Protrusive Dental Podcast

"Don't probe implants with a metal probe or you'll scratch it!" - and so for years I was afraid to check the gingival health around implants. Crazy right? Dr Pav Khaira is here to bust that myth - but like with everything, it's not a simple answer - it has some interesting anatomical considerations. His answer is so eloquent, check it out! https://youtu.be/pLDfqe8liLE Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! “If you can get to the neck of the implant, you SHOULD be probing to the neck of the implant...but you don't want to do it too aggressively, it should just be very gentle pressure.” Dr Pav Khaira In this group function we discussed: Can you probe implants? 5:33Screening Periodontal Health of Implants 11:14Referring patients with Peri-implantitis 16:22 Check out The Dental Implant Podcast! If you liked this episode, you will love revisiting Implant Assessment for GDPs: from Space Requirement to Ridge Preservation Click below for full episode transcript: Opening Snippet: You just got into the cuff just sweeping it backwards and forwards and you seeing whether that triggers any bleeding because that's a sign of inflammation... Jaz' Introduction:Hello, Protruserati. I'm Jaz Gulati and welcome to this group function. Now if you're new to the podcast, welcome, great to have you. A group function is where we work together as a team to find out a solution to a common problem. And the problem I'm presenting today and I'm hoping to get a good answer from Pav today is 'Can you probe around implants?' And what I mean by that is, I was fed a lie or a semi lie at dental school, like someone told me, I don't know who it was. But if you use a metal probe, to do a periodontal probing chart of an implant, you will scratch that implant and therefore that will harbor bacteria. And therefore you should not be probing around implants. So for the longest time, I didn't check the periodontal health of implants and it sounds really bad. But as a GDP who doesn't place implants, not much to do with implants. I thought that was the right thing to do. I thought I was doing less harm by not inserting my Williams or WHO or CPITN probe in the sulcus to check for the periodontal health because I didn't want to scratch the implant. I was scared of scratching the implant if you like. So I was expecting this to be a really quick group function. And I thought Pav was saying Yeah, you totally can. It's all good. But Pav of being Pav, an amazing guy he is. The only does he give us a really good definitive answer at the end, where he talks about the rationale of what the concerns are maybe and how each actually look a little bit deeper than Can you probe? Can you not? Because there's some anatomical variation, so I'm not going to spoil it for you. Let's join this group function with Dr. Pav Khaira. That man again. Pav Khaira. Main Interview:[Jaz] Dr. Pav Khaira, welcome back to the podcast, my friend. How are you? [Pav]I'm very good right now. How you doing? [Jaz]Yeah, great. So it is Pav Khaira from The Dental Implant Podcast. And I'm gonna just pick your brains. You need to teach us something today. You need to speak to me like I'm five years old. Because this, the following questions I'm gonna ask you on this group function today is very much basic things that you're probably gonna laugh at me like Jaz, why you asked me these basic questions? But I'm sure with the referring dentist that you've met and your colleagues, like when it comes to implants we come out in dental school, like a lot of other topics. And we're like, where do we even begin? So just before we dive into that, just reminder on people who perhaps didn't listen to our episode on finding your niche. I think it was episode 76 from memory. Do listen to finding your niche, it's a cool one where we discover what is like your calling in dentistry. So do check that one out.

Learn the challenges dentists face with back to back Class II restorations and the value of pre-wedging. Dr Chris O'Connor shares his restoration protocol and troubleshooting tips. Discover the use of sectional bands for tooth separation and the importance of pre-wedging for successful restorations. Also, explore the educational benefits of Instagram for dentists.

Happy New Year, Protruserati! In this episode we geek out with Dr Dev and Jaz as they discuss the initial stages of a Full Mouth Rehabilitation. In this 3-part series we will go on to describe the step-by-step stages for an Adhesive Full Mouth Rehab . Before we dive into the meaty part of this series later on, Dr Devang Patel will take us to the journey  of the clinician’s mindset who's doing full mouth rehab and how to communicate effectively with patients. https://youtu.be/Dnj0PDe0ulc Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: Write down one good thing that happened each day of 2022 on a post-it note, fold it and put it in a jar. By the end of the year, you're gonna have 365 post notes of all the good things that happened that year. Check out the RipeGlobal Facebook Group that inspired this pearl! “However, learning is nothing without action. So you can learn and learn and learn and learn...but if you don't take any action, then you're not going to get anywhere.” Dr Devang Patel In this episode we talked about: The mindset of the dentist doing a full mouth rehab 12:19The three step technique 25:32Appointment 1: Diagnosis and Treatment Plan 26:00Communication with Patients 37:57Reorganizing versus Conforming Occlusion 40:30 If you enjoyed this episode, be sure to check out the second part Adhesive Full Mouth Rehabs Part 2 – Wax Up and Temporaries and the third part Adhesive Full Mouth Rehabs Part 3  Click below for full episode transcript: Opening Snippet: Were you looking at step one is your diagnosis and treatment plan. That's the biggest step ever. The second step would be your anterior reconstruction and third step is posterior reconstruction... Jaz' Introduction:Happy New Year 2022. Protruserati, welcome back to your favorite dental podcast. I really appreciate you coming back. And if you're a new listener, welcome to this podcast. Hope you get lots of value from it. And today's episode is part of a three series. So this first part is about full mouth rehabilitation, adhesive dentistry, so an adhesive rehab, ie using some sort of composite resin, either direct or indirect, and how to transfer that from the wax up to the mouth. So we're gonna break it up into three different episodes with Dr. Dev Patel, who came on before, and he talked about private dentistry versus public dentistry and how we can be comprehensive in public dentistry. So in today's episode, we're looking at the mindset of the clinician who's doing full mouth rehab, because we can't just dive in talking about how to do these beautiful wax ups, and how to do all the big composites and indirect work as well, which we mentioned, that comes in episode three, actually. But we need to first start off on the right foot. And we need to know why you want to get involved with full mouth dentistry. What the mindset of the clinician is, how to diagnose, how to communicate, what to say, and how to say it at your treatment plan presentation appointment, to be able to then lead you with the correct patient, with the correct diagnosis to treat that patient in a full mouth manner. This series is titled 11 steps have a decent format rehabs and so really, this episode looks at appointment zero, ie your mindset, you as a dentist, and appointment one. And also when you bring the patient back and you speak to them. So those are the first couple appointments. The second part of the series coming probably in about four weeks time when we record is going to be appointments two to five, this is when you actually do, your mounting, your wax up, your transferring of the wax up to the mouth and you're assessing the phonetics and the aesthetics and you send them home to test drive. And then the final part getting to there are really meaty bits. Okay, but I think it's good for you to listen to these foundational parts one and two, before you come to that one,

Heated confrontations with patients are never fun. Nobody likes to argue, and no Dentist likes being pressured or micro-managed by patients! In this episode we cover a lot of communication gems with Dr Vy Phan that will definitely allow you to remain calm and be effective the next time you face a 'difficult' patient (you know who I mean!) https://youtu.be/vDP5wIaK3Ok Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! The Protrusive Dental Pearl: Never to say 'No' to patients. Instead, be tactful by pitching it and phrasing it in a different way - you are still saying 'No' but in a much less harsh and patient-friendly way. I give some concrete examples in this episode. “One of the ways of gaining patient trust is education - there's a breakdown of communication often when the patients don't trust you and they're not educated enough” Dr Vy Phan This is the IntraOral Camera I was telling you about - inexpensive, high quality and a modern day necessity in my opinion. Available on Amazon In this episode we discussed: Big Challenges young Dentists might face in terms of patient interactions and communications 10:30When to consider dismissing a 'difficult patient' 20:20Advice to young dentists when a patient questions the level of experience based on age/appearance/sex 31:08The ‘My Way or The Highway Approach’ 38:04Communication gems with Difficult Patients 46:16How to Write a dismissal letter to difficult patients 49:54Handling Patients who continually ask for discounts 59:41 Check out Dr. Vy Phan on Instagram! If you enjoyed this, you will of course love Think Comprehensive – Communication Gems with Zak Kara  Click below for full episode transcript: Opening Snippet: (Vy) I think my way or the highway approach is really appropriate when it didn't the best interest of the patient, you know, you know that it would be different, it will be risky, you know, there'd be more long term (Jaz) Inappropriate, risky, just not the, it will land you in legal issues. (Vy) Exactly... Jaz' Introduction:Hello, Protruserati, I'm Jaz Gulati and welcome to this or can I say it's an awesome episode? Oh, my God Vy Phan will blow your mind. This is a real world topic. There are so many communication gems shared in this episode. And really, when it comes to communication skills, when do they really matter? I mean, yes, it's good to get case acceptance and building value through user communication. But what really matters is so tough patients, those confrontations, those arguments that you might have with patients, you know the ones where your heart is racing? Words can really powerful. And I think communication skills are really tested in those tough scenarios. And we're talking all about those in this episode. When it comes to the word difficult in difficult patients, I was really debating whether to use it or not. Because really difficult patients are just difficult people and yet difficult people in every walk of life. Like if you take an arbitrary figure, like 1 in 20 people, well, I don't want to use the 'A' word. So 1 in 20 people are not nice people, right? And so 1 in 20 teachers will be not nice. 1 in 20 doctors will be not nice. 1 in 20 dentist were not nice, for example, right? So 1 in 20 of all your patients may not be the nicest people in the world. And so to deal with these patients, it can be tough. And these patients, we classify them as maybe difficult. But the funny thing about classing patients difficult is that what you might perceive as a difficult patient, your colleague, your associate, may find that they get along with a patient really well. And they think yeah, what do you mean, Mr. Smith is completely fine. What are you talking about? So it actually varies dentists to dentist and so our perceptions are equally important. When we decide who is "difficult". There are lots of themes that we cover in this episode, like for example,

The role of tongue position, posture and the airway on the developing occlusion is hardly covered in Dental School. Let's think BEYOND TEETH with Dr Bobby Supple, carrying on from PDP099. Follow Protrusive on Instagram! https://youtu.be/zfLK0qszdA8 Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below!  Protrusive Dental Pearl: When checking someone’s occlusion after a restoration, do not just check it while they are supine (lying down), sit them up then check their occlusion again because posture does change our occlusion, even just a little. In this episode we covered: Skeletal Bite vs Tooth Bite 4:45Trigger Points 13:28Myofunctional Therapy 17:14Dentistry and Other healthcare professionals 24:57Neuromuscular Dentistry 38:19 Check out the book Dr Bobby Supple recommends: New Trends in Myofunctional Therapy If you enjoyed this episode, check out the first part Occlusion Wars: Which is the Best Occlusal Religion?  Click below for full episode transcript: Opening Snippet: Okay, so Teeth are together for long periods of time at nighttime, then the sympathetic nervous system stays on. The sympathetic is fight or flight. That's what apnea is. Squeeze, AH... Jaz' Introduction:Hello, Protruserati. I am Jaz Gulati, and welcome to episode 101. It's a continuation from Episode 99, which was Occlusion wars: Which is the best occlusal religion? And just to give you a flavor of that episode, like a quick recap, I wanted to find out, which is the best training institute for occlusion. Is it Spear? Is it Kois? Is it Dawson? Is it Pankey? Is it neuromuscular? That kind of thing, which is a common question that we all ask on our journey after dental school. And we think that, okay, we need to upskill and learn about comprehensive dentistry and how occlusion fits into it. Very often, we'll be faced with this choice. And some people go for koiss, and some people go for Dawson. And I got someone on Bobby Supple, who continues in this episode. And he blew me away, because he's done so much training with all these greats, he's been in the same room, you know, Kois and spear and Dawson. And everyone's together debating, and he's been very much part of that. And it was great to learn from him. And essentially, it doesn't matter who you train with, they argue and they challenge you on the different processes, the outcomes are going to be very consistent. So the answer is train with whoever you want, whoever is most convenient for you, best price for you, best mentors, maybe your principal, or your boss has also done Kois so you should do Kois. So you can speak the same language maybe, or maybe because your principal's on Kois, you should do Dawson. So you can exchange notes about the how to, and how to get from point A to point B. But essentially, you will do your patient service. And you will do a great job, whoever you choose for your training partner, you make sure you implement it fully, and you do your best. And I think that was a really cool lesson. And going further now from that episode to this episode. The main thing I want to leave you with before we join the main interview is that sometimes, especially when it comes to occlusion, the first time you hear something from an educator, from a speaker, it doesn't quite make sense. And sometimes you have to hear something like for the fifth time, and it's eight years later, and then it clicks in your head because by then you've accumulated enough failures, you've got a bit more experience under your belt, you've got a bit more deep thought and experiences to reflect on. So if this episode is a little bit beyond you, because we do talk about higher level stuff, relevance of the airway, tongue posture, posture in general, this is all stuff that even I'm just learning, grasping more into, because very much, you know, my training was at the two teeth and the skeletal level. The teeth and bones,

Only a dental superstar could do episode 100 justice! For this very special episode I have deviated from the usual flow - it's kind of like a Vlog. We're going to go through some major takeaways from the BACD conference in Edinburgh, when Pascal Magne came on stage and completely blew the audience away. We have Dr Ricky Bhopal some Protruserati cameo appearances! https://youtu.be/TINNRw1_iUM Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: If ever you wanted to read or just take notes of everything we’ve said on the podcast, just scroll down below the blog post. Every episode has been fully transcribed! Celebrate the 100th episode with us! Join the 'Hoodie' giveaway in three steps: 1. Follow @protrusivedental on Instagram 2. Share the promotional video on Instagram story, tag @protrusivedental 3. Tell us your favorite Protrusive Dental Podcast episode when you share the story or in the comments! If you are interested in the RipeGlobal Fellowship in Restorative Dentistry (FRD) click here to learn more. “I think one of the things that really stuck out to me today from the course was that it's not necessarily what some one person does, it's what works in your hands.” Dr Ricky Bhopal In this episode, we discussed: The 'Enamel CADCAM' case Pascal Magne shared 13:27Importance of the Ferrule effect 14:30The fourth generation bonding system 15:47Silane coupling agent 17:32Ricky’s takeaway tip from the Pascal Magne 20:17Managing PTFE for Interproximals 22:07 Click below for full episode transcript: Opening Snippet: Oh my goodness. Welcome to Episode 100, Protruserati. I'm Jaz Gulati, your host and it's so great to have you here. This is a special episode. To celebrate 100, We're doing like a documentary, mockumentary, vlog kind of episode, but I still hopes and give you so much value... Jaz' Introduction: We're gonna talk some key lessons that I learned and we learned even I mentioned about Ricky's involvement in this from the BACD conference in Edinburgh, where Pascal Magne came and just absolutely blew the stage away. So some key lessons from that. But also speaking to other dentists, some of my colleagues, some of the Protruserati that have appeared on the podcast before and hope to make it like a fun and entertaining listen for you. Now before we dive right in, the Protrusive Dental Pearl for you is that you may or may not know this, now, maybe you do. But if ever you've listened to any of the previous episodes and thought, You know what I wish, like maybe you take notes, but some I know some of the Protruserati they show me on Instagram, they take notes of the episodes because they find it very valuable, very educational, which is awesome. I love that. I think it's great to be an active learner. So if you're taking notes, but sometimes you wish you could just like copy and paste segments of some of the things that the guests say or I say and like a little communication gems, then every episode is actually transcribed fully. They like about 99% accurate, my colleague Krissel, who's like my scientific adviser, she does all the transcriptions, so you can check them out on the Protrusive website. Under the episode blog if you like, scroll down, and every episode is fully transcribed. So that's your big pearl that if you ever wanted, like a database of everything that we've said on the podcast, it's all fully transcribed and ready for you. And by the way, also to celebrate episode 100. There's a little competition or giveaway on Instagram. So if you want to win one of the hoodies that, if you're watching on YouTube and you can see that I'm wearing, the new hoodies are even better than this. They're blue and gold. And it's pretty cool. If you're in a chance to win a hoodie, no matter where you are in the world, then log onto Instagram, share the promotional video that I'm putting on. You'll see like the giveaway video,

It's the ultimate question: Which is the best Occlusal Camp/Training? Is there really a difference between Occlusal religions? Is Kois better than Spear and Dawson? Do you really need to study each one of them? Hear what Dr Bobby Supple says about the 'Occlusion Wars'! https://youtu.be/tlhrBcodzbA Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: Check the Video on How to successfully give lower first molar anesthesia using buccal articaine (without an inferior alveolar nerve block) https://youtu.be/cCXacw5DE4M “So, as it kind of turned out, they were all the same, except for neuromuscular. Neuromuscular was the odd one out." Dr Bobby Supple In  this episode, we discuss about History of Occlusion 14:35True Meaning of Anterior Guidance 17:04Bio-Aesthetics Group 22:015Different Occlusal Religions 27:31Equilibration 41:19Airway and TMD 51:12Differences between Occlusal Camps 52:09 If you enjoyed this episode, you will love Myth Busting Occlusion and TMJ Click below for full episode transcript: Opening Snippet: (Jaz) I think you said that when it comes to the Spear group, Kois and Dawson, what I think what you're trying to say is really they're not too different. They're just arguing a little bit about slightly different ways to fix the problem. Would you say there's any more nuances or differences that perhaps we didn't go into that is well worth mentioning between those religions? (Bobby) So, as it kind of turned out, then they were all the same, except for neuromuscular. Neuromuscular was the odd one out... Jaz' Introduction: Hello, Protruserati. I'm Jaz Gulati and welcome to Occlusion Wars episode 99 with Dr. Bobby Supple. This episode was inspired by a blog post I saw Dr. Bobby Supple right in his website. And it was about the differences between the different occlusal camps or these occlusal religions. Hencewhy the name occlusion wars because the most common questions I get is Jaz, What should I do? Should I study with Dawson? Or should I study with Pankey or Should I study with Kois or Spear and neuromuscular? So there's a lot of these occlusal religions and that's what we call them throughout this episode, you know, tongue in cheek kind of thing. And which one is the best one, which is the correct religion. That's what we're hoping to answer in this episode. And the main question I asked Dr. Bobby Supple was exactly that. And really, I don't want to give too much away from this episode. But one thing to consider is that the end goal of no matter who you train with, whether it is Spear or Pankey, Kois whoever. You will do wonderful dentistry, you will do it for the benefit of the patient, you will have more fun as a comprehensive dentist. So whoever you train with, just do everything they say and do it properly and follow that system. But don't be afraid to expose yourself to other ways of thinking because essentially, what these religions, these occlusal religions argue about is the processes. How do you get from A to B, the B is the same, A is the same. A is your patient. B is a stable position, whereas a better smile, a nice comfortable bite, all those things, right? So A and B are the same. What we're fighting about is everything in the middle. And that really doesn't matter. We should be outcome based ie a longevity in our restorations, happy patients. And I think all those whose religions deliver exactly that. That's one of the sentiments that Dr. Bobby Supple passed on. I just want to echo that. Now if you want to really skip to that bit. It's probably somewhere in the middle to the end of the episode where we really get to nitty gritty. We start off in this episode, discussing the origin story. I mean, origin stories always really powerful of these clinicians that we speak to Dr. Bobby Supple has so much experience to share. So we learn about his origin story,

There is WAY too much plastic in our profession - it's insane. How can we do our part in Dentistry to make better choices for our environment? NOW is the time to spread positive messages for the environment to make a better world for our children and our children's children. In this interference cast, we are joined by Dr. Mike Gow and Marcus McLeod who basically have started the journey to Net Zero Dentistry https://youtu.be/n8rSYpf0ld0 Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! “So even if you can do a small thing.....get involved, get active and we will make a difference. This is going to happen. So be part of it!” Dr Mike Gow In this episode, we talked about Implementation of Managing Net Zero Dentistry 6:42Mental Health element of Dentistry 13:59Similar Advocates Internationally 16:50Aligner recycling Companies 17:49Quick wins Practices that aren't doing Net Zero Dentistry 20:46Being green in dentistry 24:55 Check out the Net Zero Dentistry and Let’s all contribute on becoming a greener world  If you enjoyed this episode, you may also like What Every Dentist Should Know About Managing Dental Anxiety Click below for full episode transcript: Opening Snippet: You're going to save money. Okay? And we look at the bottom line in Dentistry, we look at our profits at the end of year, you will have more bottom line profits if you follow Net Zero dentistry and follow the stuff that we're going to be talking about and that is a simple fact that will be true. You will also motivate your team. Okay? This is something that everybody in the clinic can get involved with... Jaz' Introduction: Hello, Protruserati. I'm Jaz Gulati and welcome this really, really important interference cast on how we as a profession can be greener? The time is now. It's right now, we take some massive action in our profession throughout the world, so we can have a better future for our children and our children's children. Guys, I hope this episode makes Greta Thunberg proud. I'm joined today by Dr. Mike Gow and Marcus McLeod, who basically have started this initiative, this free initiative for us all called Net Zero dentistry. I think it's a great idea. I'm fully in support of it, I want you to listen to this episode so badly. So you can implement something like for example, when I recorded with these gents, I made a promise to walk to work every day. So it doesn't have to be just like purely dental reducing plastic, which obviously we're gonna cover all that in this episode, what we can do at the workplace to be greener, even thinking outside the box. But what can we do in our lives having a meat free day, walking, being mindful of our energy consumption? All these things are so important. So yes, this is dentistry, it's very relevant to dentistry, and how we can be as a profession greener but just you personally as well. Hope you find value in this episode if you do share it with someone. Okay? Now is the time to spread positive messages for the environment like this one. Anyway, I catch you in the outro. Main Interview: [Jaz] Marcus and Mike, Welcome to Protrusive Dental podcast. How are you gents? [Marcus]Thank you very much. Excellent. [Mike] Very well. Thank you. [Jaz]Amazing to have you both. Recently I was at the BACD conference in Edinburgh, Mike I was able to reconnect with you. And on that same evening we were discussing about Net Zero dentistry. I thought this is amazing. I want to give this a voice. I want to get people to start talking about how we can be more green obviously recently with COP26. Everything's very topical. We shouldn't have to wait for two Taco to have these kinds of discussions. But here we are. It's a start. And also on the same evening, just a slight little tangent on the same evening. I also met Jeremy Cooper and he was talking about confidential and the mental health aspects of dentistry and the sad areas,

How do you manage cracks? The 'Direct Composite Splint Technique' is kind of controversial. Whilst it may seem intuitive to take cracked teeth OUT of the occlusion, this technique builds composite on top of the cracked tooth in to SUPRA-Occlusion. So what's the crack? (Sorry) - I brought on the pioneers of DCS, Professor Shamir Mehta and Dr. Subir Banerji who enlighten us about this minimally invasive technique. https://www.youtube.com/watch?v=SpkrUBIJji4 Have you subscribed on Youtube yet?! Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: Get the largest magnification loupes you can afford and you can think you can sustain. I personally use 7.5x for EVERYTHING! A sharp probe has a resolution of 40 microns, at 8x magnification the resolution is 25 microns. We need high magnification to treat cracks! In this episode we discussed: What is the Direct Composite Splint Technique? 9:23Decision making and Sequencing of Direct Composite Splint Technique 11:05DCS Technique protocol in term of of thickness and bonding 16:54Aiding disclusion with canine risers 19:55 DCS Technique Protocol 22:20How does DCS Technique work in terms of the relative actual movement? 27:15Patient Communication for Cracked Teeth 33:22Re-established occlusion after DCS? 42:53Are you sure we can leave it in Supra-Occlusion? 50:55Should you chase cracks? 54:33Favourite Sectional Matrix Bands 56:56Tips and Tricks in making patients comfortable 58:25 Check out this paper by Professor Shamir Mehta and Dr. Subir Banerji about DCS Technique Cracked-tooth-syndrome-Part-1Download Cracked-tooth-syndrome-Part-2-1Download Check out the PG Dip / Master's in Advanced Aesthetic and Restorative Dentistry: Aesthetic-Dentistry-PGDipDownload If you enjoyed this episode, you will love I Hate Cracked Teeth with Kreena Patel Click below for full episode transcript: Opening Snippet: I would encourage you to read more about it before you actually do it. And it may even save you from a tricky situation. Even if you just use it diagnostically, ie, you suspect there's a cracked tooth, you then place the composite on top, and now the pain goes away. That is a diagnostic event. So even if you don't think you're gonna go the full hog and use this technique because it's too controversial for you, I think you can still use it as a diagnostic aid... Jaz' Introduction: Hello, Protruserati. I'm Jaz Gulati. And welcome back to another episode of The Protrusive Dental podcast. On this episode, today, we're talking about something called The Direct Composite Splint Technique for managing cracked teeth. Now, if this is the first time that you're coming across this, it is a completely alien, weird, crazy concept like the first time I came across this, like, you know, our natural instinct when managing crack teeth is to take it out of occlusion, right? You see a crack, ah, let me remove it out of occlusion. But what this technique actually does is the opposite, it actually puts that same cracks tooth in Supra occlusion, right? And by doing that, you will by wrapping some composite over the crack molar, let's say, basically prevents the cusps from flexing and therefore maintaining the crack rather than allowing it to propagate. So that's how it works. And then to even add the controversies of this technique, what happens over time is that, that composite is left in the patient's mouth over the offending tooth, the cracked tooth, right? And then what happens over time is what we call relative actual movement. So that tooth, which is proud in the bite, eventually, over time is no longer proud in the bite. And suddenly, it's almost pretty much in the patient's maximum intercuspal position. So that when you remove that composite, you now have restorative space. Now, if I've gone too fast then don't worry, we've got a whole hour or something with two leading experts on this technique. So if you're listening,

The best articulator is the patient's TMJ, but you knew that already, right? As a dental student I was always confused by Facebows in Dentistry and their role. Lots of clinicians I respect used facebows....but many others do not! What role do Facebows play in relation to Articulators? How can we make sure that articulators mimic the human articulation as accurately as possible? I am joined by Dr Salman Pirmohamed to end our confusion with Facebows! https://youtu.be/l3MrLVTYsz8 Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! Protrusive Dental Pearl: If you're planning to increase the occluso-vertical dimension (perhaps for multiple restorations or an occlusal appliance) and you know the final vertical dimension, try recording your Centric relation record (or whichever bite religion you follow) AT that desired vertical dimension and NOT at the 'first point of contact'. This is because traditionally when we send the technician a first point of contact bite, they will open up the pin to give you the space that you need for the restorations and optimal aesthetics. The problem with this is that it introduces an error because the arc closure/opening of the patient is likely going to be different (even with the best Facebow in the world) to the arc on the articulator. Therefore, reduce that error by doing your bite registration, not at the first point of contact, but doing it at where you want to finish. Read that again! In this episode we discussed: Implant cases in MClindent in prosthodontics at Eastman 8:32Microbrush Technique (Stickbite) 12:24The ‘Putty Bite’ technique 16:05When to use the ‘Putty Bite’ technique? 18:29 What is the role of a Facebow? 20:52Benefits of a Facebow registration 23:41Communicating to the technician in terms of using an average Value Articulator 25:23Making Facebows a part of your Clinical Practice 31:02Kois DentoFacial Analyzer 36:40 Guidelines for using a Facebow 38:34 Check out this papers as mentioned by Dr Salaman on the Podcast! Face-bow-transfer-in-prosthodonticsDownload Dogmas-in-prosthodonticsDownload If you liked this episode, you might enjoy A Story of Digital Occlusion with Dr Ian Buckle Click below for full episode transcript: Opening Snippet: So that makes the best type of articulator, which is the patient, the patient is the best articulator. Like when you have temporaries or mock up so you can try something, you know, you've got complex restorations, just putting temporaries in the mouth, but lab provisionals checking the patient, if it will make sense, cement them in temporaries, see how it goes and when you're happy, just take a copy and use that because that's actually the best articulator you'll get... Jaz' Introduction: Let's say you have a patient in front of you and you're observing their movements, you're observing their left lateral excursion, their right lateral excursion, and this just a bite in general with their delicate, wear facets and now you're planning some restorations. Let's say you can do some crowns and veneers on this patient. Now, you send the case to a technician, a technician that you'd like to work with and what they will do is they will design some restorations. And what they hope is that as they are planning the excursions on the restorations, when they send you back that work and you try-in in the mouth, the movements that the lab was making is the same as what you're finding in the mouth. So essentially, going from patient to the technician and back to the patient. Okay? So how can we make sure that this is as reliable and as predictable as possible? Well, that's why we use articulators, right? So we use articulators to mimic the TMJ and mimic the upper jaw and the lower jaw and all the movement. So that's essentially why we use articulators, but we know that the best articulator is the TMJ. So now we have tools. Tools that help to sort of supposedly help to impro...