Very Dental Student: Real Life Dentistry with Dr. Alan Mead

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[00:00:31] [SPEAKER_02]: This is a production of the Very Dental Podcast Network.

[00:00:39] [SPEAKER_02]: It's time for a Very Dental Podcast just for students and new dentists. Welcome to the

[00:00:45] [SPEAKER_02]: Very Dental Student Podcast. And now here's your host, Mohamed Aboubasha.

[00:00:50] [SPEAKER_00]: Hello, everybody. Welcome to another episode of the Very Dental Student Podcast. I'm

[00:00:58] [SPEAKER_00]: going to get you live with Dr. Alan Mead, the host of the Very Dental Podcast. We're

[00:01:04] [SPEAKER_00]: going to be doing a little bit of a clinical interview today. So, Alan, how are you

[00:01:08] [SPEAKER_00]: doing today?

[00:01:09] [SPEAKER_00]: I'm good. How are you doing?

[00:01:11] [SPEAKER_00]: You know, I'm doing good. It's a Thursday night. Looking forward to the weekend.

[00:01:17] [SPEAKER_00]: Well, yeah.

[00:01:18] [SPEAKER_02]: Okay, I'm going to interview you in a minute about your third year. But as a

[00:01:22] [SPEAKER_02]: Thursday, do you have the day off tomorrow or something? Or you just you just

[00:01:25] [SPEAKER_00]: feeling wild and crazy don't have a test tomorrow or something?

[00:01:28] [SPEAKER_00]: Well, so tomorrow I have like a restorative lecture for one hour in the

[00:01:34] [SPEAKER_00]: morning. Okay. And which is it's more of like a refresher of topics we've

[00:01:38] [SPEAKER_00]: already discussed. Yeah. And then we just have clinic. So okay, I have

[00:01:43] [SPEAKER_00]: comprehensive care in the in the morning, which is where we see like

[00:01:46] [SPEAKER_00]: just regular patients. And then I have pediatrics in the afternoon.

[00:01:50] [SPEAKER_02]: Oh, there you go. There you go. Nice. Okay, so you actually have a workday

[00:01:54] [SPEAKER_02]: and you're still up for interviews. We're gonna we're gonna do interviews

[00:01:57] [SPEAKER_02]: and we won't go too long.

[00:01:59] [SPEAKER_00]: Yeah, well, yeah, like you said, no test, no quiz tomorrow. So that's good.

[00:02:03] [SPEAKER_00]: Yeah, doesn't doesn't really bother me to stay up a little bit.

[00:02:06] [SPEAKER_00]: Yep.

[00:02:07] [SPEAKER_00]: But yeah, how's everything been? So you don't you don't have to go into

[00:02:10] [SPEAKER_00]: work tomorrow, right?

[00:02:11] [SPEAKER_02]: No, I do not. I am working. I started middle of 2020. No early 2023.

[00:02:18] [SPEAKER_02]: For a three day clinical week. So I work three nines, which is a really

[00:02:22] [SPEAKER_02]: short week for even for a dentist. It's a really short week. It's

[00:02:27] [SPEAKER_02]: I might produce a little less, although I got to tell you, you can

[00:02:32] [SPEAKER_02]: I you know, when I cut out the fat with four days and basically I was

[00:02:36] [SPEAKER_02]: the four days I was at 31 hours per week. And with three days, I'm

[00:02:41] [SPEAKER_02]: at 27 hours per week. So I lost four clinical hours. But you can

[00:02:45] [SPEAKER_02]: essentially do if you cut out the fat, you can do the same or

[00:02:48] [SPEAKER_02]: more in three days. And that's what we do. We kind of cram it

[00:02:50] [SPEAKER_02]: in. So it's good. I like it. I will say that it's really hard.

[00:02:55] [SPEAKER_02]: If I had to go back to four days or five days clinical after being

[00:02:59] [SPEAKER_02]: three days for this long, I don't know if I could do it. Like it

[00:03:03] [SPEAKER_02]: is it sucks. The longer days suck. They're longer days and you

[00:03:06] [SPEAKER_02]: got to get up early in the morning to you know all this stuff.

[00:03:08] [SPEAKER_02]: But you know what? And long weekends are awesome. They're

[00:03:12] [SPEAKER_02]: fantastic. I know that sounds silly a little bit because like,

[00:03:16] [SPEAKER_02]: of course they are. But I I don't know. It's funny. I worked

[00:03:21] [SPEAKER_02]: four day work week for most of most of my career until then. And

[00:03:25] [SPEAKER_02]: I always just that was just kind of what it was knowing that you

[00:03:28] [SPEAKER_02]: could work three days, you know, and do almost as much.

[00:03:32] [SPEAKER_02]: I'm just like, Wow, like these the longer weekends are

[00:03:34] [SPEAKER_02]: spectacular. And even with that with teenage kids, man,

[00:03:37] [SPEAKER_02]: it's still there's not enough time for everything. But I

[00:03:40] [SPEAKER_02]: like I like three day weeks, some maybe I'll have to go back

[00:03:43] [SPEAKER_02]: to 40 weeks or maybe right now I'm loving it.

[00:03:45] [SPEAKER_00]: Yeah, I mean, I think three day week sounds perfect. Yeah,

[00:03:48] [SPEAKER_00]: yeah.

[00:03:49] [SPEAKER_00]: I mean, you never have too much time to spend with the family.

[00:03:53] [SPEAKER_00]: So yeah, yeah. So one thing like basically what I want to

[00:03:58] [SPEAKER_00]: gain from this episode is sometimes in dental school, we

[00:04:02] [SPEAKER_00]: feel like what we're being taught, clinical, like

[00:04:05] [SPEAKER_00]: clinical wise, in terms of our protocols and stuff, it

[00:04:09] [SPEAKER_00]: might not necessarily be an accurate reflection of what

[00:04:12] [SPEAKER_00]: we're going to be doing when we get out. So I just wanted

[00:04:14] [SPEAKER_00]: to talk to you about kind of some of that just the bread

[00:04:17] [SPEAKER_00]: and butter stuff. And what and how you're handling that in

[00:04:20] [SPEAKER_00]: your office. So how's that?

[00:04:22] [SPEAKER_00]: That sounds great. That's what I do. I pretty much bread

[00:04:25] [SPEAKER_00]: and butter is what I do.

[00:04:26] [SPEAKER_00]: Yeah. So so one thing I want to start with is kind of

[00:04:30] [SPEAKER_00]: your bonding protocol. Because this is something I mean,

[00:04:34] [SPEAKER_00]: we talked about it in materials, dental materials,

[00:04:37] [SPEAKER_00]: all the different like, you know, different protocols,

[00:04:42] [SPEAKER_00]: different generations of bonding agents and stuff. But then we

[00:04:47] [SPEAKER_00]: only get taught really one system. And we're using Optabond

[00:04:51] [SPEAKER_00]: Solo Plus. So we're doing that. That's like the self

[00:04:55] [SPEAKER_00]: priming bond or self bonding, whatever that is.

[00:04:59] [SPEAKER_00]: The second bottle. So that's that's all we really know.

[00:05:03] [SPEAKER_00]: So tell me about what you use.

[00:05:05] [SPEAKER_02]: Okay, so tell me, tell me about let me let me. So is

[00:05:07] [SPEAKER_02]: that one? Do you have like an an etching gel that you

[00:05:10] [SPEAKER_02]: put on first and then and then put a bonding agent on

[00:05:14] [SPEAKER_02]: afterwards? Is that what you're doing?

[00:05:15] [SPEAKER_00]: Yes. So we, we have an etching gel, which is just

[00:05:20] [SPEAKER_00]: phosphoric acid etch. And then we rinse and dry and we're

[00:05:25] [SPEAKER_00]: according to the protocol, we're supposed to re wet

[00:05:28] [SPEAKER_00]: with chlorhexidine. I don't think that that necessarily

[00:05:32] [SPEAKER_00]: happens most of the time. So then people just will go on

[00:05:36] [SPEAKER_00]: we're supposed to do two applications of the

[00:05:38] [SPEAKER_00]: Optabond Solo Plus air drying in between and then

[00:05:41] [SPEAKER_00]: curing.

[00:05:42] [SPEAKER_02]: Optabond Solo is for a lot of people, they consider

[00:05:46] [SPEAKER_02]: that the pretty much the standard bonding it like

[00:05:48] [SPEAKER_02]: the, the the bonding agent that others are judged

[00:05:51] [SPEAKER_02]: by. So I have no arguments with that. So for a

[00:05:54] [SPEAKER_02]: long time, probably back in the aughts, the early

[00:05:57] [SPEAKER_02]: aughts and maybe even into the other early 20

[00:06:01] [SPEAKER_02]: teens, I was I got into self etchers early,

[00:06:05] [SPEAKER_02]: because I don't know why. But for some reason, it

[00:06:08] [SPEAKER_02]: seemed like, yeah, be great to not have to do

[00:06:10] [SPEAKER_02]: the etch step or whatever. So I used a bunch of

[00:06:12] [SPEAKER_02]: different I used a john canka has a apex dental

[00:06:16] [SPEAKER_02]: he had. Oh, I can't surpass was one of them,

[00:06:19] [SPEAKER_02]: which was a three bottle system. And then

[00:06:20] [SPEAKER_02]: there's a so I use those for a long time and

[00:06:22] [SPEAKER_02]: then and then like a bunch of dental town

[00:06:25] [SPEAKER_02]: people went God, I don't even know how long

[00:06:27] [SPEAKER_02]: ago this was before the podcast. But I actually

[00:06:30] [SPEAKER_02]: was that trip. It's really funny. I the very

[00:06:32] [SPEAKER_02]: first time I told anyone else that I was

[00:06:34] [SPEAKER_02]: thinking about doing a podcast was on that trip.

[00:06:36] [SPEAKER_02]: And it was it was two guys that have been on

[00:06:38] [SPEAKER_02]: the podcast a bunch of times Brent Young and

[00:06:40] [SPEAKER_02]: Clayton. And we went out to a Starbucks. It was

[00:06:42] [SPEAKER_02]: in Utah. We were at Ultra Den and they were

[00:06:44] [SPEAKER_02]: giving us a class. And it was a bunch of

[00:06:46] [SPEAKER_02]: dental town people who are real active on

[00:06:48] [SPEAKER_02]: dental town. They flew us out to Utah. It

[00:06:49] [SPEAKER_02]: was a great meeting. And so Dan Fisher was

[00:06:52] [SPEAKER_02]: showing off his new it's called peak or

[00:06:56] [SPEAKER_02]: it was called peak peak universal where you

[00:06:58] [SPEAKER_02]: could use it. You could use it as a as a

[00:07:00] [SPEAKER_02]: self etch. You could use it as like a

[00:07:03] [SPEAKER_02]: standard like like regular edge where you do

[00:07:06] [SPEAKER_02]: like an etched gel and then use it

[00:07:08] [SPEAKER_02]: secondarily. And we started to use it and I

[00:07:10] [SPEAKER_02]: got really, really I liked it. I like this

[00:07:12] [SPEAKER_02]: stuff is really good. And I have to tell you.

[00:07:14] [SPEAKER_02]: So that was like I think it was like my

[00:07:15] [SPEAKER_02]: man like 2010 or 2011 maybe 2012. I don't

[00:07:18] [SPEAKER_02]: know. And that's what I use. I use that

[00:07:21] [SPEAKER_02]: still. I use I use ultra dense peak

[00:07:24] [SPEAKER_02]: universal but I use it with a blue etch

[00:07:26] [SPEAKER_02]: gel. So I actually use it with their their

[00:07:28] [SPEAKER_02]: blue etch. And so I will when I'm bonding

[00:07:32] [SPEAKER_02]: direct indirect I kind of bond all this

[00:07:34] [SPEAKER_02]: and I will say this it's an alcohol based

[00:07:36] [SPEAKER_02]: carrier. I think of the bond solo might be

[00:07:39] [SPEAKER_02]: an alcohol alcohol. Is that you think

[00:07:41] [SPEAKER_02]: that's alcohol or you think that's

[00:07:43] [SPEAKER_02]: acetone? I can't remember. I it's I think

[00:07:47] [SPEAKER_02]: it's alcohol but I think it is true. I

[00:07:49] [SPEAKER_02]: think it is too. And so you have to

[00:07:50] [SPEAKER_02]: you have to desk not desiccate. You

[00:07:52] [SPEAKER_02]: have to evaporate the solvent on an

[00:07:55] [SPEAKER_02]: alcohol one a little bit more like I feel

[00:07:58] [SPEAKER_02]: like the acetone evaporates better than

[00:08:02] [SPEAKER_02]: the alcohol. I always do too. And I have

[00:08:04] [SPEAKER_02]: to say I've read the instructions

[00:08:06] [SPEAKER_02]: since then. And it says you can do one. I

[00:08:10] [SPEAKER_02]: always do two layers. I'll etch and then

[00:08:14] [SPEAKER_02]: I'll rinse and then I don't I rinse but

[00:08:15] [SPEAKER_02]: I don't rinse like I don't desiccate

[00:08:17] [SPEAKER_02]: after that. So it's moist from the

[00:08:19] [SPEAKER_02]: rinse. I don't necessarily go in with

[00:08:21] [SPEAKER_02]: the chlorhexidine. I just I just I let

[00:08:24] [SPEAKER_02]: it be kind of moist. But the story

[00:08:26] [SPEAKER_02]: is with an alcohol based carrier that

[00:08:29] [SPEAKER_02]: I think gives the right amount of

[00:08:30] [SPEAKER_02]: moisture. And that's one of the

[00:08:32] [SPEAKER_02]: things I think the Optibot and solo is so

[00:08:33] [SPEAKER_02]: good because it's so you you but it

[00:08:36] [SPEAKER_02]: takes a little longer to evaporate the

[00:08:38] [SPEAKER_02]: the alcohol based solvent. So I'll do

[00:08:39] [SPEAKER_02]: two layers of that and then I hit it

[00:08:41] [SPEAKER_02]: with the light and I'm good to go. I

[00:08:42] [SPEAKER_02]: got to say I it does a pretty good

[00:08:45] [SPEAKER_02]: job. It does a pretty good job like

[00:08:47] [SPEAKER_02]: like that's my I'm sure everyone says

[00:08:49] [SPEAKER_02]: the same thing now sometimes especially

[00:08:52] [SPEAKER_02]: I've found when you're when you're

[00:08:55] [SPEAKER_02]: bonding and indirect of some sort

[00:08:57] [SPEAKER_02]: sometimes the film thickness of that

[00:09:00] [SPEAKER_02]: alcohol is a little bit sketchier. I

[00:09:02] [SPEAKER_02]: think I feel like just because the

[00:09:04] [SPEAKER_02]: it seems to me that because this the

[00:09:06] [SPEAKER_02]: literally the way the bonding agent

[00:09:09] [SPEAKER_02]: looks is a little bit more opaque. You

[00:09:10] [SPEAKER_02]: know it's like a little bit so I

[00:09:12] [SPEAKER_02]: don't know if that's true film

[00:09:13] [SPEAKER_02]: thickness or not but I sometimes I'm

[00:09:15] [SPEAKER_02]: a little worried about film thickness

[00:09:16] [SPEAKER_02]: with the alcohol based bonding agent

[00:09:18] [SPEAKER_02]: so I also will have the excite eyes

[00:09:20] [SPEAKER_02]: at the excite the adhesed pen. It's

[00:09:22] [SPEAKER_02]: an ivaclar product the adhesed pen

[00:09:23] [SPEAKER_02]: and one of the reasons I like both

[00:09:25] [SPEAKER_02]: these things is the that you don't

[00:09:28] [SPEAKER_02]: need to dip a separate brush in a

[00:09:31] [SPEAKER_02]: dish to do this like the the

[00:09:33] [SPEAKER_02]: extra dent product has these little

[00:09:35] [SPEAKER_02]: brush tips on the end of it. It's

[00:09:37] [SPEAKER_02]: probably more expensive but I really

[00:09:38] [SPEAKER_02]: like the handiness of it's got its own

[00:09:40] [SPEAKER_02]: brush you just kind of I love that

[00:09:42] [SPEAKER_02]: and to be honest the reason I chose

[00:09:44] [SPEAKER_02]: the adhesed pen not not only does

[00:09:45] [SPEAKER_02]: it have a really good really good

[00:09:48] [SPEAKER_02]: ratings for bonding agent for an

[00:09:49] [SPEAKER_02]: acetone based bonding agent it's got

[00:09:51] [SPEAKER_02]: the pen factor like you put a

[00:09:53] [SPEAKER_02]: special tip on it and it's also a

[00:09:55] [SPEAKER_02]: pen so like literally the the bottle

[00:09:57] [SPEAKER_02]: is the dispenser with the little tube

[00:09:59] [SPEAKER_02]: on it. I love that the convenience of

[00:10:01] [SPEAKER_02]: that to me is worth paying a little

[00:10:02] [SPEAKER_02]: extra for. I don't love having to do

[00:10:04] [SPEAKER_02]: the brushes I mean we've got that

[00:10:06] [SPEAKER_02]: other materials I use that stuff but

[00:10:07] [SPEAKER_02]: I just really like that for my

[00:10:08] [SPEAKER_02]: bonding agent so that's I gotta say

[00:10:10] [SPEAKER_02]: I've been using the adhesed pen for

[00:10:11] [SPEAKER_02]: a couple years on and off for when I

[00:10:13] [SPEAKER_02]: when I don't want to use the alcohol

[00:10:15] [SPEAKER_02]: base but I am so used to the

[00:10:16] [SPEAKER_02]: ultra dent product it's second

[00:10:19] [SPEAKER_02]: nature and I've had really good luck

[00:10:20] [SPEAKER_02]: with it. I will say this if you're

[00:10:22] [SPEAKER_02]: going to desensitize a preparation

[00:10:24] [SPEAKER_02]: if you're doing if you're doing

[00:10:27] [SPEAKER_02]: you know the direct what do they

[00:10:29] [SPEAKER_02]: call it IDS or immediate dent ceiling

[00:10:32] [SPEAKER_02]: yeah I would probably use the excite

[00:10:34] [SPEAKER_02]: product or the adhesed product because

[00:10:36] [SPEAKER_02]: I feel like the film thickness is

[00:10:39] [SPEAKER_02]: probably is probably thinner. But

[00:10:41] [SPEAKER_02]: either one of those I find works

[00:10:43] [SPEAKER_02]: really well they I think stuff sticks

[00:10:45] [SPEAKER_02]: pretty good but if you're doing the

[00:10:46] [SPEAKER_02]: immediate dent ceiling immediate dent

[00:10:48] [SPEAKER_02]: ceiling I'd probably use that

[00:10:50] [SPEAKER_02]: acetone based product and I

[00:10:51] [SPEAKER_02]: that's just a gut thing I don't know

[00:10:53] [SPEAKER_02]: I don't know how much is real to

[00:10:54] [SPEAKER_02]: that but that's probably what I

[00:10:55] [SPEAKER_00]: probably do. Okay so both of those

[00:10:59] [SPEAKER_00]: are like considered universal

[00:11:01] [SPEAKER_00]: adhesives right. So then do you when

[00:11:04] [SPEAKER_00]: you etch do you do a selective etch

[00:11:06] [SPEAKER_00]: or do you do a total etch? You

[00:11:08] [SPEAKER_02]: know it's funny I kind of go back

[00:11:11] [SPEAKER_02]: and forth I think selective etch

[00:11:13] [SPEAKER_02]: might be a little bit of BS like

[00:11:15] [SPEAKER_02]: I don't know how selective I can

[00:11:17] [SPEAKER_02]: actually be yeah like like I know

[00:11:19] [SPEAKER_02]: what you're saying you're saying

[00:11:20] [SPEAKER_02]: just get on the enamel don't get

[00:11:21] [SPEAKER_02]: on the dent and I'm like I haven't

[00:11:23] [SPEAKER_02]: found that getting on the dentin

[00:11:25] [SPEAKER_02]: particularly with the alcohol based

[00:11:28] [SPEAKER_02]: solvent in the alternate product I

[00:11:30] [SPEAKER_02]: just don't find that to be too

[00:11:31] [SPEAKER_02]: huge of a problem what's funny too

[00:11:33] [SPEAKER_02]: is both those both the bonding

[00:11:34] [SPEAKER_02]: agents I have can be used as a

[00:11:36] [SPEAKER_02]: self etch if you want to so the

[00:11:38] [SPEAKER_02]: reality is I'm I'm always pretty

[00:11:40] [SPEAKER_02]: sure I'm getting stuff etched

[00:11:41] [SPEAKER_02]: pretty well so I haven't I haven't

[00:11:42] [SPEAKER_02]: really I'll go back and forth

[00:11:44] [SPEAKER_02]: sometimes I do the selective thing

[00:11:46] [SPEAKER_02]: if I'm worried about sensitivity

[00:11:47] [SPEAKER_02]: on a deeper prep maybe I'll avoid

[00:11:49] [SPEAKER_02]: that but I just I don't give

[00:11:50] [SPEAKER_02]: that that much thought and haven't

[00:11:52] [SPEAKER_02]: had too much issue with it. It's

[00:11:54] [SPEAKER_02]: a good question though. Yeah that's

[00:11:55] [SPEAKER_00]: good to know the office I used

[00:11:57] [SPEAKER_00]: to work out before dental school

[00:11:58] [SPEAKER_00]: they use just the adhesive pen

[00:11:59] [SPEAKER_00]: with no etch so I remember it and

[00:12:02] [SPEAKER_00]: I remember thinking it was thinking

[00:12:04] [SPEAKER_00]: it was weird that we had a two

[00:12:06] [SPEAKER_00]: step once I learned it and then

[00:12:07] [SPEAKER_02]: in school. Yeah I should probably

[00:12:11] [SPEAKER_02]: go for a week and do the self

[00:12:13] [SPEAKER_02]: etch with that he's been and see

[00:12:14] [SPEAKER_02]: what see what I find because it

[00:12:16] [SPEAKER_02]: is pretty slick if you were going

[00:12:18] [SPEAKER_02]: to not use an etch gel it's

[00:12:21] [SPEAKER_02]: pretty slick that that form factor

[00:12:22] [SPEAKER_02]: is hard to argue with. Yeah I

[00:12:25] [SPEAKER_00]: mean I thought it was I thought

[00:12:27] [SPEAKER_00]: it was super convenient and I

[00:12:29] [SPEAKER_00]: felt like I was taking a step

[00:12:30] [SPEAKER_00]: backwards in when I learned the

[00:12:33] [SPEAKER_00]: dental school protocol like oh this

[00:12:34] [SPEAKER_00]: seems so much less convenient. It's more

[00:12:36] [SPEAKER_00]: more steps yeah but but like you

[00:12:38] [SPEAKER_00]: mentioned that's what's considered

[00:12:39] [SPEAKER_00]: the gold standard. It is the gold standard

[00:12:40] [SPEAKER_00]: that's probably why they did

[00:12:42] [SPEAKER_02]: your dental. Of course if you

[00:12:44] [SPEAKER_02]: if you go to the University of

[00:12:45] [SPEAKER_02]: Minnesota you're going to be using

[00:12:46] [SPEAKER_02]: them the universal from 3M because

[00:12:48] [SPEAKER_02]: everything at the University of

[00:12:50] [SPEAKER_02]: Minnesota is 3M because it's like

[00:12:51] [SPEAKER_02]: three exits down from the 3M world

[00:12:53] [SPEAKER_02]: headquarters so yeah you're using

[00:12:55] [SPEAKER_02]: 3M at Minnesota just saying. Yeah

[00:12:58] [SPEAKER_00]: on this kind of the same kind

[00:13:01] [SPEAKER_00]: of same topic for composites what

[00:13:04] [SPEAKER_00]: are the matrices that you are

[00:13:07] [SPEAKER_00]: using currently I want both both

[00:13:09] [SPEAKER_00]: posterior and anterior yeah just

[00:13:11] [SPEAKER_02]: give me a link. So I have for

[00:13:13] [SPEAKER_02]: posteriors I I split between the

[00:13:18] [SPEAKER_02]: garrison.

[00:13:21] [SPEAKER_02]: Oh man they're they're different

[00:13:22] [SPEAKER_02]: colored the garrison sectionals

[00:13:24] [SPEAKER_02]: they're purple and green and like

[00:13:26] [SPEAKER_02]: that's how I kind of ask for them.

[00:13:28] [SPEAKER_02]: They just call them slick bands I

[00:13:29] [SPEAKER_02]: think I can't remember exactly but

[00:13:31] [SPEAKER_02]: so I use some garrison sectional

[00:13:33] [SPEAKER_02]: matrices I use the I almost I use

[00:13:35] [SPEAKER_02]: the garrison rings almost always

[00:13:37] [SPEAKER_02]: because I think they go on nicer I

[00:13:38] [SPEAKER_02]: like the rubberized gasket part of

[00:13:40] [SPEAKER_02]: the but I will tell you that I

[00:13:42] [SPEAKER_02]: more often than not I'm using a

[00:13:44] [SPEAKER_02]: bio clear posterior matrix if I

[00:13:46] [SPEAKER_02]: can now here's the thing sometimes

[00:13:49] [SPEAKER_02]: if I'm reaching for a contact if

[00:13:51] [SPEAKER_02]: it's if it's a wider isthmus of

[00:13:53] [SPEAKER_02]: prep in the contact is I'm

[00:13:55] [SPEAKER_02]: having a harder time with

[00:13:56] [SPEAKER_02]: contact sometimes I'll I'll count

[00:13:59] [SPEAKER_02]: on the I feel like if it's going

[00:14:01] [SPEAKER_02]: to be a tough contact to get as

[00:14:03] [SPEAKER_02]: opposed to your composite

[00:14:04] [SPEAKER_02]: sometimes I'm going to go to

[00:14:05] [SPEAKER_02]: that metal matrix because I feel

[00:14:07] [SPEAKER_02]: like I can kind of lean it a

[00:14:08] [SPEAKER_02]: little harder than the bio clear

[00:14:09] [SPEAKER_02]: one I will say this if you're

[00:14:11] [SPEAKER_02]: patient and if you'll wedge the

[00:14:13] [SPEAKER_02]: snot out everything and let it

[00:14:14] [SPEAKER_02]: wedge for a little while so

[00:14:15] [SPEAKER_02]: sometimes if you're worried about

[00:14:17] [SPEAKER_02]: getting that contact sometimes you

[00:14:18] [SPEAKER_02]: I'll place the matrix with the

[00:14:21] [SPEAKER_02]: widest wedge I can get and I use

[00:14:23] [SPEAKER_02]: the bio clear wedges those I

[00:14:25] [SPEAKER_02]: forget what they're called

[00:14:26] [SPEAKER_02]: they're they're expensive as

[00:14:28] [SPEAKER_02]: hell and they're so yeah the

[00:14:29] [SPEAKER_02]: diamond wedges they're so good

[00:14:30] [SPEAKER_02]: there honestly I haven't found

[00:14:32] [SPEAKER_02]: anything I've tried every I've

[00:14:33] [SPEAKER_02]: tried every wedge out there and

[00:14:34] [SPEAKER_02]: I haven't found anything that

[00:14:35] [SPEAKER_02]: even comes close to the diamond

[00:14:36] [SPEAKER_02]: wedges in my hands and then of

[00:14:38] [SPEAKER_02]: course they're the most

[00:14:39] [SPEAKER_02]: expensive you're going to find

[00:14:39] [SPEAKER_02]: that's how it always seems to

[00:14:40] [SPEAKER_02]: work with me but I love the

[00:14:42] [SPEAKER_02]: diamond wedges get the widest

[00:14:43] [SPEAKER_02]: diamond wedge you can in there

[00:14:45] [SPEAKER_02]: get the matrix in place put a

[00:14:46] [SPEAKER_02]: ring on it and then if you're

[00:14:48] [SPEAKER_02]: worried about the contact you

[00:14:50] [SPEAKER_02]: know lean on it with an

[00:14:51] [SPEAKER_02]: instrument so you so you've got

[00:14:52] [SPEAKER_02]: the you've got the matrix pushed

[00:14:54] [SPEAKER_02]: against his heart and then walk

[00:14:56] [SPEAKER_02]: away for four minutes or

[00:14:57] [SPEAKER_02]: something go do a hygiene while

[00:14:59] [SPEAKER_02]: that thing is in place because

[00:15:01] [SPEAKER_02]: that actually gives it a little

[00:15:02] [SPEAKER_02]: time for the wedge and the

[00:15:04] [SPEAKER_02]: and the ring to kind of work

[00:15:05] [SPEAKER_02]: on that ligament you literally

[00:15:07] [SPEAKER_02]: want to move that tooth out

[00:15:08] [SPEAKER_02]: of way what if you had perfect

[00:15:10] [SPEAKER_02]: world would be when you take

[00:15:11] [SPEAKER_02]: that that ring off and the

[00:15:13] [SPEAKER_02]: matrix won't come out because

[00:15:15] [SPEAKER_02]: it's so tight you know I

[00:15:16] [SPEAKER_02]: occasionally when I do that I

[00:15:18] [SPEAKER_02]: occasionally have to lighten the

[00:15:19] [SPEAKER_02]: contact because it's too heavy

[00:15:20] [SPEAKER_02]: but you know composite contacts

[00:15:22] [SPEAKER_02]: even you know I've been doing

[00:15:23] [SPEAKER_02]: them for a long time and there

[00:15:24] [SPEAKER_02]: are days where I have a hard

[00:15:26] [SPEAKER_02]: time getting them even at that

[00:15:27] [SPEAKER_02]: so I think it's the pre

[00:15:28] [SPEAKER_02]: wedging is a big deal and

[00:15:30] [SPEAKER_02]: sometimes I forget about it but

[00:15:31] [SPEAKER_02]: if you can get a wedge in

[00:15:32] [SPEAKER_02]: there before you ever prep and

[00:15:34] [SPEAKER_02]: leave a wedge in there most

[00:15:35] [SPEAKER_02]: of the time you're working

[00:15:36] [SPEAKER_02]: that ligament pretty good to

[00:15:37] [SPEAKER_02]: get a nice tight contact so

[00:15:38] [SPEAKER_02]: enough so if I can use a

[00:15:39] [SPEAKER_02]: bio clear matrix I'm gonna

[00:15:41] [SPEAKER_02]: because I feel like the

[00:15:45] [SPEAKER_02]: interproximal contour is

[00:15:46] [SPEAKER_02]: prettier I think it's rounder

[00:15:48] [SPEAKER_02]: it's nicer the other thing is

[00:15:50] [SPEAKER_02]: a mylar matrix gives a smoother

[00:15:52] [SPEAKER_02]: surface when you've cured it

[00:15:53] [SPEAKER_02]: and you can cure deeper

[00:15:55] [SPEAKER_02]: because they're clear so you

[00:15:57] [SPEAKER_02]: can you can get it you know

[00:15:58] [SPEAKER_02]: you can cure from the

[00:15:58] [SPEAKER_02]: buccal lingual and really

[00:15:59] [SPEAKER_02]: get in there and get a good

[00:16:01] [SPEAKER_02]: cure where you're you're

[00:16:03] [SPEAKER_02]: only really curing from the

[00:16:04] [SPEAKER_02]: occlusal with those garrison

[00:16:06] [SPEAKER_02]: matrices until you get the

[00:16:07] [SPEAKER_02]: matrix out you can't really

[00:16:09] [SPEAKER_02]: go buckling well because

[00:16:09] [SPEAKER_02]: it's just blocking your light

[00:16:11] [SPEAKER_02]: so so I'm I will use a

[00:16:13] [SPEAKER_02]: bio clear whenever I can

[00:16:14] [SPEAKER_02]: again more expensive matrices

[00:16:16] [SPEAKER_02]: but they're really good

[00:16:18] [SPEAKER_02]: but I'll go to the garrison

[00:16:19] [SPEAKER_02]: I probably I probably lately

[00:16:21] [SPEAKER_02]: have been maybe 60 percent

[00:16:22] [SPEAKER_02]: bio clear 40 percent

[00:16:25] [SPEAKER_02]: sectional from and occasionally

[00:16:26] [SPEAKER_02]: the other thing is this is

[00:16:29] [SPEAKER_02]: the funny thing sometimes you

[00:16:30] [SPEAKER_02]: can't get a sectional matrix

[00:16:32] [SPEAKER_02]: to work sometimes it's because

[00:16:33] [SPEAKER_02]: it's too wide of an

[00:16:34] [SPEAKER_02]: isthmus or something like

[00:16:35] [SPEAKER_02]: that I have these the things

[00:16:37] [SPEAKER_02]: of my dad used forever there

[00:16:38] [SPEAKER_02]: it's from a brand called

[00:16:40] [SPEAKER_02]: de novo and they are

[00:16:41] [SPEAKER_02]: basically they're like a

[00:16:42] [SPEAKER_02]: toffelmeyer except they're

[00:16:44] [SPEAKER_02]: they're kind of like spot

[00:16:46] [SPEAKER_02]: welded themselves you choose

[00:16:47] [SPEAKER_02]: a size so you don't need

[00:16:49] [SPEAKER_02]: a toffelmeyer it's but

[00:16:51] [SPEAKER_02]: it's sort of a self holding

[00:16:52] [SPEAKER_02]: toffelmeyer now they're

[00:16:54] [SPEAKER_02]: thicker and they're not

[00:16:55] [SPEAKER_02]: as nicely contoured as

[00:16:57] [SPEAKER_02]: some of these things but

[00:16:58] [SPEAKER_02]: particularly like if you're

[00:16:58] [SPEAKER_02]: doing a big core that

[00:16:59] [SPEAKER_02]: you're going to if you're

[00:17:00] [SPEAKER_02]: going to prep a tooth on

[00:17:01] [SPEAKER_02]: or something like that

[00:17:02] [SPEAKER_02]: oh they're so great because

[00:17:04] [SPEAKER_02]: it they go all the way

[00:17:05] [SPEAKER_02]: around the tooth and

[00:17:06] [SPEAKER_02]: sometimes that's the only

[00:17:07] [SPEAKER_02]: way you can really get a

[00:17:08] [SPEAKER_02]: matrix to seat down all

[00:17:10] [SPEAKER_02]: the way is to have like an

[00:17:12] [SPEAKER_02]: un the unprepared side of

[00:17:13] [SPEAKER_02]: the tooth actually kind of

[00:17:15] [SPEAKER_02]: holds the band down a

[00:17:16] [SPEAKER_02]: little bit so I will fall

[00:17:17] [SPEAKER_02]: back to those occasionally

[00:17:19] [SPEAKER_02]: if I'm having a hard time

[00:17:20] [SPEAKER_02]: getting a sexual matrix

[00:17:21] [SPEAKER_02]: in place that it doesn't

[00:17:22] [SPEAKER_02]: give us pretty contour of

[00:17:23] [SPEAKER_02]: the composite contact I

[00:17:25] [SPEAKER_02]: don't think but sometimes

[00:17:26] [SPEAKER_02]: it's the best you can do

[00:17:27] [SPEAKER_02]: particularly if you're

[00:17:28] [SPEAKER_02]: doing kind of a bulk

[00:17:29] [SPEAKER_02]: core and you need the

[00:17:30] [SPEAKER_02]: material to stay in

[00:17:30] [SPEAKER_02]: place but you're not

[00:17:31] [SPEAKER_02]: as worried about the

[00:17:32] [SPEAKER_02]: contact because you're

[00:17:33] [SPEAKER_02]: going to be prepping

[00:17:33] [SPEAKER_02]: there so that's that's

[00:17:35] [SPEAKER_02]: that's a nice go to

[00:17:36] [SPEAKER_02]: thing I'll I can put

[00:17:38] [SPEAKER_02]: some links to what those

[00:17:39] [SPEAKER_02]: things that I it's hard

[00:17:40] [SPEAKER_02]: to describe them they're

[00:17:41] [SPEAKER_02]: super simple in and I

[00:17:43] [SPEAKER_02]: don't know anyone else who

[00:17:44] [SPEAKER_02]: use them honestly I might

[00:17:45] [SPEAKER_02]: use those forever it

[00:17:47] [SPEAKER_00]: would definitely be useful

[00:17:48] [SPEAKER_00]: to have some links in the

[00:17:49] [SPEAKER_00]: show notes just so that

[00:17:50] [SPEAKER_00]: people will kind of

[00:17:51] [SPEAKER_00]: visualize what you mean

[00:17:52] [SPEAKER_00]: so my question my first

[00:17:55] [SPEAKER_00]: follow up question is

[00:17:56] [SPEAKER_00]: with those kind of

[00:17:58] [SPEAKER_00]: top of my top of my

[00:17:59] [SPEAKER_00]: or like matrices like

[00:18:01] [SPEAKER_00]: the ones that wrap

[00:18:02] [SPEAKER_00]: around the tooth you

[00:18:03] [SPEAKER_00]: also find that it's

[00:18:04] [SPEAKER_00]: easier to get a

[00:18:05] [SPEAKER_00]: ginger will seal with

[00:18:06] [SPEAKER_02]: those yes exactly and

[00:18:08] [SPEAKER_02]: you know what the other

[00:18:08] [SPEAKER_02]: thing is sometimes

[00:18:09] [SPEAKER_02]: sometimes when you need

[00:18:10] [SPEAKER_02]: to get a deep ginger

[00:18:11] [SPEAKER_02]: will seal on your prep

[00:18:12] [SPEAKER_02]: side if you've got a

[00:18:13] [SPEAKER_02]: tooth like if you've only

[00:18:14] [SPEAKER_02]: prepped them easily

[00:18:15] [SPEAKER_02]: the distal of it you

[00:18:16] [SPEAKER_02]: can take that thing you

[00:18:17] [SPEAKER_02]: take some curved

[00:18:17] [SPEAKER_02]: scissors and take a

[00:18:18] [SPEAKER_02]: big hunk out of the

[00:18:19] [SPEAKER_02]: other side so you can

[00:18:20] [SPEAKER_02]: really set that down

[00:18:22] [SPEAKER_02]: deep on the unprepped

[00:18:24] [SPEAKER_02]: side so it really

[00:18:25] [SPEAKER_02]: holds it down to the

[00:18:26] [SPEAKER_02]: ginger will see

[00:18:26] [SPEAKER_02]: this pretty great like

[00:18:27] [SPEAKER_02]: sometimes you'll get

[00:18:28] [SPEAKER_02]: it down so far you

[00:18:28] [SPEAKER_02]: can even get a

[00:18:29] [SPEAKER_02]: wedge it's pretty

[00:18:31] [SPEAKER_02]: and I have to say

[00:18:32] [SPEAKER_02]: the ginger will seal

[00:18:33] [SPEAKER_02]: is everything like I

[00:18:34] [SPEAKER_02]: will sometimes on a

[00:18:35] [SPEAKER_02]: really deep one where

[00:18:36] [SPEAKER_02]: I want a prettier

[00:18:37] [SPEAKER_02]: contact but I know

[00:18:38] [SPEAKER_02]: it's going to be hard

[00:18:38] [SPEAKER_02]: to get a ginger

[00:18:39] [SPEAKER_02]: will seal sometimes

[00:18:40] [SPEAKER_02]: I will I will place

[00:18:42] [SPEAKER_02]: one of those matrices

[00:18:43] [SPEAKER_02]: because I know I can

[00:18:44] [SPEAKER_02]: get those deep I'll

[00:18:45] [SPEAKER_02]: place my ginger will

[00:18:46] [SPEAKER_02]: composite and

[00:18:47] [SPEAKER_02]: essentially do like

[00:18:48] [SPEAKER_02]: a margin elevation

[00:18:49] [SPEAKER_02]: get my get my preferred

[00:18:51] [SPEAKER_02]: matrix on over top

[00:18:53] [SPEAKER_02]: of that and then

[00:18:53] [SPEAKER_02]: place it because I

[00:18:54] [SPEAKER_02]: know I've got the

[00:18:55] [SPEAKER_02]: ginger will sealed up

[00:18:56] [SPEAKER_02]: yeah because I feel

[00:18:57] [SPEAKER_02]: I know I won't get

[00:18:58] [SPEAKER_02]: as pretty contact

[00:18:59] [SPEAKER_02]: with one of those

[00:19:00] [SPEAKER_02]: de novo bands but

[00:19:01] [SPEAKER_02]: I know I can get

[00:19:01] [SPEAKER_02]: that ginger will seal

[00:19:02] [SPEAKER_02]: so I'll and that's

[00:19:04] [SPEAKER_02]: you you're already

[00:19:05] [SPEAKER_02]: spending more time

[00:19:06] [SPEAKER_02]: than you want to at

[00:19:07] [SPEAKER_02]: that point but what

[00:19:08] [SPEAKER_02]: you I'm going to

[00:19:09] [SPEAKER_02]: tell you and you're

[00:19:10] [SPEAKER_02]: going to experience this

[00:19:10] [SPEAKER_02]: at some point when

[00:19:12] [SPEAKER_02]: you're in a rush

[00:19:12] [SPEAKER_02]: or something like that

[00:19:13] [SPEAKER_02]: there is fricking nothing

[00:19:14] [SPEAKER_02]: worse than not getting

[00:19:16] [SPEAKER_02]: the contact like if

[00:19:18] [SPEAKER_02]: if you may or may

[00:19:19] [SPEAKER_02]: not get it you just

[00:19:20] [SPEAKER_02]: got to spend the time

[00:19:21] [SPEAKER_02]: because guess what

[00:19:22] [SPEAKER_02]: they're coming back

[00:19:23] [SPEAKER_02]: they're coming back

[00:19:24] [SPEAKER_02]: and they're like I

[00:19:24] [SPEAKER_02]: get stuff stuck in here

[00:19:25] [SPEAKER_02]: all the time and

[00:19:26] [SPEAKER_02]: you go I know

[00:19:26] [SPEAKER_02]: because I didn't

[00:19:27] [SPEAKER_02]: probably do it right

[00:19:28] [SPEAKER_02]: the first time I

[00:19:29] [SPEAKER_02]: mean it happens

[00:19:29] [SPEAKER_02]: because you're in a

[00:19:30] [SPEAKER_02]: rush or something

[00:19:31] [SPEAKER_02]: like that so the

[00:19:31] [SPEAKER_02]: the reality is is

[00:19:32] [SPEAKER_02]: like sometimes you're

[00:19:34] [SPEAKER_02]: like dang it I'm

[00:19:34] [SPEAKER_02]: going to have to take

[00:19:35] [SPEAKER_02]: more time to do this

[00:19:36] [SPEAKER_02]: but do it because

[00:19:37] [SPEAKER_02]: you will you always

[00:19:38] [SPEAKER_02]: see that patient back

[00:19:39] [SPEAKER_02]: you always see that

[00:19:40] [SPEAKER_02]: patient back if you

[00:19:41] [SPEAKER_02]: don't get the

[00:19:41] [SPEAKER_02]: contact well it's

[00:19:43] [SPEAKER_02]: sounds dumb and

[00:19:44] [SPEAKER_02]: it sounds obvious

[00:19:45] [SPEAKER_02]: but the story is real

[00:19:46] [SPEAKER_02]: life means sometimes

[00:19:48] [SPEAKER_02]: you're in a rush

[00:19:48] [SPEAKER_02]: and you don't want

[00:19:49] [SPEAKER_02]: to go back and

[00:19:50] [SPEAKER_02]: and the other thing

[00:19:50] [SPEAKER_02]: is as soon as you

[00:19:51] [SPEAKER_02]: do don't get the

[00:19:52] [SPEAKER_02]: contact trying to

[00:19:55] [SPEAKER_02]: add a contact

[00:19:56] [SPEAKER_02]: Hey very clinical listeners

[00:19:58] [SPEAKER_02]: are you ready to

[00:19:59] [SPEAKER_02]: add implants to

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[00:21:01] [SPEAKER_02]: You almost have to prep

[00:21:03] [SPEAKER_02]: the damn thing out

[00:21:03] [SPEAKER_02]: and do it over again

[00:21:04] [SPEAKER_02]: because because adding

[00:21:06] [SPEAKER_02]: to a light contact

[00:21:07] [SPEAKER_02]: is so much harder

[00:21:08] [SPEAKER_02]: than just starting over

[00:21:09] [SPEAKER_02]: and getting the contact

[00:21:10] [SPEAKER_02]: right and I say this

[00:21:11] [SPEAKER_02]: just from a lot

[00:21:12] [SPEAKER_02]: of experience

[00:21:12] [SPEAKER_02]: maybe there's other

[00:21:13] [SPEAKER_02]: people that are great

[00:21:13] [SPEAKER_02]: at adding a little bit

[00:21:14] [SPEAKER_02]: to the I am not I find

[00:21:16] [SPEAKER_02]: and the worst thing is

[00:21:17] [SPEAKER_02]: if the composite

[00:21:18] [SPEAKER_02]: doesn't stick to

[00:21:19] [SPEAKER_02]: the original composite

[00:21:19] [SPEAKER_02]: very well all

[00:21:20] [SPEAKER_02]: the dumb stuff like that

[00:21:21] [SPEAKER_02]: you do enough of these

[00:21:22] [SPEAKER_02]: and you're going to go

[00:21:22] [SPEAKER_02]: Yep just got to get it

[00:21:23] [SPEAKER_02]: right the first time

[00:21:24] [SPEAKER_02]: and if it doesn't prep

[00:21:25] [SPEAKER_02]: it out and do it again

[00:21:26] [SPEAKER_02]: that's what I found.

[00:21:28] [SPEAKER_00]: Yeah yeah

[00:21:29] [SPEAKER_00]: that's good to know

[00:21:29] [SPEAKER_00]: and then my other

[00:21:30] [SPEAKER_00]: my other follow up question

[00:21:31] [SPEAKER_00]: when for the

[00:21:33] [SPEAKER_00]: bio clear matrices

[00:21:34] [SPEAKER_00]: so I've heard about them

[00:21:35] [SPEAKER_00]: and I'm a little confused

[00:21:37] [SPEAKER_00]: so do you use like

[00:21:38] [SPEAKER_00]: a regular packable

[00:21:40] [SPEAKER_00]: composite with those or

[00:21:42] [SPEAKER_00]: I always OK

[00:21:42] [SPEAKER_02]: so that's something

[00:21:43] [SPEAKER_02]: I didn't really tell you

[00:21:46] [SPEAKER_02]: 98 percent of the time

[00:21:47] [SPEAKER_02]: posterior composites

[00:21:48] [SPEAKER_02]: I'm using a heated

[00:21:49] [SPEAKER_02]: composite.

[00:21:50] [SPEAKER_02]: OK and so what I'm going to do

[00:21:51] [SPEAKER_02]: depending on the size

[00:21:52] [SPEAKER_02]: of preparation

[00:21:53] [SPEAKER_02]: I'll get my matrix in place

[00:21:54] [SPEAKER_02]: and I'm going to take

[00:21:55] [SPEAKER_02]: a flowable down

[00:21:56] [SPEAKER_02]: and I'll probably seal

[00:21:57] [SPEAKER_02]: the ginger with a flowable

[00:21:58] [SPEAKER_02]: a very very very

[00:22:00] [SPEAKER_02]: slight amount of flowable

[00:22:01] [SPEAKER_02]: and I make sure

[00:22:01] [SPEAKER_02]: that there's no bubbles

[00:22:02] [SPEAKER_02]: bubbles in it

[00:22:03] [SPEAKER_02]: and I get that cured

[00:22:04] [SPEAKER_02]: real good

[00:22:04] [SPEAKER_02]: and then I'm going to

[00:22:05] [SPEAKER_02]: I do what's called

[00:22:06] [SPEAKER_02]: the snow plow which is

[00:22:08] [SPEAKER_02]: it's kind of old school

[00:22:09] [SPEAKER_02]: no one really teaches it

[00:22:10] [SPEAKER_02]: except I think

[00:22:10] [SPEAKER_02]: it's freaking great.

[00:22:11] [SPEAKER_02]: I use a flowable

[00:22:12] [SPEAKER_02]: in every basically

[00:22:14] [SPEAKER_02]: almost every

[00:22:17] [SPEAKER_02]: every bit of

[00:22:18] [SPEAKER_02]: posterior composite

[00:22:19] [SPEAKER_02]: I put in there

[00:22:20] [SPEAKER_02]: I use a little bit

[00:22:21] [SPEAKER_02]: of flowable in advance

[00:22:22] [SPEAKER_02]: almost to like

[00:22:23] [SPEAKER_02]: lubricated against

[00:22:24] [SPEAKER_02]: the preparation.

[00:22:25] [SPEAKER_02]: So you've got a really

[00:22:26] [SPEAKER_02]: light body flowable

[00:22:27] [SPEAKER_02]: actually David Clark

[00:22:29] [SPEAKER_02]: uses heated flowable

[00:22:30] [SPEAKER_02]: just to make it

[00:22:31] [SPEAKER_02]: even gooier

[00:22:32] [SPEAKER_02]: to tell you the truth.

[00:22:32] [SPEAKER_02]: So but but then

[00:22:33] [SPEAKER_02]: he'll also use heated

[00:22:34] [SPEAKER_02]: like like packable

[00:22:36] [SPEAKER_02]: kind of in a compule

[00:22:38] [SPEAKER_02]: and so I will

[00:22:40] [SPEAKER_02]: I'll put as many increments

[00:22:41] [SPEAKER_02]: I think I need

[00:22:42] [SPEAKER_02]: but in a lot of cases

[00:22:43] [SPEAKER_02]: if I've got the ginger

[00:22:44] [SPEAKER_02]: sealed up I can do

[00:22:46] [SPEAKER_02]: and I've got a bio clear matrix

[00:22:47] [SPEAKER_02]: where I can really cure

[00:22:48] [SPEAKER_02]: through the matrix.

[00:22:49] [SPEAKER_02]: I can do close to bulk

[00:22:50] [SPEAKER_02]: and I have to tell you

[00:22:52] [SPEAKER_02]: I don't like using

[00:22:53] [SPEAKER_02]: 3M's bulk composite

[00:22:54] [SPEAKER_02]: or anything like that

[00:22:55] [SPEAKER_02]: because I think they

[00:22:56] [SPEAKER_02]: don't look as good.

[00:22:57] [SPEAKER_02]: They don't they look gray

[00:22:58] [SPEAKER_02]: and they're more

[00:22:59] [SPEAKER_02]: they allow more light

[00:23:00] [SPEAKER_02]: to go through.

[00:23:00] [SPEAKER_02]: That's why they can pack

[00:23:01] [SPEAKER_02]: that's why you can

[00:23:02] [SPEAKER_02]: cure more through them.

[00:23:03] [SPEAKER_02]: But what I find is

[00:23:04] [SPEAKER_02]: they just I don't think

[00:23:05] [SPEAKER_02]: there is pretty

[00:23:05] [SPEAKER_02]: I don't think there is nice looking.

[00:23:07] [SPEAKER_02]: So what I try and do

[00:23:08] [SPEAKER_02]: is I try and measure

[00:23:09] [SPEAKER_02]: knowing you've got

[00:23:10] [SPEAKER_02]: a bio clear matrix

[00:23:11] [SPEAKER_02]: you can get a better

[00:23:12] [SPEAKER_02]: cure on that than you could

[00:23:13] [SPEAKER_02]: with other matrices

[00:23:14] [SPEAKER_02]: because you can cure through them.

[00:23:17] [SPEAKER_02]: So I there are people

[00:23:19] [SPEAKER_02]: that might argue

[00:23:19] [SPEAKER_02]: that I'm bulk

[00:23:20] [SPEAKER_02]: curing with a material

[00:23:21] [SPEAKER_02]: that isn't meant to be bulk here

[00:23:22] [SPEAKER_02]: but I feel like

[00:23:23] [SPEAKER_02]: typically the preparation

[00:23:25] [SPEAKER_02]: I'm working with

[00:23:25] [SPEAKER_02]: I can get I can get a light

[00:23:27] [SPEAKER_02]: to every surface I need to.

[00:23:28] [SPEAKER_02]: So I'll do close

[00:23:29] [SPEAKER_02]: to a bulk fill with

[00:23:32] [SPEAKER_02]: basically I lead

[00:23:33] [SPEAKER_02]: with my flow bowl

[00:23:34] [SPEAKER_02]: and then I kind of

[00:23:35] [SPEAKER_02]: I kind of squished

[00:23:36] [SPEAKER_02]: that heated composite over

[00:23:37] [SPEAKER_02]: and I let it kind of overflow

[00:23:39] [SPEAKER_02]: knowing that it's much easier

[00:23:40] [SPEAKER_02]: to trim from the occlusal

[00:23:41] [SPEAKER_02]: than it is from the inter proximals.

[00:23:43] [SPEAKER_02]: And I think if a real

[00:23:45] [SPEAKER_02]: if you get a bio clear matrix place

[00:23:47] [SPEAKER_02]: well there is no contour

[00:23:49] [SPEAKER_02]: that can touch it.

[00:23:49] [SPEAKER_02]: And the other thing is

[00:23:51] [SPEAKER_02]: you only have to finish in areas

[00:23:52] [SPEAKER_02]: that are really easy to get to.

[00:23:53] [SPEAKER_02]: You finish on the buckle

[00:23:54] [SPEAKER_02]: and the lingual and the occlusal.

[00:23:55] [SPEAKER_02]: It doesn't take very long.

[00:23:57] [SPEAKER_02]: Get some discs in there

[00:23:58] [SPEAKER_02]: and you're you're

[00:23:58] [SPEAKER_02]: you're done pretty quick

[00:23:59] [SPEAKER_02]: with that stuff.

[00:24:00] [SPEAKER_02]: I just I love it.

[00:24:01] [SPEAKER_02]: They look so good

[00:24:01] [SPEAKER_02]: and they look really great

[00:24:03] [SPEAKER_02]: on the bite wings too

[00:24:03] [SPEAKER_02]: especially if you use like

[00:24:04] [SPEAKER_02]: if you if you

[00:24:06] [SPEAKER_02]: if you're really cool

[00:24:07] [SPEAKER_02]: your first increment of flow

[00:24:09] [SPEAKER_02]: well you can get one

[00:24:10] [SPEAKER_02]: of those really dark

[00:24:11] [SPEAKER_02]: radio opaque ones

[00:24:12] [SPEAKER_02]: so you can kind of see them

[00:24:13] [SPEAKER_02]: see where your

[00:24:15] [SPEAKER_02]: the floor your prep is.

[00:24:16] [SPEAKER_02]: Oh it's so cool.

[00:24:17] [SPEAKER_02]: So I'll sometimes do that too.

[00:24:18] [SPEAKER_02]: There's a GC

[00:24:20] [SPEAKER_02]: flowable that I use

[00:24:21] [SPEAKER_02]: sometimes it's really radio

[00:24:23] [SPEAKER_02]: opaque or sometimes I use

[00:24:24] [SPEAKER_02]: Cosman and Demark

[00:24:25] [SPEAKER_02]: which is it's actually meant

[00:24:26] [SPEAKER_02]: to be the you know

[00:24:28] [SPEAKER_02]: that's how you can see

[00:24:28] [SPEAKER_02]: on a radiograph.

[00:24:29] [SPEAKER_02]: You got to make sure

[00:24:29] [SPEAKER_02]: you cure those though

[00:24:30] [SPEAKER_02]: because those take a lot

[00:24:31] [SPEAKER_02]: they the radio opaque composites

[00:24:33] [SPEAKER_02]: take a lot longer time to cure.

[00:24:35] [SPEAKER_02]: So you got to make sure you cure

[00:24:36] [SPEAKER_02]: them more than you would.

[00:24:37] Yeah.

[00:24:38] [SPEAKER_00]: Yeah.

[00:24:39] [SPEAKER_00]: So what are so

[00:24:41] [SPEAKER_00]: are there any bulk fills

[00:24:43] [SPEAKER_00]: that you have in your office

[00:24:44] [SPEAKER_00]: though like I've heard

[00:24:45] [SPEAKER_00]: maybe it was the guys

[00:24:46] [SPEAKER_00]: Kevin and Zach talking about

[00:24:47] [SPEAKER_00]: like bulk easy being

[00:24:48] [SPEAKER_00]: it.

[00:24:49] [SPEAKER_00]: It's like they love.

[00:24:50] [SPEAKER_02]: Yeah they love that.

[00:24:50] [SPEAKER_02]: I've never tried it

[00:24:51] [SPEAKER_02]: and which is funny

[00:24:52] [SPEAKER_02]: because there's tons of people

[00:24:54] [SPEAKER_02]: that listen to this show

[00:24:54] [SPEAKER_02]: that say that stuff is the best.

[00:24:56] [SPEAKER_02]: I worry about being able

[00:24:58] [SPEAKER_02]: to get a good contact with it.

[00:24:59] [SPEAKER_02]: That's because because it's

[00:25:00] [SPEAKER_02]: because it's I mean like

[00:25:02] [SPEAKER_02]: I know it's it's not a core

[00:25:04] [SPEAKER_02]: material but it's a self cured

[00:25:06] [SPEAKER_02]: or at least a dual cured

[00:25:07] [SPEAKER_02]: material.

[00:25:08] [SPEAKER_02]: So I don't know how much

[00:25:09] [SPEAKER_02]: body it has like like

[00:25:11] [SPEAKER_02]: the reality is is you

[00:25:12] [SPEAKER_02]: nowadays with composite

[00:25:13] [SPEAKER_02]: you have to get the contact

[00:25:16] [SPEAKER_02]: with the matrix.

[00:25:17] [SPEAKER_02]: You can't count on the material

[00:25:18] [SPEAKER_02]: to to have enough

[00:25:20] [SPEAKER_02]: to make the contact

[00:25:22] [SPEAKER_02]: but somehow or another

[00:25:22] [SPEAKER_02]: I'm still stuck in the idea

[00:25:24] [SPEAKER_02]: that a bulk fill like that

[00:25:25] [SPEAKER_02]: doesn't actually get you

[00:25:26] [SPEAKER_02]: good contact.

[00:25:26] [SPEAKER_02]: That said when I'm doing

[00:25:28] [SPEAKER_02]: a core material I use

[00:25:29] [SPEAKER_02]: Cosmic Core which is a

[00:25:31] [SPEAKER_02]: dual cure material.

[00:25:31] [SPEAKER_02]: I can get a contact

[00:25:32] [SPEAKER_02]: with Cosmic Core a lot of times

[00:25:33] [SPEAKER_02]: if I use these same procedures.

[00:25:35] [SPEAKER_02]: So I wouldn't be against it

[00:25:37] [SPEAKER_02]: and bulk ease or bulk easy

[00:25:39] [SPEAKER_02]: is very radio pay too.

[00:25:40] [SPEAKER_02]: It looks awesome.

[00:25:41] [SPEAKER_02]: It looks awesome on a

[00:25:42] [SPEAKER_02]: radiograph if you if you look

[00:25:43] [SPEAKER_02]: back and see some of the

[00:25:44] [SPEAKER_02]: pictures they put up

[00:25:45] [SPEAKER_02]: this stuff is really dark

[00:25:46] [SPEAKER_02]: which I that looks great

[00:25:48] [SPEAKER_02]: on a book on an X-ray.

[00:25:49] [SPEAKER_02]: It's really cool.

[00:25:50] [SPEAKER_00]: Yeah I like that's all

[00:25:52] [SPEAKER_00]: stuff I like to kind of geek

[00:25:53] [SPEAKER_00]: out on even though I

[00:25:54] [SPEAKER_00]: won't be able to use any

[00:25:55] [SPEAKER_00]: of these materials for at

[00:25:56] [SPEAKER_00]: least two more years.

[00:25:57] [SPEAKER_02]: Would they ever what if what

[00:25:58] [SPEAKER_02]: if what if you showed up

[00:25:59] [SPEAKER_02]: with your own materials

[00:26:00] [SPEAKER_02]: would they let you use them

[00:26:01] [SPEAKER_02]: or not.

[00:26:02] [SPEAKER_02]: I'm sure that I'm sure

[00:26:04] [SPEAKER_02]: nobody would be okay with

[00:26:05] [SPEAKER_02]: that.

[00:26:05] [SPEAKER_02]: I remember I remember one

[00:26:06] [SPEAKER_02]: thing I'll say when we took

[00:26:07] [SPEAKER_02]: boards they let us use

[00:26:09] [SPEAKER_02]: whatever provisional material

[00:26:10] [SPEAKER_02]: we wanted to.

[00:26:11] [SPEAKER_02]: So like when we had to do a

[00:26:12] [SPEAKER_02]: provisional crown for boards

[00:26:14] [SPEAKER_02]: and so a bunch of us came in

[00:26:15] [SPEAKER_02]: with at the time

[00:26:17] [SPEAKER_02]: bisacral materials were

[00:26:19] [SPEAKER_02]: brand new.

[00:26:20] [SPEAKER_02]: And so we brought this.

[00:26:21] [SPEAKER_02]: I brought this material

[00:26:22] [SPEAKER_02]: called integrity and I made

[00:26:23] [SPEAKER_02]: my temporary boy oh boy.

[00:26:25] [SPEAKER_02]: Considering all the time I

[00:26:26] [SPEAKER_02]: spent with an acrylic temp

[00:26:27] [SPEAKER_02]: and there's something to love

[00:26:28] [SPEAKER_02]: about acrylic temps but they

[00:26:29] [SPEAKER_02]: they are not they're not as

[00:26:31] [SPEAKER_02]: convenient as is bisacral.

[00:26:32] [SPEAKER_02]: You know what.

[00:26:33] [SPEAKER_02]: But yeah that was so

[00:26:35] [SPEAKER_02]: but I remember like everyone

[00:26:36] [SPEAKER_02]: kind of looked at you cross

[00:26:37] [SPEAKER_02]: side that you brought in your

[00:26:38] [SPEAKER_02]: own materials.

[00:26:38] [SPEAKER_02]: That was a little that was

[00:26:39] [SPEAKER_02]: a little something.

[00:26:40] [SPEAKER_00]: Yeah.

[00:26:40] [SPEAKER_00]: Yeah.

[00:26:41] [SPEAKER_00]: Well integrity is the our go

[00:26:43] [SPEAKER_00]: to tap material of choice.

[00:26:44] [SPEAKER_00]: Is that right.

[00:26:45] [SPEAKER_02]: That stuff is old.

[00:26:46] [SPEAKER_02]: I mean it's good but it's

[00:26:50] [SPEAKER_00]: OK so speaking of you know

[00:26:53] [SPEAKER_00]: temporary crowns and so on.

[00:26:55] [SPEAKER_00]: So talk to me about what

[00:26:57] [SPEAKER_00]: your indirect workflow kind of

[00:26:59] [SPEAKER_00]: is like and what kind of

[00:27:01] [SPEAKER_00]: materials you're working with.

[00:27:04] [SPEAKER_00]: I don't know if you're

[00:27:04] [SPEAKER_00]: doing I think you're still

[00:27:05] [SPEAKER_00]: using a lab.

[00:27:06] [SPEAKER_00]: You're not doing you're not

[00:27:07] [SPEAKER_00]: using.

[00:27:07] [SPEAKER_00]: I don't do chair.

[00:27:08] [SPEAKER_02]: I don't I don't do chair

[00:27:09] [SPEAKER_02]: side it's but I.

[00:27:12] [SPEAKER_02]: So crown and bridge

[00:27:14] [SPEAKER_02]: probably in the posterior

[00:27:16] [SPEAKER_02]: ninety five percent of my

[00:27:17] [SPEAKER_02]: units are zirconia.

[00:27:19] [SPEAKER_02]: Sometimes I'm pre-molars I'll

[00:27:20] [SPEAKER_02]: use like a higher

[00:27:21] [SPEAKER_02]: translucency zirconia

[00:27:23] [SPEAKER_02]: but I'm using the zirconia

[00:27:24] [SPEAKER_02]: and honestly the lab I use

[00:27:27] [SPEAKER_02]: for most of stuff the guy

[00:27:28] [SPEAKER_02]: actually owns the suite right

[00:27:30] [SPEAKER_02]: next door to mine so literally

[00:27:31] [SPEAKER_02]: we're connected.

[00:27:32] [SPEAKER_02]: I can I can walk right.

[00:27:33] [SPEAKER_02]: And we it's a digital

[00:27:34] [SPEAKER_02]: workflow so I still mean

[00:27:36] [SPEAKER_02]: it still gets there digitally

[00:27:37] [SPEAKER_02]: but if I have questions or

[00:27:38] [SPEAKER_02]: concerns I can go right over

[00:27:39] [SPEAKER_02]: and talk to him.

[00:27:40] [SPEAKER_02]: It's fantastic.

[00:27:41] [SPEAKER_02]: I mean if you can get that

[00:27:42] [SPEAKER_02]: rain that's relatively new

[00:27:44] [SPEAKER_02]: is so great to go over in

[00:27:47] [SPEAKER_02]: because here's the thing

[00:27:48] [SPEAKER_02]: every dental situation

[00:27:50] [SPEAKER_02]: you know there's a lot of

[00:27:52] [SPEAKER_02]: standard ones but then if

[00:27:53] [SPEAKER_02]: you get a weird one

[00:27:54] [SPEAKER_02]: and you're like oh my god

[00:27:55] [SPEAKER_02]: I don't know how I don't

[00:27:56] [SPEAKER_02]: know if I can explain this

[00:27:57] [SPEAKER_02]: to my lab guy was great.

[00:27:58] [SPEAKER_02]: I go explain to him

[00:27:59] [SPEAKER_02]: because I can just talk to

[00:28:00] [SPEAKER_02]: him.

[00:28:00] [SPEAKER_02]: This is what happened.

[00:28:01] [SPEAKER_02]: This is what you know is the

[00:28:01] [SPEAKER_02]: story and it makes a big

[00:28:03] [SPEAKER_02]: difference.

[00:28:03] [SPEAKER_02]: I have less remakes on weird

[00:28:05] [SPEAKER_02]: stuff because I can just tell

[00:28:06] [SPEAKER_02]: him what I'm thinking.

[00:28:07] [SPEAKER_02]: You know like I'll go

[00:28:09] [SPEAKER_02]: in and I'll look at my prep

[00:28:10] [SPEAKER_02]: after the patients gone

[00:28:11] [SPEAKER_02]: like with a draw

[00:28:13] [SPEAKER_02]: on this one's not so great.

[00:28:14] [SPEAKER_02]: You know I had a six unit

[00:28:15] [SPEAKER_02]: six unit bridge

[00:28:16] [SPEAKER_02]: and I had I had an

[00:28:17] [SPEAKER_02]: abutment.

[00:28:18] [SPEAKER_02]: I had it was what it was

[00:28:19] [SPEAKER_02]: six to nine

[00:28:20] [SPEAKER_02]: to eleven.

[00:28:22] [SPEAKER_02]: And I looked at him like

[00:28:23] [SPEAKER_02]: oh my draw on that

[00:28:24] [SPEAKER_02]: nine is not so red hot

[00:28:26] [SPEAKER_02]: and I went over I of

[00:28:28] [SPEAKER_02]: course the guy was already

[00:28:29] [SPEAKER_02]: gone with a temper and

[00:28:30] [SPEAKER_02]: like oh so I went over

[00:28:31] [SPEAKER_02]: to lab and he said I don't

[00:28:32] [SPEAKER_02]: know we'll be able to do

[00:28:32] [SPEAKER_02]: this.

[00:28:33] [SPEAKER_02]: I'll just have to but

[00:28:34] [SPEAKER_02]: but we had to figure out

[00:28:36] [SPEAKER_02]: the the draw.

[00:28:36] [SPEAKER_02]: We had to figure out how

[00:28:38] [SPEAKER_02]: I was going to place it.

[00:28:38] [SPEAKER_02]: You know I can only place

[00:28:39] [SPEAKER_02]: it for me because it had

[00:28:40] [SPEAKER_02]: kind of a weird drive.

[00:28:41] [SPEAKER_02]: It worked out OK.

[00:28:41] [SPEAKER_02]: It's nice to have a lab

[00:28:42] [SPEAKER_02]: guy that understands

[00:28:43] [SPEAKER_02]: the dumb stuff that happens.

[00:28:45] [SPEAKER_02]: You know all lab people

[00:28:46] [SPEAKER_02]: probably do

[00:28:47] [SPEAKER_02]: but it having a person

[00:28:49] [SPEAKER_02]: that's connected to the

[00:28:49] [SPEAKER_02]: face I think they give

[00:28:50] [SPEAKER_02]: you a little a little bit

[00:28:51] [SPEAKER_02]: of the

[00:28:53] [SPEAKER_02]: they might they might not

[00:28:55] [SPEAKER_02]: despise you as much when

[00:28:56] [SPEAKER_02]: you come in and apologize

[00:28:57] [SPEAKER_02]: for when things aren't

[00:28:58] [SPEAKER_02]: perfect.

[00:28:58] [SPEAKER_02]: You know and I do think

[00:28:59] [SPEAKER_02]: that I do think some

[00:29:00] [SPEAKER_02]: lab people especially the

[00:29:01] [SPEAKER_02]: ones that will go

[00:29:02] [SPEAKER_02]: Chad will show up and take

[00:29:03] [SPEAKER_02]: pictures for interior

[00:29:04] [SPEAKER_02]: cases and stuff like that.

[00:29:06] [SPEAKER_02]: So shade shade match

[00:29:07] [SPEAKER_02]: doesn't always fall to me

[00:29:08] [SPEAKER_02]: because he'll come in with

[00:29:09] [SPEAKER_02]: with his camera and stuff

[00:29:11] [SPEAKER_02]: and he's able to

[00:29:12] [SPEAKER_02]: this guy is really good

[00:29:13] [SPEAKER_02]: at the single the

[00:29:14] [SPEAKER_02]: single anterior which

[00:29:15] [SPEAKER_02]: is just every lab

[00:29:16] [SPEAKER_02]: techs nightmare trying to

[00:29:18] [SPEAKER_02]: match the shades.

[00:29:19] [SPEAKER_02]: He does a really good

[00:29:20] [SPEAKER_02]: job but it's nice

[00:29:21] [SPEAKER_02]: because he's just right

[00:29:21] [SPEAKER_02]: across the hall.

[00:29:22] [SPEAKER_02]: So anyhow that's a

[00:29:23] [SPEAKER_02]: little bit of it.

[00:29:24] [SPEAKER_02]: So I do for posterior

[00:29:25] [SPEAKER_02]: units nine times out of

[00:29:27] [SPEAKER_02]: 10 or more I'm doing

[00:29:29] [SPEAKER_02]: zirconia sometimes

[00:29:30] [SPEAKER_02]: high high translucency for

[00:29:31] [SPEAKER_02]: like for pre-Moller's

[00:29:33] [SPEAKER_02]: honestly I do a bunch of

[00:29:35] [SPEAKER_02]: interiors like that.

[00:29:36] [SPEAKER_02]: If it's a really if it's

[00:29:36] [SPEAKER_02]: a high you know if it's

[00:29:37] [SPEAKER_02]: a cosmetic case honestly

[00:29:39] [SPEAKER_02]: Chad likes to stack

[00:29:40] [SPEAKER_02]: feldsbethic porcelain

[00:29:41] [SPEAKER_02]: for veneers and stuff.

[00:29:42] [SPEAKER_02]: So we'll do that.

[00:29:44] [SPEAKER_02]: But if it's you know

[00:29:44] [SPEAKER_02]: if it's crowns I'm

[00:29:45] [SPEAKER_02]: replacing crowns or

[00:29:46] [SPEAKER_02]: whatever a lot of times

[00:29:47] [SPEAKER_02]: I'll do a high

[00:29:47] [SPEAKER_02]: translucency zirconia

[00:29:48] [SPEAKER_02]: because I can prep

[00:29:49] [SPEAKER_02]: like a p.f.m.

[00:29:50] [SPEAKER_02]: Which is what we learned

[00:29:51] [SPEAKER_02]: in dental school back

[00:29:52] [SPEAKER_02]: in the late 90s.

[00:29:53] [SPEAKER_02]: You know that's that's

[00:29:54] [SPEAKER_02]: or the other thing is

[00:29:55] [SPEAKER_02]: in the posterior

[00:29:56] [SPEAKER_02]: for zirconia crown a

[00:29:57] [SPEAKER_02]: lot of times you can

[00:29:58] [SPEAKER_02]: prep almost like a gold

[00:29:59] [SPEAKER_02]: crown.

[00:30:00] [SPEAKER_02]: I do a lot on

[00:30:02] [SPEAKER_02]: the posterior what

[00:30:03] [SPEAKER_02]: what a lot of people

[00:30:04] [SPEAKER_02]: in Europe might call

[00:30:05] [SPEAKER_02]: a verte prep or a vertical

[00:30:08] [SPEAKER_02]: which is which is close

[00:30:09] [SPEAKER_02]: to a it's not quite

[00:30:11] [SPEAKER_02]: but it's closer to a

[00:30:12] [SPEAKER_02]: feather edge.

[00:30:13] [SPEAKER_02]: And I think my guy

[00:30:14] [SPEAKER_02]: gets it because I don't

[00:30:15] [SPEAKER_02]: get it.

[00:30:16] [SPEAKER_02]: I don't get these

[00:30:16] [SPEAKER_02]: crowns that are super

[00:30:17] [SPEAKER_02]: overbought.

[00:30:18] [SPEAKER_02]: He understands that kind

[00:30:19] [SPEAKER_02]: of what I'm going for.

[00:30:20] [SPEAKER_02]: But I like to I like

[00:30:22] [SPEAKER_02]: to cement with glass

[00:30:22] [SPEAKER_02]: iron.

[00:30:23] [SPEAKER_02]: It's easier as the

[00:30:25] [SPEAKER_02]: as the people over

[00:30:26] [SPEAKER_02]: at ripe call it they

[00:30:28] [SPEAKER_02]: I like to plunk.

[00:30:29] [SPEAKER_02]: I like I like to use

[00:30:30] [SPEAKER_02]: that glass armor

[00:30:30] [SPEAKER_02]: because it's

[00:30:32] [SPEAKER_02]: the simplicity is really

[00:30:33] [SPEAKER_02]: good.

[00:30:33] [SPEAKER_02]: And I do not find myself

[00:30:35] [SPEAKER_02]: in a situation where

[00:30:36] [SPEAKER_02]: I have a short preparation

[00:30:37] [SPEAKER_02]: so often that

[00:30:38] [SPEAKER_02]: that I can't get away

[00:30:40] [SPEAKER_02]: with that.

[00:30:40] [SPEAKER_02]: It's very rare.

[00:30:42] [SPEAKER_02]: In fact I don't know

[00:30:42] [SPEAKER_02]: if it's because of

[00:30:44] [SPEAKER_02]: the way that I'm

[00:30:44] [SPEAKER_02]: treatment planning

[00:30:45] [SPEAKER_02]: or whatever but I just

[00:30:45] [SPEAKER_02]: don't find myself

[00:30:46] [SPEAKER_02]: in a situation where

[00:30:47] [SPEAKER_02]: I need the added

[00:30:49] [SPEAKER_02]: strength of a of a

[00:30:51] [SPEAKER_02]: bonded restoration

[00:30:51] [SPEAKER_02]: you know to keep the

[00:30:53] [SPEAKER_02]: crown on.

[00:30:54] [SPEAKER_02]: And I will say that

[00:30:54] [SPEAKER_02]: as much when I've

[00:30:55] [SPEAKER_02]: when I'm removing

[00:30:56] [SPEAKER_02]: zirconia crowns that

[00:30:57] [SPEAKER_02]: I have used with

[00:30:58] [SPEAKER_02]: glass ionomer they

[00:31:00] [SPEAKER_02]: come off.

[00:31:00] [SPEAKER_02]: It is a bitch to get them off.

[00:31:02] [SPEAKER_02]: It is just awful to get them off.

[00:31:03] [SPEAKER_02]: So I'm like I am not super

[00:31:04] [SPEAKER_02]: worried about these

[00:31:05] [SPEAKER_02]: crowns falling off.

[00:31:06] [SPEAKER_02]: But my preparation is

[00:31:08] [SPEAKER_02]: you know I'm taking the

[00:31:08] [SPEAKER_02]: preparation down to

[00:31:09] [SPEAKER_02]: the ginger will most

[00:31:10] [SPEAKER_02]: of the time I like to do

[00:31:11] [SPEAKER_02]: equal ginger margins

[00:31:12] [SPEAKER_02]: whenever I can.

[00:31:14] [SPEAKER_02]: And when I can't

[00:31:15] [SPEAKER_02]: I'll I'll pack court

[00:31:17] [SPEAKER_02]: and get it but I

[00:31:18] [SPEAKER_02]: also I'm using right now

[00:31:19] [SPEAKER_02]: I'm using an I seven

[00:31:20] [SPEAKER_02]: hundred a medit I seven

[00:31:21] [SPEAKER_02]: hundred scanner.

[00:31:22] [SPEAKER_02]: So the the the workflow

[00:31:23] [SPEAKER_02]: is if it's a

[00:31:25] [SPEAKER_02]: single or double you

[00:31:26] [SPEAKER_02]: know next to each other

[00:31:27] [SPEAKER_02]: my my assistant will

[00:31:28] [SPEAKER_02]: seat the patient they'll

[00:31:29] [SPEAKER_02]: kind of do a quick

[00:31:30] [SPEAKER_02]: health history thing

[00:31:31] [SPEAKER_02]: might play some topical

[00:31:32] [SPEAKER_02]: and then they'll take

[00:31:33] [SPEAKER_02]: what we call a purple

[00:31:34] [SPEAKER_02]: which is a provisional

[00:31:36] [SPEAKER_02]: matrix.

[00:31:37] [SPEAKER_02]: And I use a

[00:31:38] [SPEAKER_02]: clinicians choice product

[00:31:39] [SPEAKER_02]: is called template

[00:31:41] [SPEAKER_02]: and we use it's in a

[00:31:41] [SPEAKER_02]: little tray.

[00:31:42] [SPEAKER_02]: It's a very fast setting

[00:31:43] [SPEAKER_02]: polyvinyl which makes

[00:31:45] [SPEAKER_02]: for a killer accurate.

[00:31:47] [SPEAKER_02]: It's more expensive.

[00:31:49] [SPEAKER_02]: It's I mean a lot of

[00:31:50] [SPEAKER_02]: guys throw up because

[00:31:51] [SPEAKER_02]: it's more expensive than

[00:31:52] [SPEAKER_02]: it needs to be.

[00:31:52] [SPEAKER_02]: But boy this stuff sets

[00:31:53] [SPEAKER_02]: really fast and it's

[00:31:54] [SPEAKER_02]: very accurate.

[00:31:55] [SPEAKER_02]: The other thing is is when

[00:31:56] [SPEAKER_02]: you're when you're

[00:31:57] [SPEAKER_02]: reaming out a piece of

[00:31:58] [SPEAKER_02]: the matrix because you've

[00:31:59] [SPEAKER_02]: got a busted piece

[00:31:59] [SPEAKER_02]: of the tooth or whatever.

[00:32:00] [SPEAKER_02]: Boy cuts off nice and

[00:32:02] [SPEAKER_02]: clean.

[00:32:02] [SPEAKER_02]: It makes her really nice.

[00:32:03] [SPEAKER_02]: So I've been using that

[00:32:04] [SPEAKER_02]: for years honestly.

[00:32:06] [SPEAKER_02]: It's a bite though

[00:32:07] [SPEAKER_02]: because like you

[00:32:08] [SPEAKER_02]: I order stuff in bulk

[00:32:09] [SPEAKER_02]: you know 36 cartridges

[00:32:10] [SPEAKER_02]: stuff is like 900

[00:32:11] [SPEAKER_02]: bucks or something like

[00:32:12] [SPEAKER_02]: that.

[00:32:13] [SPEAKER_02]: So it'll last you a

[00:32:14] [SPEAKER_02]: good while but it's

[00:32:15] [SPEAKER_02]: still kind of a bite.

[00:32:17] [SPEAKER_02]: So she'll make the

[00:32:18] [SPEAKER_02]: temporary matrix.

[00:32:18] [SPEAKER_02]: I'll come in and do

[00:32:19] [SPEAKER_02]: anesthesia while

[00:32:20] [SPEAKER_02]: they're getting numb.

[00:32:21] [SPEAKER_02]: That's when I do

[00:32:22] [SPEAKER_02]: pre-op scans with

[00:32:23] [SPEAKER_02]: with the medics.

[00:32:24] [SPEAKER_02]: So I'll take I'll take

[00:32:26] [SPEAKER_02]: depending on the

[00:32:27] [SPEAKER_02]: situation I go I'll

[00:32:28] [SPEAKER_02]: take a pretty good

[00:32:30] [SPEAKER_02]: a wide quadrant on

[00:32:31] [SPEAKER_02]: both you know upper

[00:32:32] [SPEAKER_02]: and lower and get the bite.

[00:32:33] [SPEAKER_02]: And then actually I can

[00:32:34] [SPEAKER_02]: process the preparations

[00:32:35] [SPEAKER_02]: and just cut the

[00:32:36] [SPEAKER_02]: preparations right out

[00:32:36] [SPEAKER_02]: before we ever start

[00:32:37] [SPEAKER_02]: prepping.

[00:32:38] [SPEAKER_02]: Push the computer away

[00:32:39] [SPEAKER_02]: by that time nine

[00:32:40] [SPEAKER_02]: out of 10 there nine

[00:32:41] [SPEAKER_02]: out of ten times already

[00:32:41] [SPEAKER_02]: numb.

[00:32:43] [SPEAKER_02]: Go ahead and prep

[00:32:44] [SPEAKER_02]: place cord or using

[00:32:46] [SPEAKER_02]: like the track

[00:32:47] [SPEAKER_02]: sedent stuff the

[00:32:49] [SPEAKER_02]: depending on how my

[00:32:50] [SPEAKER_02]: preparation is and if

[00:32:51] [SPEAKER_02]: it's if it's equal

[00:32:52] [SPEAKER_02]: ginger will or below

[00:32:53] [SPEAKER_02]: the gum line whatever

[00:32:53] [SPEAKER_02]: I'll kind of make

[00:32:54] [SPEAKER_02]: the choice.

[00:32:54] [SPEAKER_02]: I got to say

[00:32:56] [SPEAKER_02]: cord is fantastic but

[00:32:57] [SPEAKER_02]: I like that track sedent

[00:32:59] [SPEAKER_02]: even with cord.

[00:33:00] [SPEAKER_02]: Even if I'm placing

[00:33:00] [SPEAKER_02]: court I'm up with

[00:33:01] [SPEAKER_02]: that stuff on there

[00:33:02] [SPEAKER_02]: because it really dries

[00:33:03] [SPEAKER_02]: and I just feel like

[00:33:04] [SPEAKER_02]: the margin pops out

[00:33:05] [SPEAKER_02]: clearly because

[00:33:05] [SPEAKER_02]: everything's just you

[00:33:06] [SPEAKER_02]: know you're drying

[00:33:07] [SPEAKER_02]: that tissue out like

[00:33:08] [SPEAKER_02]: crazy so I love that

[00:33:09] [SPEAKER_02]: is that a retraction

[00:33:10] [SPEAKER_02]: paste.

[00:33:10] [SPEAKER_02]: Yep it's a

[00:33:11] [SPEAKER_02]: retraction paste

[00:33:11] [SPEAKER_02]: with the little little

[00:33:13] [SPEAKER_02]: cotton hat that

[00:33:14] [SPEAKER_02]: kind of pushes down

[00:33:15] [SPEAKER_02]: I use that stuff a lot.

[00:33:16] [SPEAKER_02]: Sometimes I use alone

[00:33:17] [SPEAKER_02]: but I also will use

[00:33:18] [SPEAKER_02]: it.

[00:33:20] [SPEAKER_02]: Zach and Kevin and

[00:33:21] [SPEAKER_02]: I we call it the

[00:33:21] [SPEAKER_02]: cord and a half

[00:33:22] [SPEAKER_02]: technique or whatever

[00:33:23] [SPEAKER_02]: because you put

[00:33:24] [SPEAKER_02]: cord in and then

[00:33:24] [SPEAKER_02]: put that stuff it

[00:33:25] [SPEAKER_02]: works really good

[00:33:26] [SPEAKER_02]: and I'll even do

[00:33:27] [SPEAKER_02]: when I use two

[00:33:27] [SPEAKER_02]: cords for crying out

[00:33:28] [SPEAKER_02]: so that's that is

[00:33:29] [SPEAKER_02]: a lot of retraction

[00:33:30] [SPEAKER_02]: but it works great

[00:33:31] [SPEAKER_02]: nice clear margin

[00:33:33] [SPEAKER_02]: will and then I

[00:33:34] [SPEAKER_02]: will she'll fab the

[00:33:35] [SPEAKER_02]: temp I usually come

[00:33:36] [SPEAKER_02]: in and trim the

[00:33:36] [SPEAKER_02]: temp because I feel

[00:33:37] [SPEAKER_02]: like I can do it

[00:33:38] [SPEAKER_02]: faster than my

[00:33:39] [SPEAKER_02]: assistant can typically

[00:33:40] [SPEAKER_02]: we'll get that

[00:33:41] [SPEAKER_02]: thing on there

[00:33:42] [SPEAKER_02]: and I mark the

[00:33:42] [SPEAKER_02]: margins typically

[00:33:43] [SPEAKER_02]: before the

[00:33:44] [SPEAKER_02]: patients even left

[00:33:44] [SPEAKER_02]: and so the case

[00:33:45] [SPEAKER_02]: is already the lab

[00:33:46] [SPEAKER_02]: and that's about

[00:33:47] [SPEAKER_02]: 40 to 45 minutes

[00:33:48] [SPEAKER_02]: now I've got that

[00:33:49] [SPEAKER_02]: down for like a

[00:33:50] [SPEAKER_02]: single pretty quickly

[00:33:52] [SPEAKER_02]: we do that all the

[00:33:53] [SPEAKER_02]: time and I just

[00:33:53] [SPEAKER_02]: find like the

[00:33:54] [SPEAKER_02]: results have been

[00:33:54] [SPEAKER_02]: great they come in

[00:33:55] [SPEAKER_02]: for for the

[00:33:57] [SPEAKER_02]: crown seat I'll do

[00:33:57] [SPEAKER_02]: anesthesia for 60

[00:34:00] [SPEAKER_02]: plus percent of them

[00:34:01] [SPEAKER_02]: wiggle the

[00:34:02] [SPEAKER_02]: temporary off

[00:34:03] [SPEAKER_02]: we use a I

[00:34:03] [SPEAKER_02]: use a temporary

[00:34:04] [SPEAKER_02]: material called

[00:34:05] [SPEAKER_02]: from a company

[00:34:06] [SPEAKER_02]: called I 10

[00:34:06] [SPEAKER_02]: that's called

[00:34:07] [SPEAKER_02]: Dento temp

[00:34:08] [SPEAKER_02]: and it's actually

[00:34:08] [SPEAKER_02]: meant for long

[00:34:09] [SPEAKER_02]: term long

[00:34:10] [SPEAKER_02]: term cementation

[00:34:11] [SPEAKER_02]: is actually designed

[00:34:12] [SPEAKER_02]: as an implant

[00:34:12] [SPEAKER_02]: cement so it's

[00:34:13] [SPEAKER_02]: a really firm

[00:34:14] [SPEAKER_02]: hold it's probably

[00:34:15] [SPEAKER_02]: firmer than

[00:34:16] [SPEAKER_02]: anything I've used

[00:34:16] [SPEAKER_02]: before so about

[00:34:18] [SPEAKER_02]: a third of the

[00:34:18] [SPEAKER_02]: time or more

[00:34:19] [SPEAKER_02]: I got to cut

[00:34:19] [SPEAKER_02]: that temporary off

[00:34:20] [SPEAKER_02]: because it's such

[00:34:21] [SPEAKER_02]: a firm hold

[00:34:22] [SPEAKER_02]: which can sometimes

[00:34:24] [SPEAKER_02]: be a pain usually

[00:34:24] [SPEAKER_02]: it's not that

[00:34:25] [SPEAKER_02]: big of a deal

[00:34:25] [SPEAKER_02]: but a lot of times

[00:34:26] [SPEAKER_02]: I can wiggle

[00:34:27] [SPEAKER_02]: the thing off

[00:34:27] [SPEAKER_02]: and it just comes

[00:34:28] [SPEAKER_02]: off clean as a

[00:34:28] [SPEAKER_02]: whistle and then

[00:34:30] [SPEAKER_02]: will cement

[00:34:30] [SPEAKER_02]: them typically

[00:34:31] [SPEAKER_02]: like I said I'm

[00:34:32] [SPEAKER_02]: using I'm using

[00:34:32] [SPEAKER_02]: the same Fuji

[00:34:34] [SPEAKER_02]: cement in a

[00:34:35] [SPEAKER_02]: in a I have

[00:34:36] [SPEAKER_02]: a I have a

[00:34:36] [SPEAKER_02]: triturator I

[00:34:37] [SPEAKER_02]: don't use

[00:34:38] [SPEAKER_02]: I don't do

[00:34:38] [SPEAKER_02]: amalgam but I

[00:34:39] [SPEAKER_02]: use it to

[00:34:39] [SPEAKER_02]: shake the little

[00:34:40] [SPEAKER_02]: cartridges of

[00:34:40] [SPEAKER_02]: the Fuji that

[00:34:41] [SPEAKER_02]: I use and I've

[00:34:42] [SPEAKER_02]: been stuff

[00:34:42] [SPEAKER_02]: works like a

[00:34:43] [SPEAKER_02]: charm so

[00:34:44] [SPEAKER_02]: material it's

[00:34:45] [SPEAKER_02]: it's been

[00:34:45] [SPEAKER_02]: used I've been

[00:34:46] [SPEAKER_02]: using that

[00:34:46] [SPEAKER_02]: material for

[00:34:46] [SPEAKER_02]: 25 plus years

[00:34:47] [SPEAKER_02]: it works great

[00:34:48] [SPEAKER_02]: so that's

[00:34:49] [SPEAKER_02]: kind of what I

[00:34:50] [SPEAKER_00]: do so is that

[00:34:51] [SPEAKER_00]: cement is it

[00:34:52] [SPEAKER_00]: a true glass ion

[00:34:53] [SPEAKER_00]: or is it an

[00:34:54] [SPEAKER_02]: orange resin

[00:34:54] [SPEAKER_02]: resin reinforced

[00:34:55] [SPEAKER_02]: glass ion

[00:34:55] [SPEAKER_02]: okay it's not

[00:34:56] [SPEAKER_02]: a true glass

[00:34:56] [SPEAKER_02]: ion but it's

[00:34:58] [SPEAKER_02]: stuff is

[00:34:59] [SPEAKER_02]: stuff is the

[00:34:59] [SPEAKER_02]: bomb it's

[00:35:00] [SPEAKER_02]: great

[00:35:00] [SPEAKER_02]: interesting

[00:35:00] [SPEAKER_00]: yeah that's

[00:35:02] [SPEAKER_00]: I feel like at

[00:35:04] [SPEAKER_00]: our school we

[00:35:05] [SPEAKER_00]: they tend to

[00:35:06] [SPEAKER_00]: push EMAX

[00:35:07] [SPEAKER_00]: lithium disilicate

[00:35:08] [SPEAKER_00]: more

[00:35:10] [SPEAKER_00]: but I think

[00:35:10] [SPEAKER_00]: you said that

[00:35:11] [SPEAKER_00]: I wonder why

[00:35:12] [SPEAKER_00]: is it because

[00:35:13] [SPEAKER_00]: they because

[00:35:13] [SPEAKER_00]: they want you

[00:35:14] [SPEAKER_00]: to do partial

[00:35:16] [SPEAKER_00]: well no

[00:35:17] [SPEAKER_00]: so we have

[00:35:18] [SPEAKER_00]: our requirement

[00:35:19] [SPEAKER_00]: is like about

[00:35:20] [SPEAKER_00]: 15 units

[00:35:21] [SPEAKER_00]: and only two

[00:35:22] [SPEAKER_00]: of them have

[00:35:23] [SPEAKER_00]: to be some

[00:35:24] [SPEAKER_00]: sort of partial

[00:35:25] [SPEAKER_00]: okay

[00:35:25] [SPEAKER_00]: okay

[00:35:26] [SPEAKER_00]: and then

[00:35:27] [SPEAKER_00]: most of the time

[00:35:28] [SPEAKER_00]: everybody does just

[00:35:28] [SPEAKER_00]: full coverage for

[00:35:29] [SPEAKER_00]: the rest

[00:35:30] [SPEAKER_00]: just because I guess

[00:35:31] [SPEAKER_00]: it's easier

[00:35:33] [SPEAKER_00]: for a dental student

[00:35:34] [SPEAKER_00]: to do

[00:35:35] [SPEAKER_02]: it is but also

[00:35:36] [SPEAKER_02]: I got to tell you

[00:35:37] [SPEAKER_02]: I think

[00:35:39] [SPEAKER_02]: partial and this

[00:35:40] [SPEAKER_02]: is my opinion

[00:35:41] [SPEAKER_02]: and one of

[00:35:42] [SPEAKER_02]: the things if you

[00:35:43] [SPEAKER_02]: did a lot of

[00:35:44] [SPEAKER_02]: them and you

[00:35:44] [SPEAKER_02]: worked with your

[00:35:45] [SPEAKER_02]: lab well on

[00:35:46] [SPEAKER_02]: them but sometimes

[00:35:46] [SPEAKER_02]: I find the

[00:35:47] [SPEAKER_02]: labs have a

[00:35:47] [SPEAKER_02]: hard time getting

[00:35:48] [SPEAKER_02]: the contour on

[00:35:49] [SPEAKER_02]: a partial right

[00:35:50] [SPEAKER_02]: so you'll get

[00:35:50] [SPEAKER_02]: these goofy

[00:35:51] [SPEAKER_02]: looking like you've

[00:35:52] [SPEAKER_02]: got a prep that

[00:35:52] [SPEAKER_02]: you think is

[00:35:53] [SPEAKER_02]: the greatest

[00:35:53] [SPEAKER_02]: thing ever but

[00:35:54] [SPEAKER_02]: then the lab sort

[00:35:54] [SPEAKER_02]: of you know

[00:35:55] [SPEAKER_02]: you get these kind

[00:35:56] [SPEAKER_02]: of fat margins

[00:35:57] [SPEAKER_02]: or over bulked

[00:35:59] [SPEAKER_02]: stuff it's sort

[00:35:59] [SPEAKER_02]: of a

[00:36:00] [SPEAKER_02]: what you don't

[00:36:01] [SPEAKER_02]: get is when you

[00:36:02] [SPEAKER_02]: do a full

[00:36:02] [SPEAKER_02]: full crown

[00:36:03] [SPEAKER_02]: you just don't

[00:36:03] [SPEAKER_02]: get that

[00:36:04] [SPEAKER_02]: they're so used

[00:36:05] [SPEAKER_02]: to that it's

[00:36:05] [SPEAKER_02]: such a typical

[00:36:06] [SPEAKER_02]: so unless

[00:36:07] [SPEAKER_02]: you're working

[00:36:07] [SPEAKER_02]: with someone who

[00:36:08] [SPEAKER_02]: does a lot

[00:36:08] [SPEAKER_02]: of partial coverage

[00:36:09] [SPEAKER_02]: it's probably

[00:36:09] [SPEAKER_02]: you know I like

[00:36:10] [SPEAKER_02]: doing crowns

[00:36:11] [SPEAKER_02]: for a lot

[00:36:12] [SPEAKER_02]: of reasons and

[00:36:12] [SPEAKER_02]: let's be honest

[00:36:13] [SPEAKER_02]: in Saginaw

[00:36:14] [SPEAKER_02]: where I work

[00:36:14] [SPEAKER_02]: there's a lot

[00:36:15] [SPEAKER_02]: of there's a lot

[00:36:16] [SPEAKER_02]: of amalgams

[00:36:16] [SPEAKER_02]: that are you

[00:36:17] [SPEAKER_02]: know a lot of

[00:36:19] [SPEAKER_02]: a lot of times

[00:36:19] [SPEAKER_02]: you need to do

[00:36:20] [SPEAKER_02]: one just because

[00:36:21] [SPEAKER_02]: the partial would

[00:36:22] [SPEAKER_02]: be a little tougher

[00:36:23] [SPEAKER_02]: now there's

[00:36:23] [SPEAKER_02]: people that would argue

[00:36:24] [SPEAKER_02]: you can use

[00:36:24] [SPEAKER_02]: do them all the time

[00:36:25] [SPEAKER_02]: but I don't have

[00:36:26] [SPEAKER_02]: the reps for it

[00:36:27] [SPEAKER_02]: and frankly

[00:36:27] [SPEAKER_02]: I have really

[00:36:28] [SPEAKER_02]: good results

[00:36:29] [SPEAKER_02]: with what I'm doing

[00:36:30] [SPEAKER_02]: but I certainly

[00:36:31] [SPEAKER_02]: wouldn't argue

[00:36:31] [SPEAKER_02]: with someone

[00:36:32] [SPEAKER_02]: who wants to

[00:36:32] [SPEAKER_02]: partial

[00:36:33] [SPEAKER_00]: yeah I think

[00:36:35] [SPEAKER_00]: like there's

[00:36:37] [SPEAKER_00]: maybe a trend

[00:36:37] [SPEAKER_00]: towards doing

[00:36:38] [SPEAKER_00]: more partial

[00:36:38] [SPEAKER_00]: coverage

[00:36:39] [SPEAKER_00]: but it's also

[00:36:40] [SPEAKER_00]: hard because

[00:36:41] [SPEAKER_00]: there's a lot of

[00:36:41] [SPEAKER_00]: like old

[00:36:42] [SPEAKER_00]: school professors

[00:36:44] [SPEAKER_00]: that like

[00:36:45] [SPEAKER_00]: you know

[00:36:45] [SPEAKER_00]: like Schellenberg

[00:36:47] [SPEAKER_00]: mindset I mean

[00:36:48] [SPEAKER_00]: Schellenberg was

[00:36:50] [SPEAKER_00]: was a professor

[00:36:51] [SPEAKER_00]: at our school

[00:36:52] [SPEAKER_00]: for most

[00:36:52] [SPEAKER_00]: of my professors

[00:36:53] [SPEAKER_00]: so they're

[00:36:54] [SPEAKER_00]: just used to

[00:36:55] [SPEAKER_00]: full coverage

[00:36:55] [SPEAKER_00]: gold restorations

[00:36:56] [SPEAKER_00]: like that's what

[00:36:57] [SPEAKER_00]: they that's what

[00:36:57] [SPEAKER_00]: they learned

[00:36:58] [SPEAKER_00]: that's what they did

[00:36:59] [SPEAKER_00]: so I think it's

[00:37:00] [SPEAKER_00]: but it's trending

[00:37:01] [SPEAKER_00]: towards that

[00:37:02] [SPEAKER_00]: especially as

[00:37:02] [SPEAKER_00]: there's like

[00:37:03] [SPEAKER_00]: younger faculty

[00:37:04] [SPEAKER_00]: coming in

[00:37:04] [SPEAKER_00]: yeah

[00:37:06] [SPEAKER_00]: they're definitely

[00:37:06] [SPEAKER_00]: like

[00:37:07] [SPEAKER_00]: making it

[00:37:08] [SPEAKER_00]: a push towards

[00:37:09] [SPEAKER_00]: some partial

[00:37:10] [SPEAKER_00]: coverage

[00:37:11] [SPEAKER_00]: restorations

[00:37:12] [SPEAKER_00]: which I think

[00:37:12] [SPEAKER_00]: could be a good thing

[00:37:14] [SPEAKER_00]: but I also think

[00:37:15] [SPEAKER_00]: maybe we do

[00:37:16] [SPEAKER_00]: Emacs just because

[00:37:17] [SPEAKER_00]: maybe our

[00:37:18] [SPEAKER_00]: preps

[00:37:19] [SPEAKER_00]: as dental students

[00:37:20] [SPEAKER_00]: don't have

[00:37:20] [SPEAKER_00]: as much retention

[00:37:21] [SPEAKER_00]: we might be

[00:37:22] [SPEAKER_00]: over prepping

[00:37:22] [SPEAKER_00]: a little bit

[00:37:23] [SPEAKER_00]: we might not have

[00:37:24] [SPEAKER_00]: the ideal taper

[00:37:25] [SPEAKER_00]: so the fact that

[00:37:26] [SPEAKER_00]: we can bond it in

[00:37:28] [SPEAKER_00]: I don't know

[00:37:29] [SPEAKER_00]: maybe that's just like

[00:37:30] [SPEAKER_00]: a kind of a safety net

[00:37:31] [SPEAKER_00]: for us

[00:37:31] [SPEAKER_02]: maybe

[00:37:32] [SPEAKER_02]: maybe

[00:37:33] [SPEAKER_02]: I know that's

[00:37:34] [SPEAKER_02]: because I would

[00:37:35] [SPEAKER_02]: I would argue

[00:37:35] [SPEAKER_02]: that there is no

[00:37:36] [SPEAKER_02]: easier way to cement

[00:37:37] [SPEAKER_02]: than

[00:37:38] [SPEAKER_02]: than resin reinforced

[00:37:39] [SPEAKER_02]: glass ionomer

[00:37:40] [SPEAKER_02]: it is idiot

[00:37:41] [SPEAKER_02]: idiot resistant

[00:37:42] [SPEAKER_02]: if not idiot proof

[00:37:43] [SPEAKER_02]: and I mean

[00:37:44] [SPEAKER_02]: I will say

[00:37:45] [SPEAKER_02]: there's a lot

[00:37:46] [SPEAKER_02]: of really good

[00:37:46] [SPEAKER_02]: cements that make

[00:37:47] [SPEAKER_02]: it significantly

[00:37:48] [SPEAKER_02]: less complicated

[00:37:50] [SPEAKER_02]: to bond

[00:37:51] [SPEAKER_02]: than it used to be

[00:37:52] [SPEAKER_02]: used to be

[00:37:52] [SPEAKER_02]: much more complicated

[00:37:53] [SPEAKER_02]: so it's

[00:37:54] [SPEAKER_02]: I mean I know

[00:37:55] [SPEAKER_02]: there's some people

[00:37:55] [SPEAKER_02]: doing partial

[00:37:56] [SPEAKER_02]: coverage that use

[00:37:57] [SPEAKER_02]: warm composite

[00:37:58] [SPEAKER_02]: for their cement

[00:37:59] [SPEAKER_02]: and stuff

[00:38:00] [SPEAKER_02]: and I always worry

[00:38:00] [SPEAKER_02]: about oh god

[00:38:01] [SPEAKER_02]: is it curing

[00:38:01] [SPEAKER_02]: through enough

[00:38:02] [SPEAKER_02]: all that

[00:38:02] [SPEAKER_02]: I used to do that

[00:38:03] [SPEAKER_02]: I used to do that

[00:38:03] [SPEAKER_02]: for all my veneers

[00:38:04] [SPEAKER_02]: actually

[00:38:04] [SPEAKER_02]: I could

[00:38:05] [SPEAKER_02]: I think you could

[00:38:06] [SPEAKER_02]: make a pretty good

[00:38:06] [SPEAKER_02]: argument for a

[00:38:07] [SPEAKER_02]: veneer that's

[00:38:08] [SPEAKER_02]: translucent

[00:38:08] [SPEAKER_02]: that that's not

[00:38:09] [SPEAKER_02]: a bad way to go

[00:38:10] [SPEAKER_02]: Yeah

[00:38:12] [SPEAKER_00]: So one more thing

[00:38:13] [SPEAKER_00]: I wanted to talk about

[00:38:14] [SPEAKER_00]: this is actually

[00:38:15] [SPEAKER_00]: there's been a

[00:38:15] [SPEAKER_00]: pain point of mind

[00:38:17] [SPEAKER_00]: recently

[00:38:17] [SPEAKER_00]: in clinic

[00:38:18] [SPEAKER_00]: is

[00:38:20] [SPEAKER_00]: how do you test

[00:38:21] [SPEAKER_00]: for cracktooth syndrome

[00:38:22] [SPEAKER_00]: because I feel like

[00:38:23] [SPEAKER_00]: we haven't gotten

[00:38:25] [SPEAKER_00]: really taught this

[00:38:26] [SPEAKER_00]: yet

[00:38:27] [SPEAKER_00]: maybe we're gonna

[00:38:28] [SPEAKER_00]: get a lecture

[00:38:28] [SPEAKER_00]: eventually on this

[00:38:29] [SPEAKER_00]: but I have a patient

[00:38:32] that

[00:38:32] [SPEAKER_00]: I think they have

[00:38:33] [SPEAKER_00]: cracktooth syndrome

[00:38:35] [SPEAKER_00]: we did a composite

[00:38:36] [SPEAKER_00]: for them

[00:38:37] [SPEAKER_00]: the composite broke

[00:38:39] [SPEAKER_00]: like within a week

[00:38:41] [SPEAKER_00]: and

[00:38:42] [SPEAKER_00]: we replaced the composite

[00:38:43] [SPEAKER_00]: took it out of occlusion

[00:38:44] [SPEAKER_00]: and it still bugs them

[00:38:46] [SPEAKER_00]: like every once in a while

[00:38:48] [SPEAKER_00]: it's not like

[00:38:49] [SPEAKER_00]: crazy

[00:38:50] [SPEAKER_00]: but when I tested it

[00:38:51] [SPEAKER_00]: with a tooth sleuth

[00:38:52] [SPEAKER_00]: like not it didn't

[00:38:54] [SPEAKER_00]: I don't know

[00:38:55] [SPEAKER_00]: like my faculty said

[00:38:56] [SPEAKER_00]: like it's not testing

[00:38:56] [SPEAKER_00]: positive

[00:38:57] [SPEAKER_00]: so I'm like

[00:38:57] [SPEAKER_00]: I don't know what's

[00:38:58] [SPEAKER_00]: happening

[00:38:58] [SPEAKER_02]: tooths are awesome

[00:38:59] [SPEAKER_02]: and they oftentimes

[00:39:01] [SPEAKER_02]: will do the trick

[00:39:01] [SPEAKER_02]: I also honestly

[00:39:02] [SPEAKER_02]: I like

[00:39:05] [SPEAKER_02]: so for one thing

[00:39:06] [SPEAKER_02]: depending

[00:39:07] [SPEAKER_02]: I mean if you're testing

[00:39:08] [SPEAKER_02]: without a preparation

[00:39:10] [SPEAKER_02]: in other words

[00:39:12] [SPEAKER_02]: I'll still use

[00:39:13] [SPEAKER_02]: I'll use a dye

[00:39:14] [SPEAKER_02]: sometimes

[00:39:15] [SPEAKER_02]: if it's supposed to your tooth

[00:39:16] [SPEAKER_02]: where where

[00:39:17] [SPEAKER_02]: you're not gonna

[00:39:17] [SPEAKER_02]: like wreck aesthetics

[00:39:19] [SPEAKER_02]: because you sort of

[00:39:19] [SPEAKER_02]: dyed their tooth

[00:39:20] [SPEAKER_02]: a little bit

[00:39:21] [SPEAKER_02]: I'll use a dye

[00:39:22] [SPEAKER_02]: that'll show up

[00:39:22] [SPEAKER_02]: that'll show up

[00:39:23] [SPEAKER_02]: a crack pretty easily

[00:39:24] [SPEAKER_02]: I'll also use a cotton roll

[00:39:26] [SPEAKER_02]: along with you know

[00:39:27] [SPEAKER_02]: a tooth sleuth

[00:39:28] [SPEAKER_02]: but a cotton roll

[00:39:28] [SPEAKER_02]: and you know

[00:39:29] [SPEAKER_02]: it's cool about a cotton roll

[00:39:30] [SPEAKER_02]: sometimes you'll get

[00:39:31] [SPEAKER_02]: you'll get the

[00:39:32] [SPEAKER_02]: the fracture

[00:39:33] [SPEAKER_02]: to you'll elicit

[00:39:34] [SPEAKER_02]: the fracture pain

[00:39:35] [SPEAKER_02]: on release

[00:39:36] [SPEAKER_02]: and that's

[00:39:37] [SPEAKER_02]: that works really well

[00:39:37] [SPEAKER_02]: with a cotton roll

[00:39:38] [SPEAKER_02]: is really good

[00:39:39] [SPEAKER_02]: if you're looking for the

[00:39:40] [SPEAKER_02]: fracture on release

[00:39:42] [SPEAKER_02]: also

[00:39:42] [SPEAKER_02]: I've got a microscope

[00:39:44] [SPEAKER_02]: in every operatory

[00:39:45] [SPEAKER_02]: and sometimes what I do

[00:39:46] [SPEAKER_02]: is I'll go high mag

[00:39:47] [SPEAKER_02]: and dry the snot

[00:39:48] [SPEAKER_02]: out of everything

[00:39:48] [SPEAKER_02]: just dry it really good

[00:39:49] [SPEAKER_02]: because a lot of times

[00:39:50] [SPEAKER_02]: if you get the moisture

[00:39:52] [SPEAKER_02]: off that tooth

[00:39:52] [SPEAKER_02]: you can just see

[00:39:53] [SPEAKER_02]: the surface texture

[00:39:54] [SPEAKER_02]: a little bit more

[00:39:54] [SPEAKER_02]: so sometimes you'll see that

[00:39:57] [SPEAKER_02]: remember cracks

[00:39:59] [SPEAKER_02]: diagonal lines

[00:39:59] [SPEAKER_02]: are much scarier

[00:40:01] [SPEAKER_02]: on a tooth

[00:40:02] [SPEAKER_02]: than an

[00:40:02] [SPEAKER_02]: anatomic looking line

[00:40:04] [SPEAKER_02]: you know one of those things

[00:40:05] [SPEAKER_02]: but typically

[00:40:06] [SPEAKER_02]: the crack tooth syndrome

[00:40:08] [SPEAKER_02]: of where you can't see it

[00:40:11] [SPEAKER_02]: yeah look for that

[00:40:12] [SPEAKER_02]: release with a cotton roll

[00:40:13] [SPEAKER_02]: that's my best bet

[00:40:14] [SPEAKER_02]: like

[00:40:14] [SPEAKER_02]: it's what you know

[00:40:15] [SPEAKER_02]: cracks can be

[00:40:15] [SPEAKER_02]: oh the other thing

[00:40:16] [SPEAKER_02]: I don't know if you have access to

[00:40:17] [SPEAKER_02]: to one of those bright lights

[00:40:19] [SPEAKER_02]: but sometimes

[00:40:19] [SPEAKER_02]: trans elimination is going to

[00:40:21] [SPEAKER_02]: give you an idea

[00:40:21] [SPEAKER_02]: the story is

[00:40:22] [SPEAKER_02]: if they're having

[00:40:23] [SPEAKER_02]: consistent sensitivity

[00:40:24] [SPEAKER_02]: on biting

[00:40:25] [SPEAKER_02]: I want to get some coverage

[00:40:26] [SPEAKER_02]: on that as soon as I can

[00:40:28] [SPEAKER_02]: I typically don't think

[00:40:30] [SPEAKER_02]: that a composite

[00:40:32] [SPEAKER_02]: I love bonded composite

[00:40:33] [SPEAKER_02]: I do tons of

[00:40:34] [SPEAKER_02]: posterior composite

[00:40:35] [SPEAKER_02]: but when I

[00:40:35] [SPEAKER_02]: get those kind of symptoms

[00:40:37] [SPEAKER_02]: I figure the

[00:40:38] [SPEAKER_02]: longer we wait

[00:40:39] [SPEAKER_02]: to get some coverage

[00:40:40] [SPEAKER_02]: whether that's partial coverage

[00:40:41] [SPEAKER_02]: or full coverage

[00:40:42] [SPEAKER_02]: the more likely that

[00:40:44] [SPEAKER_02]: the pulp of that tooth

[00:40:45] [SPEAKER_02]: is going to be in trouble

[00:40:46] [SPEAKER_02]: because you know

[00:40:47] [SPEAKER_02]: even if you can't

[00:40:48] [SPEAKER_02]: see it

[00:40:49] [SPEAKER_02]: they do act

[00:40:50] [SPEAKER_02]: they almost always act

[00:40:51] [SPEAKER_02]: the same way

[00:40:51] [SPEAKER_02]: a fracture even if you can't see it

[00:40:53] [SPEAKER_02]: it sucks because

[00:40:53] [SPEAKER_02]: a lot of times you can see it

[00:40:54] [SPEAKER_02]: once you've prepped

[00:40:55] [SPEAKER_02]: you start prepping

[00:40:56] [SPEAKER_02]: and then oh there it is

[00:40:57] [SPEAKER_02]: or the best thing is when you prep

[00:40:58] [SPEAKER_02]: this is

[00:40:59] [SPEAKER_02]: if this doesn't

[00:41:00] [SPEAKER_02]: hasn't happened in dental school

[00:41:01] [SPEAKER_02]: it probably will

[00:41:02] [SPEAKER_02]: when you're prepping

[00:41:04] [SPEAKER_02]: the cusp

[00:41:04] [SPEAKER_02]: that was

[00:41:05] [SPEAKER_02]: that was undermined

[00:41:06] [SPEAKER_02]: pops off

[00:41:07] [SPEAKER_02]: as soon as you get a diamond close to it

[00:41:08] [SPEAKER_02]: just goes ding

[00:41:09] [SPEAKER_02]: and you're like oh

[00:41:09] [SPEAKER_02]: there was our fracture right there

[00:41:11] [SPEAKER_02]: but of course that's not

[00:41:11] [SPEAKER_02]: that's not very diagnostic

[00:41:12] [SPEAKER_02]: you're already prepping the tooth

[00:41:13] [SPEAKER_02]: so

[00:41:15] [SPEAKER_00]: yeah

[00:41:16] [SPEAKER_00]: and then

[00:41:17] so

[00:41:18] [SPEAKER_00]: can you

[00:41:19] [SPEAKER_00]: can you treat

[00:41:20] [SPEAKER_00]: a cracked tooth

[00:41:21] [SPEAKER_00]: with partial coverage

[00:41:22] [SPEAKER_00]: I know you just mentioned

[00:41:22] [SPEAKER_00]: like whether it's full

[00:41:24] [SPEAKER_00]: if you know

[00:41:24] [SPEAKER_02]: where the fracture is

[00:41:25] [SPEAKER_02]: I mean that's the story

[00:41:26] [SPEAKER_02]: if you really know

[00:41:27] [SPEAKER_02]: where the fracture is

[00:41:27] [SPEAKER_02]: you could get wise that way

[00:41:29] [SPEAKER_02]: do I?

[00:41:30] [SPEAKER_02]: no

[00:41:30] [SPEAKER_02]: I mean

[00:41:31] [SPEAKER_02]: I'm confident

[00:41:32] [SPEAKER_02]: I can include

[00:41:33] [SPEAKER_02]: the fracture

[00:41:34] [SPEAKER_02]: if I do full coverage

[00:41:35] [SPEAKER_02]: because sometimes

[00:41:36] [SPEAKER_02]: you don't know

[00:41:36] [SPEAKER_02]: exactly where the fracture is

[00:41:38] [SPEAKER_02]: like I said

[00:41:38] [SPEAKER_02]: by the time you've prepped it

[00:41:39] [SPEAKER_02]: particularly if you're taking out

[00:41:41] [SPEAKER_02]: the old restoration

[00:41:41] [SPEAKER_02]: with a microscope

[00:41:43] [SPEAKER_02]: you can almost always find it

[00:41:44] [SPEAKER_02]: microscope and die

[00:41:45] [SPEAKER_02]: you can almost always find it

[00:41:47] [SPEAKER_02]: but not everyone has access to that

[00:41:49] [SPEAKER_02]: I'm going to say

[00:41:50] [SPEAKER_02]: whatever magnification you're using

[00:41:52] [SPEAKER_02]: and if you've got a headlamp

[00:41:52] [SPEAKER_02]: that's going to help a lot too

[00:41:54] [SPEAKER_02]: sometimes it's just making sure

[00:41:55] [SPEAKER_02]: you get

[00:41:56] [SPEAKER_02]: the best eyes on it

[00:41:57] [SPEAKER_02]: that you can

[00:41:58] [SPEAKER_02]: you're going to find it

[00:41:59] [SPEAKER_02]: but patients

[00:42:01] [SPEAKER_02]: with consistent biting symptoms

[00:42:02] [SPEAKER_02]: they've got a crack in there

[00:42:03] [SPEAKER_02]: somewhere

[00:42:04] [SPEAKER_02]: the bugger of it is

[00:42:05] [SPEAKER_02]: if they're not sure

[00:42:05] [SPEAKER_02]: which tooth it is

[00:42:06] [SPEAKER_02]: that's where a cotton roll

[00:42:07] [SPEAKER_02]: the tooth sleuth is really helpful

[00:42:09] [SPEAKER_00]: yeah

[00:42:10] [SPEAKER_00]: okay

[00:42:11] [SPEAKER_00]: and then kind of

[00:42:12] [SPEAKER_00]: my last clinical question

[00:42:13] [SPEAKER_00]: that I had for you

[00:42:14] [SPEAKER_00]: it's kind of a heavy one

[00:42:17] is

[00:42:17] [SPEAKER_00]: and I have a feeling

[00:42:18] [SPEAKER_00]: the answer is not going to be

[00:42:19] [SPEAKER_00]: so straightforward

[00:42:20] [SPEAKER_00]: but when do you think

[00:42:20] [SPEAKER_00]: a tooth becomes non-restorable

[00:42:23] [SPEAKER_00]: like what is your kind of checklist

[00:42:24] [SPEAKER_00]: of things you look for

[00:42:25] [SPEAKER_00]: when you're deciding

[00:42:26] [SPEAKER_00]: whether to restore a tooth

[00:42:28] [SPEAKER_02]: that's a great question

[00:42:29] [SPEAKER_02]: in a lot of times

[00:42:32] [SPEAKER_02]: it depends on

[00:42:37] [SPEAKER_02]: it kind of depends on

[00:42:38] [SPEAKER_02]: sometimes it's

[00:42:39] [SPEAKER_02]: sometimes it's

[00:42:42] [SPEAKER_02]: I'll tell you what

[00:42:43] [SPEAKER_02]: sometimes it depends on

[00:42:44] [SPEAKER_02]: how well

[00:42:44] [SPEAKER_02]: how well the patient tolerates

[00:42:45] [SPEAKER_02]: being worked on

[00:42:46] [SPEAKER_02]: you know

[00:42:47] [SPEAKER_02]: I will I'll bail on a tooth

[00:42:49] [SPEAKER_02]: it's going to be super hard to restore

[00:42:50] [SPEAKER_02]: just because they don't open well

[00:42:51] [SPEAKER_02]: or they don't tolerate stuff very well

[00:42:53] [SPEAKER_02]: that's when the but

[00:42:55] [SPEAKER_02]: and I will say this

[00:42:56] [SPEAKER_02]: I am probably

[00:42:57] [SPEAKER_02]: I do probably more

[00:42:58] [SPEAKER_02]: hero donics than someone

[00:43:01] [SPEAKER_02]: my age and experience level should

[00:43:03] [SPEAKER_02]: I'm a sucker

[00:43:04] [SPEAKER_02]: is what it comes down to

[00:43:05] [SPEAKER_02]: I probably do more of that stuff

[00:43:06] [SPEAKER_02]: than I should

[00:43:09] [SPEAKER_02]: I don't know

[00:43:10] [SPEAKER_02]: I'm like I said

[00:43:12] [SPEAKER_02]: I'm probably more heroic

[00:43:12] [SPEAKER_02]: I what is what is an unrestorable tooth

[00:43:14] [SPEAKER_02]: well I feel like it's

[00:43:16] [SPEAKER_02]: it's like obscenity

[00:43:17] [SPEAKER_02]: I'll know when I see it

[00:43:19] [SPEAKER_02]: you know

[00:43:20] [SPEAKER_02]: I've seen people that'll

[00:43:21] [SPEAKER_02]: that'll restore root tips

[00:43:22] [SPEAKER_02]: effectively

[00:43:22] [SPEAKER_02]: like oh my god

[00:43:23] [SPEAKER_02]: but like

[00:43:26] [SPEAKER_02]: what kind of things do you

[00:43:27] [SPEAKER_02]: what kind of things do you think

[00:43:29] [SPEAKER_02]: I'm going to say

[00:43:29] [SPEAKER_02]: if I can't get a margin

[00:43:31] [SPEAKER_02]: if I can't get a margin

[00:43:33] [SPEAKER_02]: a clean margin

[00:43:34] [SPEAKER_02]: and that's now

[00:43:34] [SPEAKER_02]: it's typically with a scanner

[00:43:36] [SPEAKER_02]: which really interesting

[00:43:37] [SPEAKER_02]: is sometimes back in the day

[00:43:38] [SPEAKER_02]: I figure I could get a margin

[00:43:39] [SPEAKER_02]: with polyvinyl

[00:43:40] [SPEAKER_02]: that I couldn't get with a scanner

[00:43:41] [SPEAKER_02]: well now I'm like

[00:43:42] [SPEAKER_02]: I'm not sure I want to rely on that

[00:43:44] [SPEAKER_02]: I just because I can get a

[00:43:46] [SPEAKER_02]: sometimes I don't want to do that

[00:43:51] god

[00:43:53] [SPEAKER_02]: unrestorable

[00:43:54] [SPEAKER_02]: yeah those are all good

[00:43:55] [SPEAKER_02]: it's funny

[00:43:55] [SPEAKER_02]: I know when I see them

[00:43:58] [SPEAKER_02]: but it's hard to describe it

[00:43:59] [SPEAKER_02]: I guess

[00:43:59] [SPEAKER_02]: what kills me is how

[00:44:01] [SPEAKER_02]: how we as a profession

[00:44:02] [SPEAKER_02]: have changed

[00:44:03] [SPEAKER_02]: it's one thing

[00:44:04] [SPEAKER_02]: it's one unrestorable tooth

[00:44:06] [SPEAKER_02]: it blows my mind

[00:44:07] [SPEAKER_02]: how quickly we are going

[00:44:09] [SPEAKER_02]: to a terminal dentition

[00:44:10] [SPEAKER_02]: on teeth that I think I could restore

[00:44:11] [SPEAKER_02]: so I mean

[00:44:12] [SPEAKER_02]: it isn't as cut and dried

[00:44:14] [SPEAKER_02]: and a lot of times

[00:44:15] [SPEAKER_02]: it has something to do

[00:44:16] [SPEAKER_02]: with the patient toleration too

[00:44:18] [SPEAKER_02]: here's the thing

[00:44:20] [SPEAKER_02]: there's teeth

[00:44:20] [SPEAKER_02]: that are unrestorable

[00:44:22] [SPEAKER_02]: because they physically

[00:44:23] [SPEAKER_02]: are unrestorable

[00:44:23] [SPEAKER_02]: and there's teeth

[00:44:24] [SPEAKER_02]: that are unrestorable

[00:44:24] [SPEAKER_02]: because the patient is going

[00:44:26] [SPEAKER_02]: to be mad at you

[00:44:27] [SPEAKER_02]: if you go out

[00:44:28] [SPEAKER_02]: and be heroic

[00:44:28] [SPEAKER_02]: and so you

[00:44:29] [SPEAKER_02]: I don't recommend here

[00:44:33] [SPEAKER_02]: Donniex

[00:44:33] [SPEAKER_02]: but if you're going to do it

[00:44:34] [SPEAKER_02]: it's good to have a good long

[00:44:36] [SPEAKER_02]: conversation with the patient

[00:44:37] [SPEAKER_02]: and at some point

[00:44:38] [SPEAKER_02]: part of the conversation

[00:44:39] [SPEAKER_02]: has got to be

[00:44:40] [SPEAKER_02]: are you going to be mad at me

[00:44:41] [SPEAKER_02]: if

[00:44:42] [SPEAKER_02]: you know fill in the blank

[00:44:43] [SPEAKER_02]: you can be mad at me

[00:44:44] [SPEAKER_02]: if this doesn't work

[00:44:45] [SPEAKER_02]: that's a that's kind of a big deal

[00:44:46] [SPEAKER_02]: that's I think it's a really big deal

[00:44:48] [SPEAKER_00]: yeah I think

[00:44:50] [SPEAKER_00]: it's definitely

[00:44:51] [SPEAKER_00]: I definitely don't have

[00:44:52] [SPEAKER_00]: like a philosophy on this yet

[00:44:54] [SPEAKER_00]: but I've been

[00:44:55] [SPEAKER_00]: I don't know just consuming content

[00:44:57] [SPEAKER_00]: and I

[00:44:58] [SPEAKER_00]: tend to feel that

[00:45:01] [SPEAKER_00]: I don't know

[00:45:02] [SPEAKER_00]: maybe in Europe

[00:45:03] [SPEAKER_00]: they're more willing to

[00:45:05] [SPEAKER_00]: like restore teeth

[00:45:06] [SPEAKER_00]: with no ferrule at all

[00:45:08] [SPEAKER_00]: yeah they'll do like

[00:45:09] [SPEAKER_00]: like you're saying

[00:45:10] [SPEAKER_00]: like they'll basically restore a root tip

[00:45:11] [SPEAKER_00]: like they'll do deep marginality

[00:45:12] [SPEAKER_02]: short clinical

[00:45:15] [SPEAKER_02]: crowns

[00:45:16] [SPEAKER_02]: are full of heartache for me

[00:45:18] [SPEAKER_02]: particularly anterior teeth

[00:45:19] [SPEAKER_02]: where you're like

[00:45:20] [SPEAKER_02]: well this root canal looks terrific

[00:45:22] [SPEAKER_02]: and the tooth's in fine shape

[00:45:23] [SPEAKER_02]: I just don't have very much to stick to

[00:45:24] [SPEAKER_02]: and then you decide

[00:45:25] [SPEAKER_02]: you're going to try and do a post

[00:45:26] [SPEAKER_02]: and that's the tooth

[00:45:27] [SPEAKER_02]: that shows up four or five times

[00:45:29] [SPEAKER_02]: with the

[00:45:30] [SPEAKER_02]: the crown and post in their hand

[00:45:31] [SPEAKER_02]: and they're

[00:45:32] [SPEAKER_02]: wanting you to keep you out

[00:45:33] [SPEAKER_02]: I mean that's

[00:45:34] [SPEAKER_02]: that's

[00:45:35] [SPEAKER_02]: I've learned my lesson so many times

[00:45:36] [SPEAKER_02]: on that

[00:45:37] [SPEAKER_02]: and I'm

[00:45:37] [SPEAKER_02]: I will say this

[00:45:38] [SPEAKER_02]: okay upper lateral incisors

[00:45:41] [SPEAKER_02]: if the

[00:45:42] [SPEAKER_02]: ridge isn't wide enough

[00:45:43] [SPEAKER_02]: to get an implant in

[00:45:44] [SPEAKER_02]: I got to tell you what

[00:45:46] [SPEAKER_02]: canine cantilever bridges

[00:45:47] [SPEAKER_02]: to lateral incisors

[00:45:48] [SPEAKER_02]: are the bomb

[00:45:49] [SPEAKER_02]: you can make them look so good

[00:45:51] [SPEAKER_02]: and almost everyone's canines

[00:45:52] [SPEAKER_02]: got an inch and a half long

[00:45:54] [SPEAKER_02]: root on it

[00:45:54] [SPEAKER_02]: that you can

[00:45:55] [SPEAKER_02]: so the story is like

[00:45:58] don't

[00:45:58] [SPEAKER_02]: don't

[00:45:59] [SPEAKER_02]: lose your mind

[00:46:00] [SPEAKER_02]: on teeth

[00:46:01] [SPEAKER_02]: and lateral incisors

[00:46:02] [SPEAKER_02]: are the most common ones

[00:46:03] [SPEAKER_02]: that

[00:46:04] [SPEAKER_02]: that shear off at the gum line

[00:46:05] [SPEAKER_02]: so I have to tell you

[00:46:07] [SPEAKER_02]: in the last five years

[00:46:07] [SPEAKER_02]: I've done

[00:46:08] [SPEAKER_02]: I've done a lot of those

[00:46:10] [SPEAKER_02]: canine cantilevers

[00:46:11] [SPEAKER_02]: and they work out awesome

[00:46:13] [SPEAKER_02]: I mean when you can't

[00:46:14] [SPEAKER_02]: get an implant in the place

[00:46:15] [SPEAKER_02]: when it's too narrow

[00:46:16] [SPEAKER_02]: where the patient's not interested

[00:46:17] [SPEAKER_00]: yeah

[00:46:18] [SPEAKER_00]: so

[00:46:19] [SPEAKER_00]: when you say canine cantilever

[00:46:20] [SPEAKER_00]: you're prepping the canine

[00:46:22] [SPEAKER_00]: for full coverage

[00:46:23] [SPEAKER_00]: and then

[00:46:24] [SPEAKER_00]: you have just the cantilever

[00:46:25] [SPEAKER_00]: you can't leave her the lateral

[00:46:26] [SPEAKER_00]: yeah

[00:46:26] [SPEAKER_00]: okay because

[00:46:27] [SPEAKER_00]: because also

[00:46:27] [SPEAKER_00]: I've also heard about like

[00:46:29] [SPEAKER_00]: resin bonded bridges

[00:46:30] [SPEAKER_00]: which are not

[00:46:31] [SPEAKER_00]: like a full preparation

[00:46:33] [SPEAKER_00]: yep

[00:46:33] [SPEAKER_00]: and I

[00:46:34] [SPEAKER_00]: I don't really know much about them

[00:46:36] [SPEAKER_00]: but I was just curious

[00:46:36] [SPEAKER_00]: what you're doing

[00:46:37] [SPEAKER_02]: if you're

[00:46:38] [SPEAKER_02]: yeah if you're bold

[00:46:38] [SPEAKER_02]: and you know the materials

[00:46:39] [SPEAKER_02]: I don't feel like I know the materials

[00:46:41] [SPEAKER_02]: and let's be honest

[00:46:42] [SPEAKER_02]: probably that canine's got

[00:46:43] [SPEAKER_02]: a big honkin filling in and out

[00:46:45] [SPEAKER_02]: so it's I mean

[00:46:46] [SPEAKER_02]: case selection is important

[00:46:47] [SPEAKER_02]: I will say

[00:46:48] [SPEAKER_02]: the one thing about those

[00:46:49] [SPEAKER_02]: what I've found about

[00:46:50] [SPEAKER_02]: and I've heard

[00:46:51] [SPEAKER_02]: research has proven

[00:46:52] [SPEAKER_02]: Maryland bridges

[00:46:53] [SPEAKER_02]: or resin bonded bridges

[00:46:55] [SPEAKER_02]: don't

[00:46:56] [SPEAKER_02]: only bond it to one tooth

[00:46:57] [SPEAKER_02]: only bond it to the canine

[00:46:58] [SPEAKER_02]: like

[00:46:58] [SPEAKER_02]: we were taught Maryland bridges

[00:47:00] [SPEAKER_02]: that would go canine to

[00:47:02] [SPEAKER_02]: to the central

[00:47:02] [SPEAKER_02]: for the lateral incisor

[00:47:03] [SPEAKER_02]: and those come off more often

[00:47:06] [SPEAKER_02]: than when you're just taking

[00:47:07] [SPEAKER_02]: the one wing off the canine

[00:47:09] [SPEAKER_02]: that's an interesting thing

[00:47:10] [SPEAKER_02]: that teaches that in double

[00:47:11] [SPEAKER_02]: but that's my understanding

[00:47:13] [SPEAKER_02]: if you're going to do it

[00:47:14] [SPEAKER_02]: do it with one tooth

[00:47:15] [SPEAKER_02]: don't try and stick to

[00:47:16] [SPEAKER_02]: because there's enough

[00:47:18] [SPEAKER_02]: of that ligament movement

[00:47:20] [SPEAKER_02]: that you really only want to

[00:47:22] [SPEAKER_02]: attach it to one tooth

[00:47:24] [SPEAKER_02]: interesting

[00:47:25] [SPEAKER_00]: I think there's a lot of

[00:47:27] [SPEAKER_00]: good thoughts

[00:47:28] [SPEAKER_00]: good nuggets in here

[00:47:29] [SPEAKER_00]: so we were all over the place

[00:47:30] [SPEAKER_00]: yeah it was kind of

[00:47:31] [SPEAKER_00]: like weird little bits and pieces

[00:47:33] [SPEAKER_00]: but yeah

[00:47:33] [SPEAKER_00]: these were just like

[00:47:35] [SPEAKER_00]: some things I've been writing down

[00:47:37] [SPEAKER_00]: like things I want to ask somebody

[00:47:38] [SPEAKER_00]: because they're all been frustrations

[00:47:40] [SPEAKER_00]: I've had in clinic

[00:47:40] [SPEAKER_00]: so I'm glad I was able to get some answers

[00:47:43] [SPEAKER_00]: and I'm sure

[00:47:44] [SPEAKER_00]: some other dental students

[00:47:45] [SPEAKER_00]: will have been thinking

[00:47:46] [SPEAKER_00]: the same thing

[00:47:47] [SPEAKER_00]: so I think it was a good one

[00:47:49] [SPEAKER_00]: yeah so thanks Alan for being on

[00:47:51] [SPEAKER_00]: and make sure all the guests

[00:47:53] [SPEAKER_00]: to tune into

[00:47:55] [SPEAKER_00]: the episode we're going to do

[00:47:56] [SPEAKER_00]: on Alan's segment

[00:47:57] [SPEAKER_00]: which will probably be released

[00:47:59] [SPEAKER_00]: on a Friday in the coming weeks

[00:48:00] [SPEAKER_02]: yep that's right

[00:48:02] [SPEAKER_02]: we're going to talk about

[00:48:02] [SPEAKER_02]: what third year was like

[00:48:03] [SPEAKER_02]: so this is really good

[00:48:04] [SPEAKER_02]: thanks a lot my man

[00:48:06] [SPEAKER_02]: yep absolutely thank you