Protrusive Dental Podcast

You're faced with a beautiful crown with what seems like a decent root filling - but there's an apical infection present. Is the answer always endodontic re-treatment? When should we instead consider apical surgery so we can clear the infection WITHOUT drilling through the crown or having to dismantle posts? In this episode, specialist endodontist Dr. Peter Raftery and his associate Dr. Manpreet Dhesi will be talking about the Apicoectomy procedure that can be used to treat root-filled teeth using a 'retrograde' approach. They will discuss about how it fits into general dentistry, its indications and contraindications, its cost analysis vs implants and and the entire protocol for performing Apicoectomy https://youtu.be/sZOsLuuf-Vo Watch PDP148 on Youtube Protrusive Dental Pearl: The periradicular surgery guidelines issued by BES and the Royal College of Surgeons. Download the guidelines about periradicular surgery or on the app under the Protrusive Vault (where all the different files and infographics and the different things that you get as a Protrusive premium member) BES-RCS-Peri-Radicular-Surgery-GuidelinesDownload Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 1:37 The Protrusive Dental Pearl 3:32 Dr. Peter Raftery’s introduction4:05 Dr. Manpreet Dhesi’s introduction5:16 What is Apicoectomy?6:29 Oral Surgeons vs Endodontists?8:48 Is a Microscope mandatory for Apicoectomy?10:08 Apicoectomy for posteriors11:00 Isolation Protocol for Anterior Apicoectomies11:35 Apicoectomy Protocol15:03 Disinfection Protocol18:41 Moisture control from the bleeding20:43 Risk of surgical emphysema - Is special handpiece needed?21:52 Indications and Contraindications for Apicoectomy 27:46 Endodontic Re-treatment29:05 Cost benefit analysis of Apicoectomy31:20 Success rate for Apicoectomy34:19 Case Scenario 1: 82-year old patient with a singular crown, root filling and a radicular pathology42:10 Retrograde fillings of choice  44:09 Grafting after Apicoectomy - is it needed?45:04 Equipments for Apicoectomy47:11 Learning more about Apicoectomy Apical Microsurgery Instrument Kit- the mirror, the pluggers, and the little curettes by Hu-Friedy UK Apical-Microsurgery-Instrument-KitDownload If you enjoyed this episode, check this another episode by Dr. Peter Raftery: How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique Click below for full episode transcript: Jaz's Introduction: Root canals are not 100% successful. Let's face it, nothing in dentistry is a hundred percent predictable, and sometimes we are confronted with a scenario such as a beautiful central incisor crown and it's a root filled tooth, or worse yet a tooth and incisor, usually with a long thick post inside of it. Jaz's Introduction:Now, just because it looks good on the radiograph doesn't mean it was a good quality x-ray. We all know that. But anyway, let's say it looks like a decent root filling. There are no voids in it, and now you're really questioning whether it's really feasible to go down a root canal re-treatment, or is there another option? And sometimes that other option, which really comes into play in these scenarios is an apicoectomy where a flap is raised, the infection is curetted, and a bit of the root, a bit of the apex is chopped away, and then boney healing takes place. Now this is known as microsurgical endodontics. It used to be done a lot by oral surgeons in the UK at least many years ago. And now endodontists have reclaimed this territory and suggest that actually this is the way we do it to get high predictability. And that's exactly what we're got to discuss in this episode. Hello, Protruserati. I'm Jaz Gulati. I'm joined in this episode by Dr. Peter Raftery,

Stop waffling and start communicating effectively. Stop giving 75 different treatment options and RECOMMEND the ideal plan based on their goal (hint: ask more questions!). Become efficient with patient communication by switching to video letters using Loom. In this episode, Prav Solanki talks about the trust built between the Dentists and their patients, and how that trust is the foundation for providing the best treatment plan for each patient. After this episode you will realise that sales is NOT a dirty word, and you will love his definition of it. https://youtu.be/cNVMKpzbqXI Watch IC038 on Youtube Check out the example Loom videos on Premium Clinical Videos section of the Protrusive App. Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content Need to Read it? Check out the Full Episode Transcript below! Highlights of the episode: 6:33 Prav Solanki’s Introduction8:56 Sales in Dentistry13:53 Information that patients needs to know before being eligible for a free consultation18:47 Learning the art of concise communication25:56 2 Stage processes in Business27:58 How to build trust with your patients34:05 Delivery of the Treatment Plan36:51 Using Loom for Treatment Plan Presentation Check out courses by Prav Solanki: https://courses.iasortho.com/courses/gb/business-mindset-mastery https://courses.iasortho.com/courses/gb/phone-school-with-prav-solanki https://courses.iasortho.com/courses/gb/sales-and-communication-mastery-for-tcos If you enjoyed this, you will also love Presenting Treatment Plans the Comprehensive Way Click below for full episode transcript: Jaz's Introduction: You could be the best dentist in the world with your hands, but if you can't communicate effectively with confidence to your patient, if a patient can't sense that you as a clinician are confident to carry out whichever plan you are advising, then guess what? Jaz's Introduction:The patient will not go ahead and that's a disservice to the patient because you have your heart in the right place. You've trained for this. You've been on additional courses, but if you can't convey that to the patient, then it's an absolute waste. Hello, Protruserati. I'm Jaz Gulati. Welcome to this Interference Cast, this non-clinical interruption to help you grow as a dentist and do more dentistry on the right patients and get better outcomes. That's what it's all about with Protrusive, as has evolved over the last three years. The key word of this episode, that episode title I really purposely picked it is RECOMMEND, right? Recommending treatment plans with confidence. And I think the word recommend is so, so key because it's something that you, as a clinician, you earned the right and you'll see later in this episode why I use these specific words. You've earned the right, you've done their full examination. You've got all this training behind you, now you can make a recommendation to a patient. And I think a lot of dentists are guilty of not recommending. What I mean by that, I'll just expand a bit, is what if you've just finished your examination and instead of recommending something to a patient, instead of that, you are just splurging out. We can do a filling, we can do a sandwich, we can do a crown, we can do an onlay, we can do this, that and the other. And then really you give your patients choice fatigue. And you're not really guiding them, you're not advising them. You're basically like trying to give them all this dental knowledge and letting them decide for themselves. There's something not quite right about that. And the beauty of the word recommend is it empowers you, the dentist, to use all that information that you've gathered during the consultation to come up what is the best plan for that patient? I'm joined today by Prav Solanki. He's now a good friend of mine.

Following the cliffhanger from Part 1 where the theme was Diagnosis - we now discuss the two main protocols of internal bleaching: the Inside-Outside Bleaching technique and Walking Bleach Technique for non-vital teeth whitening. In this episode Dr. AJ Ray-Chaudhuri discussed how to prevent peroxide gel from entering the root canal system while performing non-vital bleaching. We cover every detail of the procedure and offer step-by-step guidance on how to make a tray, how much to charge patients, which gels to use and much more. https://youtu.be/5Pl238679j4 Watch PDP147 on Youtube Protrusive Dental Pearl: The full protocol workflow - summarised PDF of Part 1 and 2 of this Internal Bleaching Series plus the patient advice sheet AND lab instruction sheet by Dr. AJ Ray-Chaudhuri Click Here to Request the PDFs Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 2:28 Protrusive Dental Pearl3:40 Tips and Advice for Internal Bleaching in Practice7:21 The Inside-Outside Whitening Technique17:45 Internal Bleaching Protocol23:21 Getting the proper access cavity27:21 Dealing with patients who do not follow instructions well31:47 Considerations and Tips to maximize success or to avoid mistakes33:08 Internal resorption and relapse If you enjoyed this episode, check out the first part of this episode: Internal Whitening Protocols Pt1 (Non-Vital Bleaching)  Click below for full episode transcript: Jaz's Introduction: Hello, Protruserati. I'm Jaz Gulati, and you are listening to this episode because you've just finished part one and you are pumped to get into the full protocols for internal bleaching where Dr. AJ Ray-Chaudhuri, or you just clicked on. Jaz's Introduction:Because you've got a patient next week who's got a black tooth and you want to follow all the protrusive pearls shared in this full guide on how to actually carry out internal beach treatment, or you are in luck because we cover all those things today. In the previous episode, so part one of internal bleaching we covered about getting your diagnosis right, making sure you've got a really good root canal treatment, and also the difference between a yellow tooth, which is more likely be like a calcific metamorphosis versus an actual non vital tooth. Now, why one will not need a root canal treatment? So if you haven't listened to that one yet, please go back one episode and check that one out. Now towards the end of that episode, I left you on a cliffhanger because you got really saucy. We started talking about barrier materials. Like what material, what restorative materials should you put over your gutta percha before you put your whitening gel, right? Because the logic says that we need to put a barrier to prevent our peroxide gel from actually going into the root canal system. But you know what? I'm going to give you a spoiler now, right? What AJ actually practices is no barrier material, providing you don't have a scope because the problem is like, imagine you don't have a scope and you're going to provide some sort of a barrier. Like have you ever tried placing GIC deep down three millimeters below the CEJ? And how difficult it is not to smear that glass ionomer material all the way up the tubules. Because if you smear them, then how is that whitening gel? How is the proxide gel going to enter the tubules? And that's when you get ineffective whitening. That's when most of the tooth whitenings, but you get a neck that's still discolored. So his argument actually is really good. So we'll listen to that first thing up. But we also talk about my protocol and what I've done as well. We go through every single detail and step-by-step protocol of non-vital bleaching, including tray design,

Non-vital bleaching or internal whitening comes in many forms, but it's often confusing which exact protocol to adopt. When you learn this technique you can make a HUGE difference to a patient's smile in a minimally invasive manner. Restorative Specialist Dr. AJ Ray-Chaudhuri covered the all-important diagnoses and indications of internal bleaching as well as how to treat tooth calcific metamorphosis (the obliterated pulp). We answer the key question: do you always need to have a root canal treatment present? https://youtu.be/mEHIypt-WW4 Watch PDP146 on Youtube The Protrusive Dental Pearl: When carrying out internal bleaching make sure to clean out the entire pulp chamber especially the necrotic pulp horns - clean the necrotic tissue inside using ultrasonics. Ensure the entire chamber is de-roofed - remember that these are mostly trauma cases and the pulp went necrotic in youth - hence large pulp chambers. No role for Ninja access here! Need to Read it? Check out the Full Episode Transcript below! Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content Highlights of this episode: 3:03 The Protrusive Dental Pearl 5:55 Dr. AJ Ray-Chaudhuri’s journey into restorative dentistry13:02 Internal Bleaching Protocol15:45 Whitening obliterated pulp (Calcific Metamorphosis)21:22 No prep veneer/Composite veneer VS Tooth Whitening22:50 Q: Best time for Internal bleaching after Endodontics? STAY TUNED for Part 2 Next week when it gets really spicy - we have a PDF infographic to follow! If you enjoyed this episode, check out Post Operative Pain after Endodontics – Prevention and Management Click below for full episode transcript: Jaz's Introduction: Non-vital bleaching or internal bleaching is something that you don't really learn or get to practice at dental school. It's something that you don't really often get to do, but when you get to do it, you get to make a huge difference to a patient smile. Jaz's Introduction:But there's lots of different ways to do it. It can get very confusing and the first time you come across a case, you end up going online and searching for all the different papers and different techniques out. And you just end up getting confused, which is why I've got this killer two-part series with Dr. AJ Ray-Chaudhuri, restorative consultant. We both discuss the indications, the diagnoses, so basically it's two parts. This first part you listen to right now is going to cover his journey as a restorative consultant. The diagnoses that you can make, like when you have a yellow tooth, and you take a peri-apical radiograph and you observe that, 'Hey, where's the pulp gone? There is no canal anymore.' That's a calcific metamorphosis, right? That's a sclerosed canal, and that can be a discolored tooth. Now, how do you whiten that, and how is that different to an actual non-vital tooth where you actually drill an access cavity if there isn't one already and you whiten the tooth from within the tooth? So your diagnosis is really important. And some of the big questions that we cover are things like, do you always need to have a root canal treatment present? Does that root canal treatment need to be perfect quality, even if the patient is asymptomatic? And then we go on to discuss about which barrier material. Barrier material is something that you put over the gutter percha before you put the whitening gel to whiten the tooth. So these are all the nitty gritty things that we build up to. And in part two next week, wow. That's really going to go into the full protocol for non-vital or internal bleaching. Hello, Protruserati. I'm Jaz Gulati. Those of you who are listening, I probably sound a bit different. And those of you who are watching, yeah, I look in a different place. So, I'm actually in between Reading where I work and live and West London at the moment becau...

Rochette Bridges are a popular option for interim tooth replacement whilst implants in the aesthetic zone are 'cooking'. In this episode with Dr Pav Khaira we discuss his interim restoration protocols using Rochette Bridges and Dentures, as well as gaining an insight in to custom healing abutments. https://youtu.be/InBOBHfYxEA Watch PDP145 on YouTube Which cement is best for Rochette Bridges? How do you remove them? Ceramic or Composite pontic? When might we consider a Denture instead? We then expand in to soft tissue augmentation at the time of implant surgery to get the best pink aesthetics. This episode is packed full of gems even if you do not place implants - much of the benefits of soft tissue augmentation can be applied to non-implant fixed prosthodontics. The Protrusive Dental Pearl:  Steal my Resin Bonded Bridges consent form! It is a visual aid for patients and helps with information and consent for RBBs. If you are on Protrusive Premium, head to the 'Protrusive Vault' to download it. Otherwise you can request your free download here. Need to Read it? Check out the Full Episode Transcript below! Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content "It's all about how you communicate the soft tissue grafting surgery to your patient" - listen/watch the episode to hear this absolute peach of a communication pearl! Learn Implants from Dr Pav Khaira Highlights of this episode: 3:40 Dr Pav Khaira's Introduction7:20 Interim Restoration vs Immediate Loading of Implant10:12 TWO Golden Rules of Temporary Dentures for Implants11:15 What is a Customised Healing Abutment?17:40 Rochette Bridges Protocol23:54 Temporary Implant Crown Protocol31:36 Communicating Soft Tissue Grafting If you enjoyed this episode, check out Success with Resin Bonded Bridges. Click below for full episode transcript: Jaz's Introduction: If you've placed an implant or maybe your surgical colleague has placed an implant and now it's come to you as the restorative dentist, and you need to give this patient a tooth because they're not going to go for immediate loading, i.e, they're not going to have the temporary crown on this implant the same day. Jaz's Introduction:We're going to wait some healing, and therefore, how can you give this patient a tooth? It's going to be a denture or a bridge of some sort temporarily. There might be some other ways, but these are the two most common ways to do it. Now, you might have heard of something called a Rochette Bridge. Rochette Bridge is basically like a metal resin bonded bridge with HOLES in it. It's very popular way. A lot of the implant dentists use to TEMPORARILY have a tooth there so that everything can heal, the soft tissue can heal, the implant can osseointegrate, and then you can take off this bridge and continue on with placing a crown for that implant. But there's lots of nuances when it comes to Rochette Bridges. So I've got on Pav Khaira today to talk about Rochette Bridges. Talk about dentures, like how do you make sure the denture's not impinging on the soft tissues and on the healing abutment. Now if all these terms aren't making sense to you, then I'll make sure that Pav breaks down exactly what a healing abutment is. So really is the bare bones of everything and builds you up and we build up all the way towards the end. We talk about soft tissues and how in many cases soft tissue augmentation to get a nice papilla is so important and Pav will share with you a very interesting stat about the number of people that show their papillas. Have a guess, actually, if you don't know this already, when people smile, when our patients smile, what percentage of them will show a papilla? At least a papilla, one papilla anteriorly, right? So what percentage of patients will show papilla, at least.

No need for violins - this episode was to share our behind-the-scenes story of creating an online occlusion course. This year has been the most challenging for me and Mahmoud Ibrahim as we worked hard to make OBAB the most tangible, real-world, and comprehensive occlusion training on the planet. We faced many struggles, hardships, and sacrifices along the way. I want to thank you all for your support, your help and your feedback. You have been a great help in this journey and I am so grateful that we were able to accomplish it with your blessings. In this episode, me and Dr. Mahmoud Ibrahim were invited to the Dental Innovator Podcast to talk about the journey, challenges and sacrifices we made while working on OBAB. This episode will also inspire you regardless of your own situation. Whether you are starting a practice, buying a practice or starting a business within or outside of dentistry, this episode will give you inspiration and a perspective. OBAB One-Time Pre-Launch Deal is now SOLD OUT – thanks for all your support! Highlight of this episode: 2:27 Dr. Jaz and Dr. Mahmoud’s Introduction5:52 Driving force in doing OBAB8:56 Process in making online course13:04 Online Course vs Live Course16:48 Work-Life Balance20:31 OBAB Journey28:12 OBAB’s post course support34:54 Responsibilities in Business Partnership41:00 Qualifications of Dr. Jaz and Dr. Mahmoud to teach people occlusion47:33 Dr. Mahmoud’s journey inside and outside dentistry49:12 Marketing aspect of an online course52:04 Advice for young dentists55:42 Innovations in Dentistry If you liked this episode, you will love How to Win at Life and Succeed in Dentistry – Emotional Intelligence

As you may recall from the first part of this series, Dr. Wayne William is an amazing dentist in our community who has been kind enough to share his insights into local anaesthetics with us. Today we'll be talking about the second half of this topic: The most commonly used anesthetic agents used by GDPs (and why we should ditch one)Is it safe to inject lingually? Adrenaline for Cardiac Risk Patients - is it really a worry? https://youtu.be/E9q4t5z7LdI Check out this full episode on YouTube Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content The Protrusive Dental Pearl: Do NOT use the technique of lingual infiltration that I did! There IS a better way! (Lingual Infiltrations are not bad - just the way I did them was not ideal) If you’re curious what technique that was, Protrusive Premium will get to see it in the middle of this episode including Dr Williams' 'live' unedited, uncut reaction. This is GOLDEN content! Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 4:34 The Protrusive Dental Pearl 5:38 Large red headed people are difficult to numb. Is it a myth or is it real?8:29 Lingual Infiltrations17:02 Adrenaline being avoided for certain patients23:49 Adrenaline for Cardiac Risk Patients  Occlusion: Basics and Beyond is the most tangible, real-world, and comprehensive occlusion training on the planet. Get the OBAB One-Time Pre-Launch Deal which SOLD OUT - the only way now is the Waiting List as IAS are preparing 20 extra starter kits. Be sure to watch the first part of this episode: Articaine ID Blocks and the ‘CIA Technique’ for Local Anaesthetic Click below for full episode transcript: Jaz's Introduction: Welcome back Protruserati to Articaine ID Blocks Part Two. How good was part one? Thanks to Dr. Wayne Williams. [Jaz]What I love about bread and butter episodes like these is the engagement it gets from the community. So you guys, Protruserati on the Instagram app @protrusivedental, had some really interesting things today. Like for example, Cony, Cony Caravotas we met in Brighton and also at the Finlay Sutton course. Hope you're doing well. She said that she hasn't done an ID block since 2009, so that was 14 years ago. That is bloody impressive, right? I told you I do about one a month. Coney hasn't done once in 2009. She said, buccal articaine infiltrations all the way. And there were loads of comments just like that about how we're all getting really good results with buccal articaine. But of course, Dr. Wayne Williams suggested that it's only really appropriate for single tooth procedures. But I know many of you, including myself on many occasions, use it for quadrant dentistry in the lower molar. Now, I wouldn't use it, like I said in the previous episode of people with large bones, large heads, big bony exostosis. But for the average person, I think it does work well in my hands, and that's what it's all about. Don't change your technique if something is working well, unless there's more efficiency, more safety involved, or lower cost involved. But if you're not compromising a lot on those areas and something is working well in your hands, I wouldn't change anything about your protocol as long as you're safe, efficient, and cost effective. So more power to anyone who's getting great success with buccal articaine. I personally will say that by putting it in the attached gingiva. Now, something that, @ohheyitsdoctoralbert also said on Instagram is the importance of attached gingiva. I find that the attached gingiva retains it, and probably by going in the attached gingiva I'm entering that coal area that Dr. Wayne Williams talked about in the first episode, and therefore, these em mystery canals, these holes in the mandible to allow our anesthetic to get in the right place.

There is a massive trend of Dentists ditching ID blocks in favour of articaine buccal infiltrations. For many that are still using ID blocks routinely, they are afraid of using Articaine due to fear of paraesthesia. Should we be doing less ID blocks? And when we do, is it ACTUALLY harmful to use articaine or is that a myth? I have to admit, the main reason I heavily switched to buccal articaine was to avoid ID blocks. Dr. Wayne William, our straight-talking, no-BS Prosthodontist guest will bust some myths and improve your daily delivery of safe and effective local anaesthesia. In this episode he taught us the Crestal Intraosseous Approach (CIA), a technique developed by Dr. Wayne to improve our buccal infiltrations. https://youtu.be/LbOxlXIZCkw Check out this full episode on YouTube Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content The Protrusive Dental Pearl:  Check out the couple of videos I posted recently on YouTube and on the app https://youtu.be/yFfKVLmSr5Q Robin Hood Dentistry - a careful and well-considered enameloplasty https://youtu.be/3QLby2U_W3E No More High Restorations 2023 Update - Stop Grinding Away Your Composites! "There is no such thing as a periodontal ligament injection" Dr. Wayne Williams Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 3:02 The Protrusive Dental Pearl5:49 Dr. Wayne Williams’ Introduction8:06 Buccal infiltration with articaine for lower molars13:09 Crestal Intraosseous Approach (CIA)22:28 ID Blocks - is it safe?28:13 Hitting Bone while giving injections - safe or not?31:04 Failure rate for ID Blocks Occlusion: Basics and Beyond is the most tangible, real-world, and comprehensive occlusion training on the planet. Get the OBAB One-Time Pre-Launch Deal before 21st March to get access to OBAB for two whole years and get a fully mentored case worth £550. Plus get £1445 of exclusive extras!!!  If you enjoyed this episode, check out Hot Pulps, Painless Palatals and ID Block Failures Click below for full episode transcript: Jaz's Introduction: There's been a huge trend in dentists doing less and less inferior alveolar nerve blocks and to be fair, I've been part of this, right? Jaz's Introduction: I'm actually, I wouldn't say afraid. I'm not afraid of doing ID blocks. I'm just do them way less because I'm afraid of some of the POTENTIAL COMPLICATIONS that you see in papers and in opinion articles about the potential risk of paraesthesia and other complications from ID blocks, and therefore I've been a bit put off. So what I did many years ago is I started to do more and more articaine infiltrations, buccally, and to be fair like I told Wayne, Dr. Wayne Williams, the prosthodontist who's a fantastic straight talking guests. I love straight talking guests. Right? You're going to love him too. And I shared with him that, look, I only do about one ID block a month. A) Because I'm getting so much success with my buccal articaine. But B) Because I'm being overly cautious, I'm really trying to prevent it. Because I think this scare mongering has worked on me. I am a little bit worried about the risk and the more ID blocks you do, the more you increase your risk or so I thought, because there's so much we talk about in this episode in terms of the power of a buccal, articaine, but also, knowing when to respect and knowing when that might not be serving your patient the best, and why he should be perhaps doing some more ID blocks. And in fact, Wayne even says that he's a huge advocate of articaine for ID block. So we're going to cover a lot of controversial topics and as you heard already, Wayne is no stranger to controversy and I love that so much. One thing I really respect about Wayne is that he helped to develop the CIA, the Crestal Intraosseous Approach. I had to really,

From the studio that brought you 'The Fresh Prince of Appliances'... I present: Dots and Lines Music Video https://www.youtube.com/watch?v=5vHKt3kUJ84&ab_channel=JazGulati-ProtrusiveDentalPodcast Sign up before 21st March for: 2 years of access instead of 1 (worth £399)£500 offStarter Kit and OBAB Hardback Book1 Fully Mentored Case on our Platform (worth £550)

After the cliffhanger from Part 1, Dr. Sandra Hulac is back to share more information about Frictional and Constricted Chewing Patterns (CCP) with cases shared and explanations given. Check out the Full Episode with a Free membership on Protrusive.App Download Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE content The Protrusive Dental Pearl: Overjet is King. We don't want tight bites. We want a bit of overjet that gives chewing space - this will reduce the chances of a functional attrition and avoid 'too much anterior guidance' or locking the patient in. “It's important to know why things fail and try and avoid failure the next time” Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 0:28 PDP141 - Stop Blaming Bruxism Part 1 Recap6:34 The Protrusive Dental Pearl: Overjet is King6:56 The role of pre-restorative orthodontics9:24 Case #1: Extremely traumatic deep bite14:10 Case #2: Crowding of the lower anterior segment19:41 Case #3 Lot of wear on the front teeth 23:54 Case #4: Chipped and worn front teeth 27:06 Case #5: Worn front teeth 32:41 Case #6: Patient had an extraction ortho Dr. Mahmoud and I are also excited to share the occlusion that we learned over the years –  in a way that you have never seen before!  Occlusion: Basics and Beyond is the most tangible, real-world, and comprehensive occlusion training on the planet. LIMITED DELEGATE SPOTS DUE TO STARTER KIT STOCK – AVOID DISAPPOINTMENT! Occlusion Online Course Be sure to watch Part 1: Stop Blaming Bruxism! How to Spot Frictional and Constricted Chewing Patterns (CCP)  Click below for full episode transcript: Introduction: Hello, Protruserati. I'm Jaz Gulati and thanks so much for coming onto the app for part two or what was quite a brilliant part one with Dr. Sandra Hulac. Her energy is just absolutely amazing. Jaz's Introduction:Now, just a recap, we left you on a bit of a cliffhanger last time. We talked about, I asked Sandra about orthodontics. You know, how often does orthodontics come into it? Is it every single time? And the answer she gives is really pragmatic. So you'll hear that or see that in just a few minutes. But I just want to do a bit of a recap, what we talked about last time, right? So, a constricted chewing pattern is someone who really wants to bite here, but the teeth meet together here, so the condyle gets sort of pushed back, if you like. Right. So for this patient, the centric relation is actually further forward. So who's at risk? People who've got upright or retroclined upper incisors, right? And their jaw wants to be further forward, right? Maybe cuz of growth, the jaw wants to be further forward, which is why Sandra said that people who've had orthodontics and upper pre-molars extracted. The maxilla gets smaller if you like, and mandible start continues to grow and those patients may be at risk. So if you see those kind of traits, then maybe we shouldn't be using like a leaf gauge for centric relation on those patients. We should be using like a deprogramming appliance Lucia Jig or a Kois deprogrammer. If you fancy that one because that's what Dr. Sandra does. And what you find with these patients with a CCP is yes, their jaw gets shifted back, but you might get more wear on their edges. And that's not from bruxism. That's because the outside in movement. Right? Their jaw wants to be further forward. Now, this is similar. The cousin of this is the frictional chewing pattern who their condyle isn't getting forced back, right? Their MIP is okay. It's just that as they're chewing the outside in is causing this. So, let's say that's normal, the incisal edges are not worn here. Can you see? They're a bit jaggedy over here, right? It's just, to over here and over here. We see this all the time and let me show you some photos actually on th...