https://youtu.be/zX4fcYn7POM No More High Restorations Be sure to check out the best Dental Event of the year, the Dentinal Tubules Congress And as a reference for the terms, here’s THE GLOSSARY OF PROSTHODONTIC TERMS 9th Edition If you liked this episode, you will also enjoy Posterior Guided Occlusion 

Vertiprep? Dirtyprep? There are some Dentists who will literally opt for an adhesive onlay for every indirect restoration. That’s not cool – they are not a panacea. On the flipside, there is a breed of Dentists who identify as ‘Verticalists’. They will vertiprep their grandmother if they could. The answer lies somewhere in the middle – everything is case dependent. In this episode, with the return of my friend Jorge Cardoso, we revise Vertical Preparation, decision making protocols for indirect and then explore the nuances of digital scanning for vertical preps (even if they are super subgingival). https://youtu.be/AAWRJjEKN_U Check out this full episode on YouTube Protrusive Dental Pearl: Impressions vs Digital. Remember, if you’re going digital, you need to be more aggressive in your tissue retraction compared to impressions. If the light from the scanner tip does not reach beyond your margin, it will not be recorded. Whereas with impressions, the wash material can flow beyond the margin and capture the sulcus, even if you cannot see it. Treatment Plan Letters with MakeMeClear discount – all of the Protruserati clan get 25% OFF the monthly or Annual plan with the code ‘protrusive‘! Trial it for 21 days and generate letters and listen to Episode 49 – Crystal Clear Treatment Plan Letters Fancy joining us for a POTENTIAL trip to Portugal for hands-on Vertical Prep? Click here and I’ll email you if/when this gets the go-ahead. We are thinking Spring 2022! In this episode Dr Jorge and I talked about: What is vertical preparation 8:17 Two types of vertical preparations (BOPT / Edgeless vs Shoulderless) 13:57 Guidelines on temporising vertical preps 17:40 Traditional vs Digital in Vertical Preparation 23:29 Criticism of Vertical Preparation with Biological width 30:19 Concept of “kissing the bone” 35:33 Spacer Protocols for Technician 40:54 Common mistakes with verti prep 45:02 Digital Scanning tips for Vertical Preparation 49:37 Sorry that Dr Jorge’s screen share did not show in the main video, we had some AV issues. Please find below an 8 min snippet where he shares his screen at various points https://youtu.be/e8psNUVMQ5g As promised here’s BOPT by Ignazio Loi Do Check out Dr. Jorge Cardoso’s episode with Crystal Clear Treatment Plans that Wow Patients and are Easy to Understand If you want to learn more about vertical preparations check out eMax Onlays and Vertipreps with Dr Jason Smithson