Protrusive Dental Podcast

Should we be doing more to save questionable teeth? What if you could buy more time — without compromising patient care? Dr. Omar Ikram returns for a powerful episode diving into the real-world decision-making between endodontics and implants. Together with Jaz, they explore tough scenarios — like teeth with nasty cracks or minimal remaining structure — and ask the critical question: when is it truly time to extract? They break down concepts like retained roots, root burial, amputation, and a new term Jaz introduces — palliative endodontics. Because sometimes the best outcome isn’t immediate replacement, but smart, strategic delay. https://youtu.be/5msP908JvuI Watch PDP238 on Youtube Protrusive Dental Pearl: When discussing treatment longevity with older patients, tailor your language to be more relatable. Instead of saying, “I plan my dentistry to age 100,” say, “I want this to last well into your eighties or nineties.” This makes the conversation more personal and realistic, helping patients better connect with the concept of long-term outcomes. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Understanding the limitations of implants compared to natural teeth is vital. Medical history significantly impacts dental treatment decisions. Managing patient expectations is crucial for satisfaction. Palliative endodontics can provide temporary relief and management. Reading and interpreting CBCT scans requires skill and experience. If it’s not that five millimeter defect, it’s up to you. The second molar is a good one because often second molars can’t be replaced with an implant. Retaining roots is definitely a good way to go. You need to risk assess the patient before extraction. Palliative endo is technically always an option. Success in endo can be often difficult to achieve. Asymptomatic and functional is a good criteria. If endo is on the table, it’s feasible. Highlights of this episode: 00:00 Teaser 00:35 Introduction 01:48 Protrusive Dental Pearl 04:15 Interview with Dr. Omar Ikram: Philosophy and Growth 10:17 Endodontics vs. Implants: Treatment Planning 16:35 Antidepressants and Dental Implant Failure 19:37 Managing External Cervical Resorption (ECR) 22:30 Patient Communication 24:16 Cracks and Complications in Endodontics 29:12 Endodontic Protocol 30:50 Challenges with CBCT and Cracks 32:07 Second Molars: Retain or Extract? 35:05 Retaining Roots for Future Implants 36:21 Root Burial and Special Cases 40:08 Root Amputation: A Niche Solution 40:57 Key Signs to Rethink Root Canal Treatment 43:17 Cracked Teeth: Poor Prognosis 47:08 Stained Crack Tooth 50:19 Success vs. Survival in Endodontics 56:02 Final Thoughts and Upcoming Events Want to sharpen your endo game even further? Watch Stop Being Slow at Root Canals! Efficient RCTs with Dr Omar Ikram – PDP163 Check out Specialist Endo Crows Nest — led by Dr. Omar Ikram, offering expert care, hands-on courses, and practical tips for real-world endodontics. 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: 070 ENDODONTICS (Endodontic diagnosis) Aim: To help clinicians develop a deeper understanding of when to preserve a tooth through endodontic treatment versus when to consider extraction and implant placement. Dentists will be able to – Identify key red flags that may contraindicate definitive root canal treatment. Understand the concept of palliative endodontics and how it can be used to delay or defer implant placement responsibly. Recognize the value of retained roots in maintaining alveolar bone, particularly in medically compromised or high-risk patients. #PDPMainEpisodes #EndoRestorative #BreadandButterDentistry

Is Practice Ownership worth the stress?  What’s the most difficult thing you have to do as a practice owner?  Thinking about starting your own squat practice? How long does it really take before you see profit, and what sacrifices do you need to make along the way? In this episode, Jaz is joined by Dr. Shabnam Zai to unpack the real highs and lows of running a dental practice. From the loss of control as an associate, to the resilience needed during COVID, to the challenges of leadership and managing a team—nothing is sugar-coated here. They also tackle the big money question: when does a squat practice finally become profitable, and is it worth the grind in those first few years? If you’ve ever wondered whether practice ownership is for you—or why it might not be—this episode will give you the clarity (and reality check) you need. https://youtu.be/Tf1bgOWMA2A Watch PDP237 on Youtube Protrusive Dental Pearl: “DO NOT COMPARE YOUR WORK TO WHAT YOU SEE ON SOCIAL MEDIA” Most cases shown online are the very best results, done under perfect conditions by clinicians with thousands of hours of experience.  Instead of letting that trigger self-doubt or imposter syndrome, use it as inspiration: respect it, aspire toward it, and occasionally achieve it — but remember that real-world dentistry is different. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Engagement in work is crucial for job satisfaction. Time management is essential for balancing work and family. Marketing and patient relationships are vital for practice growth. Quality time with family is more important than quantity. Coaching can help surface potential and provide accountability. Delegation is essential for effective practice management. Vulnerability can arise unexpectedly in practice ownership. Managing people requires empathy and clear communication. Being an associate can be fulfilling and offers flexibility. It’s important to have projects outside of dentistry. Balancing family life with practice ownership is challenging but possible. Financial planning is crucial before starting a practice. Understanding your priorities helps in making career decisions. Documenting staff performance is key to effective management. Continuous learning and self-improvement are vital for success. Highlights of this episode: 0000 Teaser 00:25 Intro 06:10: Guest Introduction – Dr. Shabnam Zai 08:38 Journey into Dentistry and Practice Ownership 15:08 Practice Philosophy and Security 16:33 Decision Making and Growth 19:10 Hardest Part of Being a Practice Owner 24:30 Balancing Parenthood and Dentistry 26:10 Coaching and Supporting Others 30:44 Compliance and Personality Types 34:15 Compliance and Personality Types 35:55 Navigating Career Vulnerability During COVID-19 37:06 The Importance of Self-Awareness and Managing People 40:07 The Forever Associate Trend 43:01 Projects vs Goals 48:33 Balancing Parenthood and Professional Growth 50:47 Financial Considerations for Starting a Practice 59:05 Final Thoughts and Mentorship Opportunities 59:42 Outro Enjoyed this episode? You might also like Treatment Co-Ordinators – Are They Right For Your Practice? – IC043 #PDPMainEpisodes #CareerDevelopment #BeyondDentistry Connect with Dr. Shabnam:Website → shabnamzai.comInstagram → @drshabnamzai This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes: B: Effective management of self and working with others in the dental team. AGD Subject Code: 550 PRACTICE MANAGEMENT AND HUMAN RELATIONS Aim: To provide dentists with an honest, practical insight into practice ownership—particularly squat practices—covering the challenges, rewards, financial realities, and mindset shifts needed for success. Dentists will be able to – Explain the main motivations for becoming a practice owner versus remaining an associate. 2. Describe the key challenges of practice ownership, including compliance, leadership, and financial planning. 3. Outline the realistic financial commitments involved in setting up a squat practice.

Are you living your career by design—or just letting it happen to you? Do you know what your ideal day as a dentist looks like? What about your ideal week? In this episode, Jaz is joined by Dr. Andrea Ogden to explore how you can design a career—and a life—in dentistry that feels purposeful and fulfilling. They dive into why many of us get stuck on autopilot, chasing goals we’ve never truly chosen, and how to break free by aligning work with your values.  Andrea also shares practical techniques to help you fall back in love with dentistry, so you can build a career that energises you—inside and outside the surgery. https://youtu.be/XDxlUFeEpbw Watch IC060 on Youtube Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 00:00 Teaser 00:21 Introduction 04:49 Guest Introduction – Dr. Andrea Ogden 06:05  Andrea’s Journey in Dentistry 08:51 Pivotal Moments in Dentistry 14:51 Trial and Error in Career Development 15:51 Current Role 16:59 Identifying Strengths vs. Enjoyment in Dentistry 18:18 Challenges for Young Dentists 21:51 The Importance of Career Awareness 24:05 Impact of Social Media 26:57 Understanding the Decline in Dentist Morale 31:51 External Factors Contributing to Stress 35:09 Internal Factors and Cognitive Dissonance 41:17 Practical Steps to Reignite Passion for Dentistry 47:32 Resilience Through Adaptation 48:59 Community and Support Networks 51:46 Enjoying the Journey 56:30 Outro Key Takeaways:  Dentistry is more than fillings and crown preps—it’s a career you can shape to truly excite you. Choose Variety & Joy – Build a mix of roles that energise you, not just ones you’re good at. Ditch the Comparison Game – Your journey is unique; stop measuring it against 15-year veterans on Instagram. Guard Your Values – Burnout often comes from a mismatch between what you believe in and where you work. Align the two. Create Space to Reflect – Slow down, think, and use SMART goals to plan your next step.  Find Your Tribe – Mentors, colleagues, and community will keep you inspired and resilient. Celebrate the Wins – Small or big, they’re proof you’re moving forward. Loved this conversation? You’ll also enjoy Passion and Values in Dentistry – PDP014 #CareerDevelopment #InterferenceCast #BreadandButterDentistry This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes  B: Effective management of self and working with others in the dental team. C: Maintenance and development of knowledge and skills within your field of practice. D: Maintenance of skills, behaviours and attitudes which maintain patient confidence in you and the dental profession, and put patients’ interests first.  AGD Subject Code: 770 – Practice Management and Human Relations Aim: To provide dentists with strategies, insights, and practical steps to rekindle passion for dentistry, align their work with personal values, and develop sustainable career satisfaction. Dentists will be able to – 1. Identify personal values and career drivers that contribute to long-term job satisfaction. 2. Recognise common stressors affecting dental morale and their underlying causes. 3. Apply structured decision-making frameworks (e.g., SMART goals) to career planning.

Is gold really dead or making a comeback 2025? Are zirconia and biomimetic dentistry sounding the final bell for precious metal restorations? Is there still a place for gold in modern practice—and when is it actually the best option? Dr. Lane Ochi joins Jaz for a rare live podcast episode to unpack the current and future role of gold restorations. From skyrocketing costs and lost lab skills, to emerging alternatives like milled cobalt chrome, this episode covers everything you wish dental school taught about gold. They even dive into clever tricks for temporizing gold and discuss the surprising lab workaround that may save your patient money—without compromising function. https://youtu.be/QWhY2_Oghd0 Watch PDP236 on Youtube Protrusive Dental Pearl: You can achieve profound anesthesia for lower molars—including cracked, heavily worn ones—using Articaine buccal infiltrations instead of an ID block, even in dense bone cases. 🔑 Key nuance: Ensure blanching of the attached gingiva and infiltrate through the papillae for better effectiveness. Watch the detailed technique breakdown (including patient feedback): https://youtu.be/cCXacw5DE4M?si=gDmYTKiFYxhYvbj3 Articaine works—master the nuances!  Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Use gold in tight spaces, short preps, or when longevity matters. Simpler preps = better milling, easier seating. Burnish when needed—but focus on great impressions. Talk to your lab. Explain your margins, internal spacing, and cement plans. Treat the patient, not just the prep: comfort, cost, and communication matter. Highlights of this episode: 0:00 Introduction 2:06 Protrusive Dental Pearl 06:19 Welcoming Dr. Lane Ochi 09:40 The Resurgence of Gold in Dentistry 14:11 The Importance of Preparation and Cementation 18:17 Cost-Effective Alternatives to Gold 21:39 Burnishing Gold Margins 26:53 Partial Coverage Margin Designs 29:04 Retention vs. Resistance in Tooth Preparation 43:14 Vertical Preps with Gold 45:05 Immediate vs. Delayed Dentin Sealing 47:23 Challenges with Temp Bonding and Solutions 49:13 Recap 50:02 Lab Considerations for Gold Crowns 54:53 Perforated Gold Crowns 57:24 Temp Bond Troubles and Fixes 59:59 Gold vs. Ceramic Longevity 1:06:25 Gold Crowns on Implants 1:08:44 Wrapping Up and Final Thoughts  Unlock webinars like this one by joining the Protrusive App. Studies Mentioned in the Episode: Marginal Gap of Milled versus Cast Gold Restorations Marginal Fit of Gold Inlay Castings Longevity of the Tooth Restoration Complex : A Review Catch another episode from Dr. Lane Ochi: Cracked Teeth and Dentistry’s Tough Questions with Dr Lane Ochi – PDP175 #PDPMainEpisodes  #BreadandButterDentistry #OrthoRestorative 🎓 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 Don’t miss Dr. Jaz Gulati and Dr. Mahmoud Ibrahim as featured speakers, presenting on “Occlusion Basics and Beyond” This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes B and C. AGD Subject Code: 250 OPERATIVE (RESTORATIVE)DENTISTRY – Preparation technology Aim: To provide clinicians with a comprehensive understanding of the rationale, techniques, and clinical considerations for using gold restorations in modern restorative dentistry, including when and how to use them, cost-effective alternatives, and how to communicate value to patients. Dentists will be able to – 1. Justify the use of gold restorations based on their mechanical properties, clinical longevity, and adaptability under occlusal forces. 2. Compare gold with alternative materials (e.g., zirconia, cobalt chrome) in terms of fit, performance, and cost-effectiveness. 3. Explain the principles of traditional and modern gold preparation designs, including vertical margins, bevels, and resistance features.

Can you apply the Dahl technique to localised POSTERIOR wear? Spoiler alert: hell yeah! How can the Dahl Technique help when there is posterior wear and NO space to restore? How predictable is building up posterior teeth (rather than the usual worn anteriors)? In this episode, Jaz dives into the ‘Reverse Dahl Technique’, a twist on the classic method typically used for localized anterior wear. Dr. Hans Kristian Ognedal from Norway shares his insights, explaining how building up posterior teeth with composite can lead to occlusion magic!  If you’re curious about this technique and want to see a real-life case study, this episode breaks it all down, with a special visual breakdown for those watching on YouTube or Protrusive Guidance. https://youtu.be/V8MTFfXmdlw Watch PDP235 on Youtube Protrusive Dental Pearl: Jaz shares insights from Hold On to Your Kids by Dr. Gordon Neufeld & Dr. Gabor Maté, emphasizing how modern children lose parental attachment too soon, turning to peers for guidance. This shift can lead to anxiety and emotional disconnection.  Takeaway: Kids thrive when their primary attachment remains with parents, not peers. Strengthening this bond is crucial for healthy development.  Need to Read it? Check out the Full Episode Transcript below! Key Takeaways The traditional Dahl principle focuses on creating occlusal space for anterior crowns. The reverse Dahl technique is a direct method for treating worn POSTERIOR teeth. Diet plays a significant role in tooth wear and dental health. Taking photographs of patients’ teeth can help track wear over time. Understanding the etiology of tooth wear is crucial for effective treatment. Building up dental anatomy is essential for successful restorations. Occlusion should be viewed as a dynamic system rather than a static one.  Patients can adapt well to this treatment modality “Patients that wear their teeth, they don’t usually have TMJ problems.” Highlights of this episode: 02:22  Protrusive Dental Pearl 04:50 Guest Introduction: Dr. Hans Kristian Ognedal 07:06 Understanding the Original Dahl Concept 09:31 Exploring Reverse Dahl Technique 13:30 Etiology and Patterns of Tooth Wear 23:46 Facial Patterns and Occlusal Traits Linked to Wear 24:44 Clinical Approach to Posterior Wear 30:26 Patient Comfort and Staging Treatments 32:11 Cuspal Planes and Guidance 34:21 Review Schedule and Observations 38:44 Longevity of Treatments 44:04 Contraindications and Patient Selection  45:24 Case Studies and Practical Tips 49:30 Night Guard Use 53:06 Final Thoughts and Education Opportunities If you want to learn more about Dahl Technique, be sure to listen/watch: Why do some Dentists find Dahl Distasteful? – PDP016 Dahl Part 2 (The Spicy Bit) – PDP017 Dahl Technique and ‘Maryland Bridges’ – GF001 This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes B and C. AGD Subject Code: 180 OCCLUSION (Occlusal functional concepts) Aim: To explore and understand the Reverse Dahl Technique, focusing on its application for patients with localized posterior tooth wear. This technique provides a solution when posterior teeth are worn, and there is insufficient space for proper restoration. Dentists will be able to – 1. Understand the principles behind the Reverse Dahl Technique and how it differs from the traditional Dahl Technique. 2. Identify the clinical scenarios where the Reverse Dahl Technique can be applied. 3. Comprehend the role of composite build-up in restoring posterior wear and its impact on occlusal reestablishment.

Do you feel confident managing patients with TMD or oro-facial pain? Are you clear on when to treat conservatively—and when to escalate? What’s the best SEQUENCE of care for TMD patients? Emma returns to Protrusive Students fresh from her finals, joining Jaz for an insightful episode on the basics of TMD management. Together, they explore the foundational steps of TMD care, from proper diagnosis to the logic behind a structured treatment hierarchy. They break down conservative versus aggressive approaches, share clinical tips for muscle and joint assessment, and highlight common mistakes to avoid—especially during palpation and history taking. Whether you’re a student, a dentist returning to practice, or just want a refresher on TMD, this episode will help solidify your approach and boost your clinical confidence. https://youtu.be/p5VJzwSka94 Watch PS016 on Youtube Need to Read it? Check out the Full Episode Transcript below! Key Takeaways TMD is a complex topic with various treatment approaches. Patient education is crucial in managing TMD effectively. Physiotherapy can significantly aid in TMD treatment. Different splints serve different purposes in TMD management. Bruxism can be a silent issue that affects many patients. Identifying the source of pain is essential for effective treatment. Stress can exacerbate TMD symptoms in patient cohorts Continuous learning and resources are vital for dental professionals. Highlights of this episode: 02:35 Emma’s Finals Experience and Advice 05:16 Deep Dive into TMD: Clinical Insights 09:59 Common TMD Disorders and Their Presentation 18:31 TMD Treatment Options 28:00 Medications and Appliance Therapy 34:25 Practical Tips for Managing TMD 37:19 Addressing Bruxism and Patient Communication 41:00 Protrusive Pathways and Future Plans 43:46 Protrusive Students S2 🔗 Protrusive Resources OPPERA Study Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group† TMD Therapy Hierarchy of Management Effects of occlusal splint therapy in addition to physical therapy on pain in patients affected by myogenous temporomandibular disorders: A pilot randomized controlled trial Splints Decision-Making Flowchart  📚 Protrusive Pathways Structured playlists grouped by topic (e.g., TMD, bridges, onlays): TMD Content Playlist 📝 Crush Your Exam Student NotesDownloadable summaries by Emma, covering TMJ anatomy and function, are available inside the Protrusive Guidance App (request student access via Mari) If you loved this episode, be sure to watch TMD New Guidelines! Evidence-Based Care – PDP213 #OcclusionTMDandSplints #BreadandButterDentistry #Communication This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes  C – Maintenance and development of knowledge and skill within your field of practice. AGD Subject Code: 200 – Orofacial Pain / TMD Aim: To provide a practical, evidence-informed framework for the conservative diagnosis and management of Temporomandibular Disorders (TMD). Dentists will be able to – 1. Describe the three major categories of TMD and their clinical features. 2. Differentiate muscular from joint-related symptoms using simple chairside tests. 3. Explain the rationale for a conservative, staged approach to TMD management.

Have you heard of Photobiomodulation (PBM)? Or are you thinking… ‘photo-what?!’ Is red light therapy just voodoo science—or is it already part of mainstream healthcare? Can PBM really help with wound healing, pain relief, and even reduce the risk of dementia? In this episode, Professor Praveen Arany joins Jaz Gulati to break down the science and clinical relevance of PBM in dentistry. They explore how this light-based therapy works, its applications in managing oral lesions, and why it’s already standard care for cancer patients undergoing chemotherapy. They also discuss real-world cases, practical protocols, and how PBM could shape the future of dental care. Whether you’re a skeptic or just curious, this episode will open your eyes to an emerging and evidence-based treatment modality. https://youtu.be/lQrawr3-YQA Watch PDP234 on YouTube Protrusive Dental Pearl: SHEEP Scoring as a practical tool to assess the prognosis and restorability of compromised teeth. 🐑 SHEEP stands for: S – Structure: Amount of remaining tooth structure H – History: Patient’s dental and medical history (e.g. caries risk, trauma) E – Endodontics: Endodontic prognosis (ease/difficulty of root canal treatment) E – Expertise: Your personal skill and experience with managing such cases P – Periodontal: Periodontal condition and bone support Each category is scored out of 10, and the total is doubled to give a percentage-based prognosis. This structured approach supports clinical decision-making, encourages honest reflection on the clinician’s own skills, and enhances patient communication during consent. The method is backed by literature, including a paper co-authored by Martin Kelleher. Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Photobiomodulation can significantly improve patient comfort and healing. The treatment is standard for cancer patients undergoing chemotherapy. There are no known adverse effects of PBM when used correctly. PBM can be used effectively in various dental procedures. The future of PBM includes personalized treatment protocols. Research is ongoing to optimize PBM applications in dentistry. PBM is distinct from other laser treatments and has unique benefits. The technology is becoming more accessible to practitioners. Awareness of PBM’s benefits is growing in the wellness industry. 📚 ResourcesProf. Praveen Arany shares papers on: Light buckets and laser beams: mechanisms and applications of photobiomodulation (PBM) therapy Photobiomodulation therapy: Ushering in a new era in personalized supportive cancer care Photobiomodulation Therapy by Prof. Praveen R. Arany Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022 For full PDFs, you can check out Protrusive Guidance. 📖 You can find more of Prof. Praveen Arany’s scientific papers on Google Scholar 📢 Two Upcoming PBM Courses! ADA PBM Course – A dental-focused program by the American Dental Association.📧 Contact: Sherie Tynes – tyness@ada.org PBM in Supportive Cancer Care – Held at Gustav Roussy Hospital, Paris.📧 Contact: Dr. Camelia Billard – camelia.billard@gustaveroussy.fr If you liked this episode, check out Medication Related Osteonecrosis for GDPs – What You Need to Know (MRONJ) – PDP215 #PDPMainEpisodes #OralSurgeryandOralMedicine #BreadandButterDentistry #CareerDevelopment This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B & C. AGD Subject Code: 135 – Laser Therapy/Electrosurgery Aim To introduce dental professionals to the fundamental science, clinical applications, and emerging potential of Photobiomodulation (PBM) therapy in dentistry. Dentists will be able to – Define photobiomodulation (PBM) and explain how it differs from surgical laser applications. Describe three key mechanisms of PBM at the molecular level. Identify clinical situations where PBM can enhance patient outcomes (e.g., mucositis, ulcers, TMD).

Should you be re-treating that root canal—or referring it out? What are the red flags that scream “specialist only”? How do you confidently remove GP without compromising disinfection? Dr. Ayman Al-Sibassi joins Jaz in this endo-packed episode to help you navigate the tricky world of root canal re-treatments. From solvent selection and GP removal techniques to assessing case difficulty, they break down everything a GDP needs to know to make smart, confident decisions. You’ll learn how to spot the cases you should be tackling, which ones to send to your endodontist, and what tools and techniques will make the re-treatment process smoother and safer. Because not all re-treatments are created equal—and some are surprisingly simple once you know what to look for. https://www.youtube.com/watch?v=apMtcuNTLqI Watch PDP233 on YouTube Protrusive Dental Pearl: A crack in a bonded ceramic restoration isn’t necessarily a failure! Just like we accept cracks in natural enamel, we can also accept cracks in ceramics—as long as it’s been properly bonded. Shoutout to Dr. Pascal Magne for this powerful mindset shift! Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Specialist training in endodontics includes a variety of surgical skills. The complexity of root canal retreatments varies significantly. General dentists can perform some retreatments, but should assess complexity carefully. Patient consent is essential, especially regarding potential unrestorability. Communication about fees should be clear and upfront with patients. Red flags for retreatment include poor coronal seal and previous treatment quality. CBCT imaging is becoming increasingly important in endodontic practice. Collaboration between general dentists and specialists enhances patient outcomes. Many referrals stem from straightforward cases that are poorly managed. Using solvents can aid in GP removal but should be approached cautiously. Single visit treatments are often preferred for patient convenience. Adequate disinfection is crucial, sometimes necessitating a second visit. The survival rate of root canal-treated teeth is comparable to implants. Patient age and overall health should guide treatment decisions. Understanding the difference between success and survival in endodontics is essential. Highlights of this episode: 00:00 Introduction 05:02 — Protrusive Dental Pearl: Cracks in enamel vs. dentine  06:34 — Guest Introduction: Dr. Ayman Al-Sibassi and his journey into Endo  11:03 Assessing the complexity of re-treatments and when to refer 15:21 The role of CBCT in diagnosis and treatment planning 17:47 Ethical and financial dilemmas: charging for unrestorable teeth 22:05 Red flags in root canal re-treatments 34:55 Techniques for GP removal and file selection 47:07 Cost vs. predictability: re-treatment vs. implants and long-term outcomes Take a look at this Endodontic Complexity Assessment Tool to help you evaluate how challenging a root canal case really is. If you enjoyed this episode, you’ll definitely want to check out: Stop Being Slow at Root Canals! Efficient RCTs with Dr. Omar Ikram – PDP163 This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject Code: 070 ENDODONTICS (Non-surgical treatment)  #PDPMainEpisodes #EndoRestorative Aim: To provide clinicians with a structured approach to diagnosing, planning, and executing simple Re-Root Canal Treatments (Re-RCTs), while recognizing case limitations and improving treatment outcomes. Dentists will be able to: Identify clinical situations where Re-RCT is appropriate and distinguish them from cases requiring referral or alternative treatment. Describe the potential challenges such as canal blockages, separated instruments, or apical complications, and know when to refer. Communicate effectively with patients regarding prognosis, risks, and treatment expectations, including the need for possible referral.

Are you confident when increasing the vertical dimension? How do you plan, stage, and sequence a full-mouth case safely? What’s the right deprogramming method—leaf gauge, Kois appliance, or something else? Dr. David Bloom joins Jaz in this powerhouse episode to demystify the real-world process of increasing vertical dimension. With decades of experience in comprehensive dentistry, David shares how he approaches diagnosis, bite records, temporization, and final restorations—with predictability and confidence. https://youtu.be/gAaP0VYP84s Watch PDP232 on YouTube Protrusive Dental Pearl: Pick one occlusal philosophy and stick with it until you understand it well through real cases. Once you’re confident, stay open to other approaches—hearing different views will make you smarter, more flexible, and a better dentist. If you are looking to get started with the foundations of Occlusion, check out our comprehensive Online Occlusion Course. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 00:00 Trailer 00:55 Introduction 04:43 Guest Introduction: Dr. David Bloom 10:25 Equilibration Techniques Explained 11:18  Interjection #1 15:50  Opening Vertical Dimension vs. Orthodontics 18:06 Interjection #2 23:05 Whitening and Restorative Solutions 25:27 Guidelines for Raising Vertical Dimension 25:52 Interjection #3 29:28 Midroll 32:49 Guidelines for Raising Vertical Dimension 36:06 Visual Try-In and Adapting Vertical Dimension 40:16 Case Planning and Execution 41:16 Interjection #4 43:42 Case Planning and Execution 50:23 Material Preference for Provisionals 52:00 Bite Registration and Final Adjustments 55:06 Do’s and Don’ts for Clinicians 57:15 Conclusion and Resources 58:59 Outro Key Takeaways Vertical Dimension and Adaptation: Opening the vertical dimension in dentistry can be challenging, especially for edentulous patients who lack proprioception. However, with proper planning and understanding of occlusion, the human body can adapt remarkably well. Occlusal Philosophy: It’s important to learn one occlusal philosophy well, whether it’s Kois, Dawson, or another. Understanding different approaches can make you a more rounded clinician, as different patients may benefit from different methods. Equilibration and Deprogramming: Equilibration is crucial for idealizing occlusion by eliminating interferences. Deprogramming helps in achieving centric relation, a stable and repeatable position for the condyles, which is essential for successful equilibration. Orthodontics vs. Vertical Dimension: Deciding between orthodontics and opening the vertical dimension depends on the specific case. For example, pre-aligning patients with orthodontics might be necessary to address a restricted envelope of function. Testing and Adaptation: Testing the vertical dimension with transitional materials like composite can help patients adapt before moving to definitive restorations. Experienced clinicians may sometimes proceed directly to final restorations based on their judgment and diagnostic steps. Get CE/CPD for this episode only on the Protrusive Guidance App. 🖥️ A new website is launching soon by Dr. David Bloom — ppcontinuum.com Also, Dr. David Bloom’s hands-on courses on veneers and minimally invasive dentistry If you found this episode valuable, you’ll definitely want to watch PDP197: Vertical Dimension – Don’t Be Scared!, part of Occlusion Month. #PDPMainEpisodes #OcclusionTMDandSplints #BreadandButterDentistry This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject Code: 180 OCCLUSION (Occlusal therapy) Aim: To provide clinicians with a comprehensive understanding of how to safely and predictably increase the vertical dimension of occlusion (VDO) for restorative cases, using a diagnostic-driven, conservative, and patient-centred approach. Dentists will be able to:  Describe the indications and contraindications for increasing VDO. Differentiate between conformative and reorganized approaches to occlusal rehabilitation. Identify the steps involved in diagnostic planning, including CR bite records, wax-ups, and visual try-ins.

How do you manage patients that have ultra high expectations? What’s the best way to communicate cosmetic outcomes before the final result? How do you balance your aesthetic vision with what they see? Dr. Brandon Mack joins Jaz for a deep dive into the realities of cosmetic dentistry—from subjective perceptions of beauty to practical tips that make or break a case. They discuss how to navigate aesthetic stress, manage patient expectations, and even go into Brandon’s favorite veneer cement and occlusal philosophy. Plus, Brandon shares key failures that shaped his journey—and how you can avoid the same pitfalls. https://youtu.be/s7puDNP3d7U Watch PDP231 on YouTube Protrusive Dental Pearl: When discussing smile design with patients, especially in high-end cosmetic cases, set the right expectations early by using this memorable “Eyebrow Analogy”: Central incisors = Twins (they should be as symmetrical as possible) Lateral incisors = Sisters (not identical, but related) Canines = Cousins (more individual) This helps patients understand that perfect symmetry isn’t always natural or necessary — especially for lateral incisors! Need to Read it? Check out the Full Episode Transcript below! Key Takeaways Cosmetic dentistry as a lens through which all treatment should be approached—balancing patient autonomy with ethical care. Managing expectations begins before the patient sits in the chair. It continues through structured checkpoints: from initial consultation to provisional feedback and final delivery. Temps aren’t just placeholders—they are test drives. They align expectations between the dentist, patient, and lab, reducing surprises and improving satisfaction. Some dentists may under-diagnose due to fear of rejection—not out of true minimalism. Thoughtful planning can make “more treatment” actually less invasive. Patients often want teeth that are both ultra-white and natural-looking. Brandon developed the concept of believability—a visual balance that delivers a wow-factor while still appearing real. Creating a mathematically perfect smile can make natural facial asymmetries more obvious. Dentists must weigh beauty against harmony. Social media and filters have distorted patient self-perception. Dentists must learn to identify signs of body or tooth dysmorphia and respond ethically—not just clinically. Building relationships with ceramists over time—expecting 15–20 cases before finding synergy. Each technician has unique strengths and should be matched accordingly. Composite veneers are accessible and beautiful—but extremely technique-sensitive. You become the ceramist. Brandon admires them but uses them selectively due to long-term maintenance concerns. Panavia Veneer Cement – Translucent for its predictable handling, strength, and minimal risk to thin ceramic restorations. Highlights of this episode: 01:35  Protrusive Dental Pearl 03:11 Dr. Brandon Mack’s Journey and Philosophy 09:19 Managing Patient Expectations in Cosmetic Dentistry 14:23 Choosing the Right Technician 21:13 “Undersell and Overdeliver” Philosophy 25:12 Conservatism in Cosmetic Dentistry 26:48 Overcoming Failures 33:15 Body Dysmorphia in Dentistry 37:28 Occlusal Philosophy and Techniques 38:30 Fake It Till You Make It? 40:38 Veneer Cement  42:07 Composite Veneers 44:17 Upcoming London Event and Final Thoughts 🌴 Coming Soon: Occlusion in Dubai 🌴A luxury course experience at Atlantis, The Palm — yes, the one with the famous waterpark! 🦷 Learn practical occlusion during the day👨‍👩‍👧‍👦 Bring your family for a fun, relaxing getaway📍 World-class location, world-class content 🎟️ Coming Soon: Brandon in London (February 6th and 7th, 2026) – Soho Hotel Two-day immersive aesthetic experience aka ReturnofTheMack Rewire how you think about cosmetics with Dr Brandon Mack Participants will learn how to create personalized smile transformations that harmonize with each patient’s unique facial features, moving beyond generic smile designs to achieve truly customized results that enhance overall facial aesthetics. Bigger picture and smaller details in 2 days: transition zones, light interaction, surface modulation For new grads and seasoned dentists alike→ “It’s like re-reading a great book. The content didn’t change — but you did.” Discount Code: PROTRUSIVE for £100 off (case sensitive) If you enjoyed this episode, don’t miss PDP129: 4 Rules of Planning Aesthetic Dentistry (Ortho-Resto) #PDPMainEpisodes #AdhesiveDentistry #CareerDevelopment This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A, B, C, and D AGD Subject Code: 780 ESTHETICS/COSMETIC DENTISTRY (Tooth colored restorations) Aim:  To enhance the clinician’s ability to manage patient expectations, communicate effectively with labs, and deliver predictable, high-level aesthetic outcomes in cosmetic dentistry through philosophy-driven protocols and reflective case-based learning. Dentists will be able to – Understand the importance of managing patient expectations in elective cosmetic procedures. Recognize the role of provisional restorations as communication tools between dentist, patient, and lab. Reflect on how personal failures can lead to clinical growth and stronger aesthetic outcomes.