Protrusive Dental Podcast

In this episode, Jaz dives into the complexities of Temporomandibular Disorders (TMD) management with Dr. Suzie Bergman, a US-based dentist and TMD sufferer. They discuss why treatments for TMD vary so much and examine the current state of evidence-based approaches. https://youtu.be/r3QpkMYeTWk Watch PDP212 on Youtube Dr. Bergman shares her personal journey, highlighting conservative treatments, the role of occlusal appliances, and the power of multidisciplinary care. But just when you think you’ve got it all figured out—Dr. Bergman reveals a game-changing insight that could completely shift your approach to TMD management. Ready to find out what it is? Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 02:40 Protrusive Dental Pearl 04:32 Meet Dr. Susie Bergman: A Personal Journey with TMD 7:27 The Wild West of TMD Treatments 10:32 Challenges in TMD Research and Treatment 13:34 Suzie’s TMD Journey: From Trauma to Advocacy 21:42 Evidence-based Therapies and Occlusal Appliances 27:11 Orthodontics and TMD: A Complex Relationship 33:40 The Role of Occlusal Appliances 35:05 Debating Disc Displacement 39:17 Comprehensive TMD Diagnosis 44:09 Orthopedic Stability in Dentistry 51:04 Splints and TMD 53:52 Managing Bruxism Effectively 58:16 Suzie’s TMD Course and Final Thoughts Listen to Dr. Suzie Bergman’s "Why is healthcare disjointed?" | TEDxStrathcona Women Check out Dr. Suzie’s Course “21st Century TMD Protocols" Looking for an Online course to allow General Dentists to treat 80% of TMD cases and 100% of Bruxists? Check out SplintCourse Online by Jaz Gulati  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: 200 Orofacial Pain (Diagnosis and treatment) Dentists will be able to:  1. Recognize the multifaceted nature of Temporomandibular Disorders (TMD) and the various factors influencing treatment variability. 2. Evaluate current evidence-based treatments for TMD and their effectiveness, including conservative methods and occlusal appliances. 3. Discuss the importance of a collaborative approach in TMD management, integrating different specialties for optimal patient outcomes. If you loved this episode, be sure to check out Deep in to TMD – An Orthopaedic Perspective – PDP172 Click below for full episode transcript: Teaser: I tell them T. A. T. U., which stands for Teeth Apart, Tongue Up, so during the day as much as possible, try to keep your teeth away from each other so that you're not clenching. I tell them, we want you to do the three S's, which are- Teaser:I always tell people it's unrealistic with chronic pain patients to think that there will be a day that you go to zero in pain. I don't know what it's like to not be in pain. Some days might be a little bit better, but there's never a time that I'm not in pain. And part of that is because- When we have pain for so long, it can become a central nervous system issue. So when we have that central sensitization, our brain interprets non painful stimuli as painful. We have patients who have discs that are either anteriorly and medially displaced, which is most common. It's very uncommon for there to be a posterior displacement of the disc. We have to think about how that patient's body has responded to the changes if the disc has been displayed. Some people will adapt beautifully and some people will not. And so, it's really about the individual patient. Jaz's Introduction:The management of Temporomandibular Disorders is like the Wild West. I know for a fact that for the same issue you can go to one dentist who will suggest orthodontics, you can go to a surgeon who may suggest some form of surgery, even if it's like an arthrocentesis, you can go to another person they might suggest some botox to calm those muscles,

How far should you extend composite resin? When does edge bonding become a composite veneer?  How do you decide where to finish the restoration?  And most importantly, how do you avoid that dreaded yellow-brown stain line that can form on anterior resins? These are just some of the burning questions tackled in this episode with my guest, Dr. Mahmoud Ibrahim. We dive deep into the artistry and engineering of  decision-making in anterior composites. https://youtu.be/_q2O57-Y-d4 Watch PDP211 on Youtube Protrusive Dental Pearl: use a zirconia primer which contains 10-MDP (e.g. Monobond, Z-Prime Plus) on the intaglio of crowns to enhance bond strength, even with conventional cements like GIC. This low-risk, high-reward tip improves retention, especially for teeth with limited height. Incorporating a zirconia primer can significantly improve outcomes without switching to resin cement. Interested in the Unchippable 2 Day Course? Click here to register your interest! Key Takeaways: Choosing between edge bonding or veneers is not a black-and-white decision. The height of contour is key in cosmetic dentistry. Seamless transitions between composite and tooth are pivotal. Aesthetic considerations vary based on individual cases. Material choice is influenced by patient risk factors. Layering techniques enhance the natural appearance of teeth. Patient previews are essential for managing expectations. Thickness of composite affects durability and aesthetics. Understanding angles is key to successful restorations. Not all patients require the same approach to bonding. Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode: 02:43  Protrusive Dental Pearl 04:49 Personal Anecdotes and Health Goals 09:37 Anterior Composites: Edge Bonding vs Veneering 16:00 Importance of Finishing Composite Correctly 17:09 Understanding the Height of Contour 18:36 Importance of Layering in Dental Procedures 21:35 Choosing the Right Materials for Layering 23:56 Importance of Layering in Dental Procedures 27:14 Challenges and Solutions in Composite Layering 32:31  The Marshall Hanson Method 36:29 Mockups and Wax-Ups: Planning for Success 43:03 Treatment Considerations This episode is eligible for 0.75 CE credits via the quiz on Protrusive Guidance.  This episode meets GDC Outcome C - Maintenance and development of your knowledge and skills within your field(s) of practice. AGD Subject Code: 250 OPERATIVE (RESTORATIVE)DENTISTRY (Direct restorations) Aim: To enhance clinicians' understanding and decision-making in anterior composite restorations, focusing on when edge bonding transitions to a veneer, optimizing aesthetics and functionality, and minimizing common challenges such as staining and occlusal complications. Dentists will be able to - Understand the key factors that influence the transition between edge bonding to full veneers. Apply guidelines for minimum composite thickness and bonding angles to enhance durability and aesthetic outcomes. Identify high-risk patients and tailor material choices, layering techniques, and bonding approaches to individual needs. If you loved this episode, make sure to watch Composite Veneers vs Edge Bonding – Biomimetic Dentistry with George The Dentist – PDP075 Click below for full episode transcript: Jaz's Introduction: How far should you extend your composite resin up a tooth, i. e. like when is it just edge bonding and when is it a composite veneer? Is it somewhere in between? How do you decide where to finish that resin up a tooth? And then how do you avoid that horrible stain line that can sometimes form on your resins anteriorly? Jaz's Introduction:So that horrible yellow brown line that you see around a composite. And when should you layer like different tints and shades? And when should you stick to monoshade? Just one shade.

What influences your decision when choosing ceramics? What are the main ceramics nowadays—and do porcelain-fused-to-metal still have a place in dentistry? Are the protocols different for various types of ceramics and crown materials? How important is rubber dam isolation, and is a split dam good enough? In this Back to Basics Protrusive episode, Jaz teams up again with Emma Hutchison, ‘the Protrusive Student’, to break down these critical questions and simplify the world of ceramics. From decision-making frameworks to practical rubber dam tips, this episode is packed with insights to elevate your practice. Whether you're a student navigating the foundations or a seasoned clinician revisiting the essentials, this discussion offers a fresh, evidence-based perspective on mastering ceramics in dentistry. https://youtu.be/z4a8Hv6peVU Watch PS013 on Youtube Key Takeaways: Understanding the role of metal ceramic crowns is crucial in modern dentistry. Monolithic ceramics are preferred for posterior restorations due to their strength. Layered ceramics can enhance aesthetics but may compromise strength. Proper crown preparation is essential for successful restorations. Communication with lab technicians is vital for successful bonding. The choice of ceramic material largely depends on the amount of enamel available. Following manufacturer protocols is key to achieving optimal results. Bruxism patients require careful consideration in material selection. Rubber dam isolation is crucial for predictable bonding. Digital scanning requires more aggressive tissue management. Impressions are still valuable, but digital methods are advancing. Need to Read it? Check out the Full Episode Transcript below! Highlights for this episode: 03:52 Emma's Exam Experience 07:28 Feedback on Previous Episode 08:00 Discussion on Ceramics in Dentistry 10:51 Practical Applications and Material Choices 19:45 Monolithic vs. Layered Ceramics 24:18 Exploring Milled Cobalt Chromes and Gold Crowns 26:14 Challenges in Fitting Restorations and Bonding Techniques 30:03 Rubber Dam Techniques and Benefits 37:01  Intraoral Scanners vs. Traditional Impressions 40:14 Effective Communication with Lab Technicians 44:25 Conclusion and Future Plans 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: 010 BASIC SCIENCE (Dental materials) Dentists will be able to - Identify the suitability of ceramics based on their strength, aesthetics, and application. Highlight the importance of proper crown preparation and manufacturer protocols for optimal results. Emphasize the importance of rubber dam isolation and compare the benefits and challenges of analog impressions versus digital scanning. If you love this episode, make sure to watch Composite vs Ceramic with Dr Chris Orr – PDP030 and make sure to read the Protrusive Notes!  Click below for full episode transcript: Teaser: I do not place lithium disilicate and I cement it. So for me, the way my mind works is if I'm cementing and not bonding, if I'm cementing just using a GIC based cement, so I'm not relying on enamel for adhesion, why would I use lithium disilicate? Using lithium disilicate posteriorly and bonding it, excellent strength, good, it's going to be fine, as long as you give it enough thickness, 1.5-2mm, you're golden, okay. Teaser:If you don't respect the thickness, or if you use cement and you don't bond it, you're going to really compromise on the strength, you're not going to get the high strength. So therefore, the same material, lithium disilicate, cemented is a completely different ceramic to the same ceramic lithium disilicate, bonded. You need to know your material and the correct protocol for your material. You're not supposed to air abrade lithium disilicate.

What’s the best way to reduce post-op pain after extractions? And why should we never use the term “painkiller” with patients? What to do when you hear the dreaded *crack* of a tuberosity? In this episode we talk about all things post-operative extraction complications! And I’m joined by one of the nicest guys in dentistry - Dr. Nekky Jamal  Complications are something we ALL experience, so this episode is great for any dentist. Whether you're brushing up on dry socket prevention, mastering post-op communication, or just curious about advanced healing hacks, tune in for real-world advice to make extractions smoother - for both you and your patients https://youtu.be/BvB3hDESYDY Watch PDP210 on Youtube Protrusive Dental Pearl: The "Niche Kebab" concept encourages dentists to narrow their focus by reducing the variety of procedures they perform and prioritizing those they genuinely enjoy. By evaluating every new skill or treatment added and strategically dropping less-loved procedures, dentists can avoid overextension and the "jack of all trades, master of none" pitfall.  Learn how to Extract Impacted 3rd Molars, don't miss out on Third Molars Online and use the coupon code ‘protrusive’ to get 15% off! Key Takeaways Pain management is about setting realistic expectations. Dexamethasone can be beneficial but must be used cautiously. Dry socket is often overhyped; proper care can prevent it. Effective communication can alleviate patient anxiety and prevent misunderstandings and complaints. Preoperative care can help manage pain expectations. Understanding the signs of infection is essential for diagnosis. Chlorhexidine rinses can significantly reduce dry socket risk. Patients appreciate being informed about their unique dental situations. PRF can significantly reduce the incidence of dry socket. Dentists should embrace new techniques like PRF to enhance patient care. Patient involvement in post-surgical care is crucial for healing. Dentists should not hesitate to refer complex cases to specialists. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 02:54 Protrusive Dental Pearl 04:05 Dr. Nekky Jamal  08:39 Managing Post-Extraction Pain and Swelling 21:37 Infection 25:02 Identifying Dry Socket and How to Prevent it 28:30 Case Selection and Communication 37:13 Mitigating Dry Socket with Platelet-Rich Fibrin (PRF) 39:47 The Importance of Nicheing in Dentistry 43:19 Cryotherapy and Post-Surgery Care 47:32 Handling Tuberosity Fractures 55:08 Patient Consent  57:55 Litigation and Patient Communication This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes A, C and D. AGD Subject Code: 310 ORAL AND MAXILLOFACIALSURGERY (Exodontia) Dentists will be able to: Identify and differentiate common postoperative complications, and recognise the  key symptoms associated Evaluate the ethical and clinical considerations of case selection for extractions Communicate effectively with patients regarding potential complications If you loved this episode, be sure to check out another epic episode with Dr. Nekky Jamal - Wisdom Teeth Extractions – SURGICAL TOP TIPS Click below for full episode transcript: Teaser: Overexplain and then have them on your page, have them take ownership for their anatomy before you even start. You know what I mean? Dentistry is about talking to patients and Jaz, you've seen how I talk to my patients. I keep everything light, but after I joke around, I say, okay, but seriously, do you understand that this is a risk like this could actually happen and in this case scenario I don't want that to happen for you. Teaser:I'll do everything I can for you. But there's things that are out of our control. Do you understand? And patients have to take ownership of it? Otherwise, I'm not doing work.

In this special recap, we’ll explore 12 key lessons from 2024 —insights that have shaped our practice, validated our protocols, and sometimes, inspired small but meaningful changes. Happy New Year from Team Protrusive! As we kick off 2025, we want to express heartfelt gratitude for your incredible support throughout 2024. What were the standout moments that shaped your learning this year? Which episodes gave you that “aha” moment? Whether you’re a seasoned listener or just jumping in, this recap will help solidify the lessons that you can apply to your practice every day. https://youtu.be/OxfRmNhQ7Wk Watch PDP209 on Youtube Protrusive Dental Pearls:  Take time to reflect on your goals for 2025 and consider what sacrifices you're prepared to make to achieve them. Emphasizing the importance of writing down both your objectives and the trade-offs they require, align your time and priorities with your personal and professional aspirations.  “You overestimate what you can achieve in a year and underestimate what you can accomplish in ten years.”  Productivity is about knowing how badly you want something and what you're willing to sacrifice to achieve it. Take a deep dive into this literature: Clinical considerations for increasing occlusal vertical dimension: a review  Australian Dental Journal - 2012 - Abduo - Clinical considerations for increasing occlusal vertical dimension a reviewDownload Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 01:08  Protrusive Dental Pearl 06:25 Value Your Skills 11:54 Importance of Photography and App Launch 14:42 Audio Notes in Dentistry 16:41 Rubber Dam Mastery 18:07 Composite Techniques and Innovations 21:07 Onlays vs Full Crowns 25:54 Best Bonding Agents 28:55 Digital Dentures Revolution 31:24 Mastering Vertical Dimension 32:29 Perfecting Posterior Composites 34:58 Creating Awesome Dentures 36:27 Extraction Techniques and Avocado Analogy 37:47 Looking Forward to 2025 Here are some episodes and webinars mentioned in this episode that are definitely worth checking out: Value Your Skills – How to Stop Underselling Yourself – AJ006 Your Occlusion Questions Answered by Dr Michael Melkers – PDP015 Cracked Teeth and Dentistry’s Tough Questions with Dr Lane Ochi – PDP175 NEVER Write Notes Again! How I Use AI for Awesome and Efficient Dental Records – PDP181 Canine Guidance vs Group Function – Does it Matter?! – PDP182 Class II Composites WITHOUT a Wedge + Contact Opening Technique – PDP188 Onlays Vs Full Crowns – Decision Making 2024 – PDP189 Quick and Slick Rubber Dam Vertipreps for Plonkers  Premium Clinical Videos  My Productivity Secrets Revealed Webinar REPLAY Deep and Dark Class III Restorations Which Generation Bonding Agent is the Best? 2024 Adhesive Systems – PDP192 Digital Dentures for Every Dentist – The Death of Impressions? – PDP195 [OCCLUSION MONTH] Vertical Dimension – Don’t Be Scared! – PDP197 How to Place Posterior Composites without Destroying Your Anatomy – PDP200 Making Awesome Dentures – Border Moulding and Beyond – PDP205 Exodontia for Beginners – Extractions via Avocados! – PS012 Take your practice to the next level with DigitalTCO, Dental Audio Notes, and the Greater Curve. This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD waiting for you on the Ultimate Education Plan, including Premium clinical workthroughs and Masterclasses. Click below for full episode transcript: Jaz's Introduction: Happy New Year, Protruserati. 2025, from all of us here at Team Protrusive, honestly, thank you so much for an awesome 2024 and looking forward to so much in 2025. In this episode, we're going to look back at all the gems from 2024 and looking forward to 2025. So I'll give you at least 12 takeaways, 12 key lessons from the episodes of 2024.

Are you focusing enough on pink aesthetics in smile design? What role does gingiva play in achieving a truly stunning smile? When should you refer for recession around lower incisors or upper canines? Can you get the gum to grow back through orthodontics? And how about class 5 restorations? Should we do them, or should we work on the gingival recession first? In this episode, Jaz is joined by the expert Dr. Tidu Mankoo, who shares his extensive knowledge on the importance of gingival health in aesthetic dentistry. They dive into the crucial role of the dento-gingival complex.  https://youtu.be/Ao_vgJ-IbOg Watch PDP208 on YouTube Protrusive Dental Pearl: Shade Matching Composite button technique - a small blob of composite is applied to a dry tooth without etching or bonding to assess shade match and translucency, avoid excess thickness, which can affect opacity and aesthetics (Jason Smithson’s Tip: take a black-and-white photo to evaluate the composite's value and ensure it matches the natural teeth) Using a custom composite shade guide like Smile Line by Style Italiano for more precise shade matching. Key Takeaways Gingival architecture plays a vital role in aesthetics. Dentists should focus on patient-centered care. Understanding tooth position is key to treatment planning. Orthodontics can sometimes resolve gingival issues without surgery. Communication with patients is essential for effective treatment. Aesthetic dentistry requires a comprehensive approach. The dental field is evolving, and practitioners must adapt. Root coverage procedures can be effective with proper techniques. Understanding prognosis is crucial for successful treatment outcomes. Aesthetic considerations are a primary reason for root coverage. Restorative dentistry should consider the position of the gingiva. Crown lengthening should not expose root surfaces unnecessarily. Mucogingival surgery plays a vital role in implant aesthetics. Education and training are essential for dental professionals. Need to Read it? Check out the Full Episode Transcript below! Highlights for this episode: 4:29 Protrusive Dental Pearl 6:16 Dr. Tidu Mankoo's Journey and Inspirations 11:48 Reflections on Comprehensive Dentistryand Lifelong Learning 15:59 Balancing Work and Family in Dentistry 17:52 Understanding Gingival Architecture 19:49 Creating a Harmonious Smile 21:52 Addressing Gingival Aesthetics & Limitations 26:56 Orthodontics and Surgical Interventions 29:40 Root Coverage Procedures 33:49 The Value of Early Diagnosis and Referral 35:01 Indications for Root Coverage 36:03 Root Coverage vs. Class V Restorations 39:50 Managing Gingival Zenith Irregularities 41:23 Role of Mucogingival Surgery inImplant Success 47:47 Course on Mucogingival Surgery with IAS 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: 780 ESTHETICS/COSMETIC DENTISTRY (Esthetic diagnosis and treatment of intraoral soft tissues)  Dentists will be able to - Discuss when and how to manage gingival recession, including the role of root coverage procedures. Explore the anatomy and function of the dento-gingival complex and its influence on smile aesthetics. Promote the value of early diagnosis and timely referrals to specialists for successful treatment. 🚨 Join the Ultimate Masterclass on Implant Soft Tissue and Complex Cases! 🚨 📅 Dates: April 2024🌟 Event: Implant Soft Tissue and Complex Case Masterclass Join this two-day masterclass to elevate your skills in: ✅ Implant soft tissue management ✅ Root coverage and crown lengthening ✅ Complex case planning and aesthetics If you loved this episode, be sure to check out PDP035 - Case Acceptance in Smile Design with Dr Gurs Sehmi Click below for full episode transcript:

In this episode, we focus on the link between periodontal disease and the systemic effects on the human body. There’s more to oral hygiene than just saving our teeth, so let’s dive into this fascinating episode with Dr Reena Wadia to learn more about the importance of perio and how it is associated with the rest of our health. https://youtu.be/fldpB_8h2Dc Watch GF024 on Youtube Key Takeaways: There is a strong link between gum health and systemic health. Diabetes and cardiovascular disease are key conditions linked to gum health. Understanding correlation vs. causation is crucial in dental practice. Effective communication with patients can improve treatment outcomes. Treating pregnant patients for periodontal health is safe and beneficial. Proper diagnosis is essential for effective dental treatment. Patients are often unaware of the links between gum health and overall wellness. Motivating patients with health benefits can enhance compliance. Evidence-based dentistry is vital for accurate patient information. Add the word diagnosis to templates for clarity. Team collaboration (dental and medical practices) enhances patient care effectiveness. Screening for conditions like diabetes can save lives. Holistic care in dentistry is becoming increasingly important. A periodontal protocol is crucial for consistent care. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode:  3:50 Introduction to Dr Reena Wadia 7:14 Systemic Link 12:24 Under Investigation 13:54 Using this with our Patients 17:04 Birthweight-related Studies and Pregnancy 20:14 Make a Periodontal Diagnosis 23:34 Medicine and Dentistry Collaboration 26:29 Understanding the Patient 29:14 HbA1c Machine 32:19 The Perio Handbook This episode is eligible for 0.5 CE credits via the quiz on Protrusive Guidance.  This episode meets GDC Outcome A, B and D. AGD Code: 490 PERIODONTICS (Pathophysiology of periodontal disease)  Aim: To enhance dentists' understanding of the link between periodontal health and systemic diseases, enabling them to integrate evidence-based periodontal care into their clinical practice. Learning Outcomes: Knowledge and Application: Dentists will gain a thorough understanding of the bi-directional relationship between periodontal disease and systemic conditions such as diabetes and cardiovascular disease, and learn how to apply this knowledge in clinical practice to improve patient outcomes. Patient Education: Dentists will acquire practical strategies for effectively educating patients about the systemic implications of periodontal health, using analogies, visual aids, and evidence-based communication methods. Holistic Treatment Planning: Dentists will learn how to incorporate systemic health considerations, such as screening for diabetes or collaborating with medical professionals, into their periodontal treatment plans to deliver comprehensive care. Enhance your knowledge with Dr. Reena Wadia's Perio School and establish a habit of implementing Perio protocols in your practice. Don't forget to grab a copy of the Perio Handbook by Dr. Reena for valuable insights! If you enjoyed this episode, check out: Communication Masterclass for Periodontal Disease [B2B] – PDP086 Click below for full episode transcript: Teaser: When you hear stories like that, it's like, could that have been undiagnosed diabetes, heart attack, et cetera, et cetera. So I feel so privileged being able to have that ability to do that test on our patients. And yeah, it's not the nicest thing to say to someone, you might have diabetes, but actually like that could save someone's life. Teaser:The guidelines now are, for example, for diabetics, once they've been diagnosed with diabetes, they're supposed to see their dentist, but they need to push it more, because they definitely push the eye appointments,

What are the steps involved in Functional Crown Lengthening? Which scenarios/teeth are best for this type of surgery? What is biologic width and why should we care? Is Bone sounding a diagnostic test, or just a genre of music? The answer to these questions and a lot more can be found in this packed episode with Dr Hiten Halai. We cover the right protocols when crown lengthening and understand the difference between aesthetic and functional crown lengthening.  https://youtu.be/KRlEtz16I8c Watch PDP207 on Youtube Protrusive Dental Pearl - Bone Sounding Using a periodontal probe, go into the depth of the sulcus, pushing deeply until you hit bone, all while recording the measurement with the probe. This measurement will then guide you on how to carry out your crown lengthening procedure. Push hard to pass the connective tissue and ensure you are touching the bone. Not using AI to write your notes and letters for you yet? Save hours every day and save money using this affiliate link for DigitalTCO: Click Here  Need to Read it? Check out the Full Episode Transcript below! Highlights of this Episode:03:19 Protrusive Dental Pearl06:10 Introduction - Dr Hiten Halai12:56 Functional Crown Lengthening15:41 Understanding Crown Lengthening Types18:42 University of Dental Instagram22:38 Biologic Width aka Supra-crestal Tissue Attachment25:51 Functional Crown Lengthening: Practical Considerations31:09 Assessments & Keratinised Tissue35:47 Understanding Tissue Phenotypes39:16 Case Study: Premolar Treatment43:17 Bone Sounding and Biologic Width46:58 Shape of Gingivectomy50:31 Flap Designs52:37 Burs for Crown Lengthening56:13 Healing and Restoration Timelines58:31 Learning and Training Opportunities Key Takeaways: Hiten's journey began with a passion for periodontics during dental school. Managing time effectively is crucial for specialists with busy schedules. Functional crown lengthening is often underutilized in practice. Aesthetic crown lengthening can lead to complications if not done correctly. Understanding biologic width is essential for successful crown lengthening procedures. Preoperative assessments are critical for determining candidacy for crown lengthening. The type of gingival tissue affects surgical outcomes and healing. Proper surgical techniques can prevent complications and ensure better healing. Postoperative care is vital for achieving desired aesthetic results. Continuous education and mentorship are important for dental professionals. This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcome C. ADG Code: 490 PERIODONTICS (Mucogingival management)  Aim: To enhance knowledge and practical understanding of crown lengthening procedures, with a focus on distinguishing between aesthetic and functional crown lengthening, and the importance of biologic width in achieving predictable clinical outcomes. Learning Outcomes: Identify the key differences between aesthetic and functional crown lengthening and the clinical scenarios in which each is most appropriate. Demonstrate an understanding of biologic width and its significance in the success of crown lengthening procedures, including the impact on long-term periodontal health. Apply the principles of bone sounding to accurately assess the need for crown lengthening and ensure optimal restoration outcomes, minimising risks such as gingival recession and bone loss. If you liked this episode, check out: PDP079 - Crown Lengthening Click below for full episode transcript: Teaser: Despite what the University of Instagram tells you, all cases cannot be treated by laser gingivectomy. And that is the truth. Four or five years down the line, when there has been enough time for that tissue to relapse, what happens is they'll come back with that persistent inflammation. And actually the management of it is much more complex now.

Application points, luxation vs elevation, avoiding common mistakes - this one's an episode that I wish I had when I was at dental school! How do you know when you've found the application point during extractions? What are the key protocols that can help make your extractions more efficient? https://youtu.be/rOBPnCTyAwM Watch PS012 on Youtube This week's Protrusive Student episode is all about exodontia - and again I'm joined by Emma Hutchison, our Protrusive Student Ambassador, to discuss some tips and tricks on how to make extractions that little bit easier. Jaz also shares a memorable analogy—could removing a stone from an avocado be the perfect way to describe an extraction?! Key Takeaways Tactile feedback is crucial during tooth extractions. Understanding application points can improve extraction techniques. Using the right amount of pressure is essential to avoid breaking teeth during extraction. Luxators are typically used to sever the PDL before extraction. Atraumatic extraction techniques are important for preserving bone for future implants. Luxators should not be used as elevators. Understanding the mechanics of elevators is crucial for effective extractions. The ‘six second rule’ helps in assessing extraction progress. Having a plan for extractions can prevent complications. Communicating with patients about the extraction process is essential. Avoid tunnel vision; consider the surrounding teeth during extractions. Breaking interproximal contacts can simplify extractions. Always check the patient's medical history before procedures. An audible checklist can prevent mistakes during extractions. Need to Read it? Check out the Full Episode Transcript below! Highlight of this episode: 00:00 Introduction 02:07 Catching Up with Emma 05:58 Teeth are like avocados! 11:13 Understanding Application Points in Extractions 17:01 Luxators vs. Elevators: Techniques and Safety 24:10 Extraction Technique 25:08 The Six-Second Rule 28:04 Having a plan 29:58 Common Mistakes and  How to Avoid Them 38:17 Conclusion and CE Certification This episode is eligible for 0.75 CE credit via the quiz on below.  This episode meets GDC Outcomes B and C. AGD Subject Code: 310 Oral and Maxillofacial Surgery (Exodontia) Dentists will be able to - 1. Recognise essential steps to establish secure application points 2. Develop approaches for patient communication around extraction procedures, potential risks, and expected outcomes 3. Implement the “6-second rule” and other practical techniques to streamline extractions and troubleshoot common challenges If you loved this episode, make sure to watch Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth [B2B] – PDP085 Click below for full episode transcript: Jaz's Introduction: This episode on basics of extractions is the episode I wish I had when I was learning extractions when I was a student. But also what I've found from this Protrusive Student series is that so many dentists are listening to them and they're commenting and they're enjoying and they're liking it. Jaz's Introduction:What I've discovered is that it's so good to just reconnect with basics and actually by listening to these kind of episodes you do sometimes pick a few things up or it's validation. It helps to validate some techniques, some ideas, some protocols that you're already using. It's also a wonderful way to see how far you've come. Sometimes we move so far in our career that we forget what it's like to have those struggles like we did when we were a student. So the reason I gave you that little preamble is because now from this episode, most Protrusive Student episodes, I think, will be eligible for CPD or CE credits. And so this one is eligible for 0. 75 CE credits or 45 minutes, if you're in the UK. Protrusive Education is a PACE approved education pro...

Are you confident in diagnosing white patches? Which white patches need an URGENT referral? How do you tell the difference between lichen planus, lichenoid reactions, and other common lesions? Dr. Amanda Phoon Nguyen is back with another amazing episode, this time diving deep into the world of oral white patches. Jaz and Amanda explore the most common lesions you’ll encounter, breaking down their appearance, diagnosis, and management. They also discuss key strategies to help you build a strong differential diagnosis, because identifying the right lesions early can make all the difference in patient care. https://youtu.be/xlQpuQu2Hl0 Watch this full episode on YouTube Protrusive Dental Pearl: A new infographic summarizing Dr. Amanda Phoon Nguyen’s key teachings. Jaz describes it as an easy-to-follow "cheat sheet" designed to simplify complex ideas and make it easier to apply the concepts discussed in the episode. You can download the Infographic for free inside Protrusive Guidance 'Free Podcasts + Videos' section. Key Takeaways White patches in the oral cavity can be classified into normal variants, non-pathological patches, and potentially malignant disorders. It is important to identify the cause of the white patch and differentiate between different types. Referrals should be made based on the characteristics of the white patch and the urgency of the situation. Clinical photographs are valuable in referrals and can aid in triaging patients. Ongoing monitoring is important for potentially malignant disorders. Lichen planus can have different types and presentations, and a biopsy may be necessary for certain cases. Enlarged taste buds, particularly in the foliate papillae, are usually bilateral and not a cause for concern. Oral lichenoid lesions can be triggered by dental restorative materials or medications, and a change in dental material may sometimes improve the condition. Smoker's mouth can present with white patches and inflammation in areas where smoke gathers, and counseling patients to reduce smoking is important. Oral submucous fibrosis, often caused by areca nut chewing, requires regular review and counseling patients to stop chewing the nut.  Need to Read it? Check out the Full Episode Transcript below! Highlights for this episode: 01:22 Protrusive Dental Pearl 05:13 Dr. Amanda Phoon Nguyen Introduction 07:39 White Patches Introduction 09:16 Understanding Geographic Tongue 12:44 Keratosis vs. Leukoplakia 19:02 Proliferative Verrucous Leukoplakia 22:18 Referral Tips for General Dentists 29:56 Understanding Leukoplakia 33:17 Urgent and Non-Urgent Referrals 34:37 Patient Communication 39:17  Discussing Erythroplakia  41:03 Oral Lichen Planus: Diagnosis and Management 47:50 Enlarged Taste Buds 49:47 Oral Lichenoid Lesions vs Oral Lichen Planus 53:43 Smoker's Mouth 55:14 Oral Submucous Fibrosis 57:23 Learning more from Dr. Amanda Phoon Nguyen  This episode is eligible for 1 CE credit via the quiz below.  This episode meets GDC Outcomes B and C. AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Diagnosis, management and treatment of oral pathologies) Dentists will be able to - Identify the cause of a white patch and differentiate between different types. Understand when and how to make referrals based on the characteristics of the white patch and the urgency of the situation. Appreciate the importance of ongoing monitoring for potentially malignant disorders, including when to consider a biopsy. For those interested in visual case studies and deeper insights into oral lesions and conditions, follow Dr. Amanda on Instagram and Facebook! If you loved this episode, be sure to check out another epic episode with Dr. Amanda - Prescribing Antifungals as a GDP – Diagnosis and Management – PDP151 Click below for full episode transcript: