1 00:00:00,675 --> 00:00:02,742 Hi, everyone. It's hugh, and if you like 2 00:00:02,742 --> 00:00:04,649 me, Endo dom is a really scary part 3 00:00:04,649 --> 00:00:07,033 of dentistry. Today, I'm joined by doctor. Harry 4 00:00:07,113 --> 00:00:09,507 Mo, specialist endo on, and he walks us 5 00:00:09,507 --> 00:00:10,007 through 6 00:00:10,537 --> 00:00:12,915 workflows in Endo and the importance of stripping 7 00:00:12,915 --> 00:00:14,659 down the retreat before studying root canal. 8 00:00:15,467 --> 00:00:17,456 Doctor Mo is also running a Cp event 9 00:00:17,456 --> 00:00:18,967 where a hundred percent of the ticket goes 10 00:00:18,967 --> 00:00:21,433 to charity and includes fantastic speakers from all 11 00:00:21,433 --> 00:00:23,675 around the country. It's happening really soon on 12 00:00:23,675 --> 00:00:25,424 the seventeenth of August, so be sure to 13 00:00:25,424 --> 00:00:26,458 check it out in our show nights. 14 00:00:27,173 --> 00:00:29,320 I found this discussion really helpful and practical 15 00:00:29,320 --> 00:00:30,990 as I'm facing my first few canals in 16 00:00:31,069 --> 00:00:32,991 Denver school. And I really hope you find 17 00:00:32,991 --> 00:00:35,214 some good tips in it as well. Enjoy. 18 00:00:37,119 --> 00:00:39,366 I guess after I've done sort of my 19 00:00:39,898 --> 00:00:40,612 instrumentation, let's say, 20 00:00:41,342 --> 00:00:43,888 And I'm trying to close backup up getting 21 00:00:43,888 --> 00:00:45,161 ready for the next appointment. 22 00:00:45,558 --> 00:00:47,070 What should I be thinking about in these 23 00:00:47,070 --> 00:00:49,548 moments here? Yeah. I mean, I think I've 24 00:00:49,548 --> 00:00:50,048 probably 25 00:00:50,421 --> 00:00:51,930 even taken a few steps back. 26 00:00:52,883 --> 00:00:53,383 So, 27 00:00:53,756 --> 00:00:55,686 you know, if we really wanna 28 00:00:56,314 --> 00:00:59,662 dive deep ti that rest aspects of Endo. 29 00:00:59,821 --> 00:01:00,858 And I think I think that's 1 of 30 00:01:00,858 --> 00:01:03,010 the things that's overlooked is that Endo is 31 00:01:03,010 --> 00:01:03,669 a rest 32 00:01:04,046 --> 00:01:05,916 specialty. It's it's so 33 00:01:06,531 --> 00:01:08,840 tidy with the rest aspects of dentistry. 34 00:01:09,875 --> 00:01:11,547 The first thing I'm always looking at when 35 00:01:11,627 --> 00:01:12,981 I see my patient, 36 00:01:13,634 --> 00:01:15,172 for a consultation is 37 00:01:15,550 --> 00:01:16,667 endo onyx aside, 38 00:01:17,625 --> 00:01:19,860 can this to be restored? And how can 39 00:01:19,860 --> 00:01:20,659 it be restored? 40 00:01:21,297 --> 00:01:22,117 And so 41 00:01:23,066 --> 00:01:24,734 I guess, we'll start right at the beginning 42 00:01:24,734 --> 00:01:25,552 with the diagnosis. 43 00:01:26,402 --> 00:01:29,579 Even there, I would always tell my, you 44 00:01:29,579 --> 00:01:31,882 know, my fellow practitioners and and students, 45 00:01:32,533 --> 00:01:34,681 you want to take a bite link for 46 00:01:34,681 --> 00:01:35,500 all your posterior. 47 00:01:36,432 --> 00:01:39,217 And you wanna assess the rest prognosis of 48 00:01:39,217 --> 00:01:41,388 that too that is part of your endo 49 00:01:41,938 --> 00:01:42,257 assessment. 50 00:01:43,055 --> 00:01:44,570 So why do we take a bike ring, 51 00:01:44,650 --> 00:01:46,426 not just a Pa, not just an Op 52 00:01:46,804 --> 00:01:48,181 because we wanna know 53 00:01:48,878 --> 00:01:51,111 a good assessment of the rest margin? 54 00:01:52,161 --> 00:01:54,549 In relation to the gen margin and in 55 00:01:54,549 --> 00:01:56,004 relation to the crest bone level 56 00:01:56,538 --> 00:01:57,038 because 57 00:01:57,414 --> 00:01:59,403 that's what's then gonna decide as part of 58 00:01:59,403 --> 00:02:00,677 my treatment planning, Okay. 59 00:02:01,328 --> 00:02:03,156 What's the rest started prognosis for this tooth? 60 00:02:03,713 --> 00:02:06,200 Is it just okay to place a direct 61 00:02:06,335 --> 00:02:08,345 restoration? Does it need crown lengthening 62 00:02:08,894 --> 00:02:10,903 well, I need to do some gin vector 63 00:02:11,117 --> 00:02:13,262 to get access to that. And, of course, 64 00:02:13,421 --> 00:02:15,883 all the other patient specific things like, okay. 65 00:02:16,121 --> 00:02:17,551 I can restore this but then can the 66 00:02:17,551 --> 00:02:20,351 patient maintain it. And so on. So that's 67 00:02:20,351 --> 00:02:21,785 kinda where it all all begins. 68 00:02:22,422 --> 00:02:23,161 And then 69 00:02:23,617 --> 00:02:25,153 the main thing I always 70 00:02:25,624 --> 00:02:26,823 So once we get to the sort of 71 00:02:26,823 --> 00:02:27,802 treatment phase 72 00:02:28,181 --> 00:02:29,380 at the first appointment, 73 00:02:30,259 --> 00:02:32,735 the difficulty is if you have a patient 74 00:02:32,735 --> 00:02:33,135 in pain, 75 00:02:34,189 --> 00:02:36,049 sometimes you've got maybe a 76 00:02:36,590 --> 00:02:38,370 45 minute appointment allocated, 77 00:02:38,989 --> 00:02:41,229 and it's an emergency, and you've gotta to 78 00:02:41,229 --> 00:02:41,969 work out 79 00:02:42,603 --> 00:02:43,581 What's the diagnosis? 80 00:02:44,277 --> 00:02:45,870 You've then got to develop a treatment plan 81 00:02:45,870 --> 00:02:46,588 to get consent, 82 00:02:47,384 --> 00:02:48,898 and then you've got it an ace type 83 00:02:48,898 --> 00:02:49,377 for patient. 84 00:02:50,109 --> 00:02:51,947 And then you gotta to execute the treat 85 00:02:51,947 --> 00:02:52,825 in 45 minutes. 86 00:02:53,624 --> 00:02:55,083 Sometimes you're spending 87 00:02:55,941 --> 00:02:57,000 15 20 minutes 88 00:02:57,395 --> 00:03:00,775 on the diagnosis and treatment plan, then another 89 00:03:01,395 --> 00:03:01,955 15 minutes, 90 00:03:02,435 --> 00:03:04,455 getting the patient adequately in ace. 91 00:03:05,088 --> 00:03:06,122 For example, hot pulp. 92 00:03:06,997 --> 00:03:08,986 Because in some cases the mean time for 93 00:03:08,986 --> 00:03:10,417 pulp anesthesia, it can be up to, you 94 00:03:10,417 --> 00:03:11,531 know, 15, 20 minutes. 95 00:03:12,103 --> 00:03:14,096 What are you left with? Something like 10 96 00:03:14,096 --> 00:03:16,907 minutes to execute your actual 97 00:03:17,364 --> 00:03:17,683 procedure. 98 00:03:18,241 --> 00:03:21,129 So in that situation, you're not gonna be 99 00:03:21,129 --> 00:03:21,949 able to 100 00:03:22,810 --> 00:03:24,810 strip the tooth and remove all the restoration, 101 00:03:25,370 --> 00:03:27,789 remove all, you know, the sort of undermined 102 00:03:28,330 --> 00:03:29,229 enamel and 103 00:03:29,703 --> 00:03:31,319 carries and all that stuff 104 00:03:31,934 --> 00:03:35,360 assess and then reconstruct the tooth and getting 105 00:03:35,360 --> 00:03:37,989 an the bolt. That's that's just not feasible. 106 00:03:38,148 --> 00:03:38,308 Right? 107 00:03:39,279 --> 00:03:41,911 So in that unique situation, you just wanna 108 00:03:41,911 --> 00:03:43,209 do some relief of pain 109 00:03:43,985 --> 00:03:45,660 and get your patient back. But once you're 110 00:03:45,660 --> 00:03:47,893 getting that patient back, or in the patient 111 00:03:47,893 --> 00:03:48,770 who's not in pain, 112 00:03:49,581 --> 00:03:52,361 you really need to allow adequate amount of 113 00:03:52,361 --> 00:03:53,656 time at Vis 1 114 00:03:54,268 --> 00:03:57,286 for the rest side of the endo procedure. 115 00:03:58,097 --> 00:03:59,293 And so for me, 116 00:03:59,930 --> 00:04:01,763 that comes back to how do we do 117 00:04:01,763 --> 00:04:04,551 the dental dam. I will always do multiple 118 00:04:04,551 --> 00:04:07,101 tooth isolation for my first visit of endo. 119 00:04:07,753 --> 00:04:11,089 So most people assume endo, dental dam, 1 120 00:04:11,089 --> 00:04:13,949 hole, 1 tooth, clamp it off we go. 121 00:04:15,158 --> 00:04:17,711 For me, at a minimum, I'm isolating the 122 00:04:17,711 --> 00:04:18,588 teeth either side. 123 00:04:19,865 --> 00:04:21,381 And at that first visit, 124 00:04:22,035 --> 00:04:23,314 and this is a little bit different when 125 00:04:23,314 --> 00:04:25,074 it's an indirect restoration when there's a crown, 126 00:04:25,475 --> 00:04:27,634 but assuming it's a a direct restoration, 127 00:04:28,754 --> 00:04:31,564 removing all the rest started materials I'm removing 128 00:04:31,564 --> 00:04:32,439 all the car, 129 00:04:32,995 --> 00:04:34,586 I'm getting, you know, 130 00:04:35,381 --> 00:04:37,448 leaving nothing at the margin. So if it's 131 00:04:37,448 --> 00:04:40,016 a d box, I'm fully removing that 132 00:04:40,804 --> 00:04:42,583 and this allows me to make sure 133 00:04:42,961 --> 00:04:45,199 I've got no more carries there, so I 134 00:04:45,199 --> 00:04:47,595 can confirm that my new restoration is good 135 00:04:47,595 --> 00:04:48,155 corona seal. 136 00:04:49,204 --> 00:04:51,350 And also I can assess, are there any 137 00:04:51,350 --> 00:04:51,850 cracks 138 00:04:52,383 --> 00:04:55,244 underneath to respiration, which again may affect the 139 00:04:55,244 --> 00:04:55,721 prognosis. 140 00:04:56,774 --> 00:04:58,472 And it's a 141 00:04:59,091 --> 00:05:01,888 very important lesson, and then a lesson I've 142 00:05:01,888 --> 00:05:03,507 learned and others have learned 143 00:05:04,045 --> 00:05:04,545 through 144 00:05:05,019 --> 00:05:07,180 they're basically ignoring the lesson in has. 145 00:05:07,660 --> 00:05:08,779 You know, sometimes you're like, 146 00:05:09,579 --> 00:05:11,740 come on. That looks alright. We'll just... Ignore 147 00:05:11,740 --> 00:05:13,669 that 1. And then, you know, you spend 148 00:05:13,669 --> 00:05:15,741 2, 3 visits. The tooth not settling down. 149 00:05:15,980 --> 00:05:17,573 Finally, you think, maybe, I should strip it 150 00:05:17,573 --> 00:05:19,485 all back, and there's a big crack underneath. 151 00:05:19,977 --> 00:05:22,462 And that explains why it didn't work 152 00:05:22,915 --> 00:05:24,820 how you need to approach things differently and 153 00:05:24,820 --> 00:05:25,138 so on. 154 00:05:26,170 --> 00:05:27,996 So that first is that I'm always suggesting 155 00:05:27,996 --> 00:05:28,734 that you 156 00:05:29,044 --> 00:05:30,399 allocate little bit extra, 157 00:05:31,275 --> 00:05:33,369 time for the rest respective side of things 158 00:05:33,586 --> 00:05:35,818 and that you really spend time stripping the 159 00:05:35,818 --> 00:05:36,296 tooth down, 160 00:05:37,107 --> 00:05:37,845 and then 161 00:05:38,220 --> 00:05:40,366 building up a good interim restoration. 162 00:05:41,638 --> 00:05:42,138 So 163 00:05:42,512 --> 00:05:44,420 there's a few... You you'll notice is the 164 00:05:44,420 --> 00:05:45,613 term interim restoration. 165 00:05:46,423 --> 00:05:47,640 It's not a temporary 166 00:05:48,016 --> 00:05:50,406 restoration. So why do we call that an 167 00:05:50,406 --> 00:05:52,977 interim restoration? What's the purpose of the interim 168 00:05:53,034 --> 00:05:55,996 restoration Is that I wanna have I wanna 169 00:05:55,996 --> 00:05:57,270 ensure I have a good colonel seal. 170 00:05:57,986 --> 00:06:01,408 I wanna ensure I have some reproducible stable 171 00:06:01,408 --> 00:06:03,717 reference points, so it's not gonna change throughout 172 00:06:03,717 --> 00:06:04,353 my procedures. 173 00:06:05,324 --> 00:06:07,476 I want it to be strong enough to 174 00:06:07,476 --> 00:06:10,347 last for several months in case I want 175 00:06:10,347 --> 00:06:12,579 to review the patient. So it has guarded 176 00:06:12,579 --> 00:06:13,615 prognosis, for example, 177 00:06:14,188 --> 00:06:16,094 I'm not just gonna go bang bang bang 178 00:06:16,094 --> 00:06:18,080 straight through Wack a crown on it. We're 179 00:06:18,080 --> 00:06:20,066 done, not that Id crown. But as an 180 00:06:20,066 --> 00:06:20,623 dentist right? 181 00:06:21,273 --> 00:06:23,101 I'm gonna wanna see some healing, so that 182 00:06:23,101 --> 00:06:24,770 takes time that takes 3 to 6 months 183 00:06:24,770 --> 00:06:25,088 minimum. 184 00:06:25,724 --> 00:06:27,870 So these restoration have to last that amount 185 00:06:27,870 --> 00:06:28,267 of time. 186 00:06:29,078 --> 00:06:29,578 So 187 00:06:30,036 --> 00:06:32,189 again, there, you got so many options for 188 00:06:32,189 --> 00:06:35,220 your interim restoration. So you could do... You 189 00:06:35,220 --> 00:06:37,453 may be familiar with stainless steel bands. 190 00:06:38,012 --> 00:06:38,512 So, 191 00:06:39,142 --> 00:06:40,654 I actually... Let's take a step back. So 192 00:06:40,654 --> 00:06:42,087 what was 1 of the other important things 193 00:06:42,087 --> 00:06:44,815 of the interim restoration is to provide cusp 194 00:06:45,191 --> 00:06:46,146 coverage protection. 195 00:06:46,799 --> 00:06:49,596 So reduce the likelihood of that tooth fracturing. 196 00:06:50,076 --> 00:06:51,594 So it's gonna have to last me 3 197 00:06:51,594 --> 00:06:52,873 to 6 months while I review the tooth. 198 00:06:53,033 --> 00:06:54,871 Well, I don't want to develop cracks or 199 00:06:54,871 --> 00:06:55,910 fracture during that time. 200 00:06:56,883 --> 00:06:59,117 So all these things are considerations. 201 00:07:00,234 --> 00:07:02,708 So, you know, there's some really good literature 202 00:07:02,708 --> 00:07:05,039 that that shows us that you know, once 203 00:07:05,039 --> 00:07:07,217 we lose a marginal ridge on a posterior 204 00:07:07,276 --> 00:07:08,954 to a model or or a prem mold, 205 00:07:09,833 --> 00:07:10,892 it becomes very 206 00:07:11,671 --> 00:07:12,790 susceptible to fracture. 207 00:07:13,684 --> 00:07:16,320 However, if we were then to overlay those 208 00:07:16,320 --> 00:07:20,155 cusp, so build them with composite overlay or 209 00:07:20,155 --> 00:07:22,395 what called a Gi dome, which is effectively 210 00:07:22,395 --> 00:07:25,097 a Gi overlay or if we cement a 211 00:07:25,097 --> 00:07:26,606 stainless steel band around the tooth. 212 00:07:27,401 --> 00:07:28,775 That then reinforces 213 00:07:29,244 --> 00:07:32,275 those cusp, and it provides some fracture resistance. 214 00:07:33,072 --> 00:07:35,225 So when we're planning our interim restoration, we 215 00:07:35,225 --> 00:07:37,219 wanna have 1 of those 3 things, either 216 00:07:37,219 --> 00:07:38,256 at composite Overlay, 217 00:07:38,909 --> 00:07:42,407 a Gi overlay or a stainless steel band. 218 00:07:43,282 --> 00:07:45,349 In my practice, and in in my experience, 219 00:07:45,746 --> 00:07:48,211 I'm much more comfortable with composite overlays. 220 00:07:48,864 --> 00:07:49,903 Because they're strong. 221 00:07:50,782 --> 00:07:53,260 They look nice, they're easy to keep clean. 222 00:07:54,139 --> 00:07:56,616 Gi overlays, they can be quite brittle and 223 00:07:56,616 --> 00:07:58,547 over time that I last that 6 to 224 00:07:58,547 --> 00:08:00,616 12 months I might need sometimes we'll review. 225 00:08:01,332 --> 00:08:02,207 Stainless steel baths. 226 00:08:02,763 --> 00:08:04,036 They're very hard to keep clean. 227 00:08:04,593 --> 00:08:07,655 And also, I feel like sometimes these interim 228 00:08:07,792 --> 00:08:09,327 restoration like, you know, best practices, 229 00:08:09,941 --> 00:08:11,932 you know, we do the Rc, and we 230 00:08:11,932 --> 00:08:13,936 say please see a dentist and have a 231 00:08:13,936 --> 00:08:17,374 definitive restoration, you, you know, indirect placed within 232 00:08:17,588 --> 00:08:18,382 next couple of months. 233 00:08:19,573 --> 00:08:21,813 5 years later, the patient turns are they're 234 00:08:21,813 --> 00:08:24,366 still got a stainless steel brand on. It's 235 00:08:24,366 --> 00:08:26,360 retained food and plaque for the last 5 236 00:08:26,360 --> 00:08:28,832 years. You know, they've got ginger dividers or 237 00:08:28,832 --> 00:08:32,059 period old disease or adjacent care or secondary 238 00:08:32,116 --> 00:08:32,434 carries. 239 00:08:32,991 --> 00:08:35,059 So for those reasons, I I'm not... I've 240 00:08:35,059 --> 00:08:37,207 moved away from using stainless steel bands in 241 00:08:37,207 --> 00:08:40,093 my personal practice, and I've shifted towards 242 00:08:40,404 --> 00:08:42,954 a composite ob. So at my first appointment, 243 00:08:43,511 --> 00:08:46,459 I actually allow adequate time to strip that 244 00:08:46,459 --> 00:08:47,517 tooth right back 245 00:08:47,828 --> 00:08:49,897 build it up with a composite overlay and 246 00:08:49,897 --> 00:08:51,647 then get right back into the tooth and 247 00:08:51,647 --> 00:08:54,533 actually start my my procedures. I see 248 00:08:54,925 --> 00:08:56,845 Yeah. Right. Okay. So that's what you mean. 249 00:08:57,085 --> 00:08:59,425 Stripping down the tooth, getting rid of everything 250 00:08:59,644 --> 00:09:00,144 that 251 00:09:00,524 --> 00:09:03,004 carries anything, having a look a good look 252 00:09:03,004 --> 00:09:03,485 at the tooth. 253 00:09:04,139 --> 00:09:05,577 Is that when you take that bite wing 254 00:09:05,577 --> 00:09:07,096 then or you take it beforehand, 255 00:09:07,655 --> 00:09:09,413 and then you see... Oh, no. So my 256 00:09:09,413 --> 00:09:11,511 bike wing? I'm taking at my my diagnosis? 257 00:09:11,730 --> 00:09:13,743 So what, you know, It's gonna aid me 258 00:09:13,743 --> 00:09:15,980 my diagnosis, taking that bite then and there. 259 00:09:16,539 --> 00:09:19,495 Once I've started the actual treatment is when 260 00:09:19,655 --> 00:09:22,149 I'm doing that process. So I've got my 261 00:09:22,149 --> 00:09:23,350 multiple tooth isolation. 262 00:09:24,230 --> 00:09:26,790 I've removed all the restoration from the tooth. 263 00:09:27,350 --> 00:09:28,309 Got, you know, 264 00:09:29,043 --> 00:09:31,593 naked it. And then at that point, actually, 265 00:09:31,673 --> 00:09:33,266 you gotta make a decision. So once you've 266 00:09:33,266 --> 00:09:35,497 removed all the carries and so on, you 267 00:09:35,497 --> 00:09:37,250 kinda have to decide, do I go into 268 00:09:37,250 --> 00:09:38,467 the pulp chamber 269 00:09:38,858 --> 00:09:40,211 Or do I build up and then go 270 00:09:40,211 --> 00:09:41,722 back into the pulp chamber? Mh. 271 00:09:42,358 --> 00:09:43,870 How do you decide between which 1 you 272 00:09:43,870 --> 00:09:46,353 go for? Yeah. So in kinda, a few 273 00:09:46,353 --> 00:09:48,427 things plays into it. 1 is the quality 274 00:09:48,427 --> 00:09:50,901 of your isolation. So did your 3 hole 275 00:09:50,901 --> 00:09:52,816 or 4 hole or multi isolation? Is it 276 00:09:52,816 --> 00:09:55,055 holding up? So, you know, no saliva would 277 00:09:55,055 --> 00:09:56,166 get in there if you went in there. 278 00:09:57,039 --> 00:09:59,420 Ideally, that should be a tick. So let's 279 00:09:59,420 --> 00:10:01,741 say it is holding up. I'm always gonna 280 00:10:01,741 --> 00:10:02,697 try and going in first. 281 00:10:03,335 --> 00:10:06,784 Because again, it's about learning all those informations 282 00:10:06,842 --> 00:10:08,857 as fast as I can. So 283 00:10:09,169 --> 00:10:10,523 I then I've strip the tooth. 284 00:10:11,081 --> 00:10:12,913 I could see. I'm at I'm very close 285 00:10:12,913 --> 00:10:13,790 to the pulp chamber. 286 00:10:14,746 --> 00:10:17,070 I'm just gonna go straight in and assess 287 00:10:17,070 --> 00:10:18,342 because what if I go in and then 288 00:10:18,422 --> 00:10:19,694 I find a big crack in the tooth. 289 00:10:20,251 --> 00:10:22,795 Well, then I'm not gonna bother spending ages 290 00:10:22,795 --> 00:10:24,783 making a beautiful composite and going back in. 291 00:10:24,942 --> 00:10:25,760 I'm just gonna 292 00:10:26,469 --> 00:10:29,043 you know, pop on a satisfactory, Gi 293 00:10:29,420 --> 00:10:30,297 restoration and say, hey, 294 00:10:31,334 --> 00:10:34,604 actually, I'm updating the prognosis to paul, and 295 00:10:34,684 --> 00:10:36,692 I really think instead of this, we should 296 00:10:36,692 --> 00:10:38,919 be looking at removing it tooth. So at 297 00:10:38,919 --> 00:10:40,828 that point, I would say get into the 298 00:10:40,828 --> 00:10:41,226 chamber, 299 00:10:41,942 --> 00:10:44,269 and then you have to put some sort 300 00:10:44,269 --> 00:10:46,350 of barrier in the chamber so that when 301 00:10:46,350 --> 00:10:46,990 you do your... 302 00:10:48,190 --> 00:10:50,429 What we call a pre endo buildup concert 303 00:10:50,429 --> 00:10:50,830 builder. 304 00:10:51,309 --> 00:10:52,050 You don't 305 00:10:52,363 --> 00:10:54,109 feel the chamber composite, which should be a 306 00:10:54,109 --> 00:10:56,492 nightmare there. So once I've gotten into the 307 00:10:56,492 --> 00:10:58,103 chamber and assessed 308 00:10:58,636 --> 00:10:58,953 happy. 309 00:10:59,509 --> 00:11:01,097 I'll then put some cabo on. 310 00:11:01,750 --> 00:11:03,429 In the chamber and then build it up. 311 00:11:03,909 --> 00:11:05,669 And for you guys as, you know, 312 00:11:06,309 --> 00:11:06,709 students, 313 00:11:07,669 --> 00:11:09,990 you know, early clinicians, general dentists, 314 00:11:10,963 --> 00:11:13,530 that's actually a good stage to determine 315 00:11:14,064 --> 00:11:16,131 case complexity as well. Because you get into 316 00:11:16,131 --> 00:11:18,755 the chamber and you're like, oh, this is 317 00:11:18,755 --> 00:11:19,653 really cal. 318 00:11:20,679 --> 00:11:23,151 Or, like, or, I I can't find anything. 319 00:11:24,028 --> 00:11:25,941 Well, that might be a a point where 320 00:11:25,941 --> 00:11:27,297 he's say okay. Well, you know what? I've 321 00:11:27,297 --> 00:11:28,812 learned really early in the case. 322 00:11:29,703 --> 00:11:31,689 That maybe this is 1 I need a 323 00:11:31,689 --> 00:11:33,515 hand with, or maybe this is 1 I 324 00:11:33,515 --> 00:11:34,071 need to refer. 325 00:11:35,024 --> 00:11:37,566 Because again, from a patient management standpoint, 326 00:11:37,978 --> 00:11:39,831 the more you sort of 327 00:11:40,444 --> 00:11:43,092 screw around in a tooth before you realize 328 00:11:43,229 --> 00:11:43,945 this is too hard. 329 00:11:44,581 --> 00:11:46,172 Then when the patient sees me or whoever 330 00:11:46,172 --> 00:11:47,536 it is they see, but they're kinda like, 331 00:11:47,615 --> 00:11:49,676 oh man. I already spent 3 visits on 332 00:11:49,676 --> 00:11:51,895 this thing and now you're telling me you 333 00:11:51,895 --> 00:11:53,639 have to spend another 2 visits, like, 334 00:11:54,688 --> 00:11:57,322 it just develops this sort of frustrated mentality 335 00:11:57,322 --> 00:11:59,476 for the patient. So, again, it's it's sort 336 00:11:59,476 --> 00:12:01,471 of about getting all those assessments early on, 337 00:12:01,551 --> 00:12:01,711 like, 338 00:12:02,524 --> 00:12:04,044 same thing, Why do we strip the tooth 339 00:12:04,044 --> 00:12:06,044 at the beginning. Why do we take that 340 00:12:06,044 --> 00:12:07,884 bite wing? So I know... Okay. 341 00:12:08,524 --> 00:12:10,044 Oh, wow. We can do this, but we 342 00:12:10,044 --> 00:12:11,404 don't need surgical Crown lint? 343 00:12:11,979 --> 00:12:13,894 But that's not my area of expertise. Okay. 344 00:12:14,054 --> 00:12:16,230 I need to employ the assistance of 345 00:12:16,687 --> 00:12:18,762 someone else who does surgical crown lengthening either 346 00:12:18,762 --> 00:12:21,335 in my office or a period on or 347 00:12:21,335 --> 00:12:22,054 nothing like that. 348 00:12:22,855 --> 00:12:25,914 So again, I wanna find that out early 349 00:12:26,294 --> 00:12:27,975 because I don't wanna then go through and 350 00:12:27,975 --> 00:12:28,875 do all endo 351 00:12:29,269 --> 00:12:30,950 Then I send it to the surgical crown 352 00:12:30,950 --> 00:12:33,429 lengthening person and and because they know more 353 00:12:33,429 --> 00:12:35,429 about surgical crown lengthening than I do, they 354 00:12:35,429 --> 00:12:37,190 came around and say, we can't do surgical 355 00:12:37,190 --> 00:12:39,122 crown lengthening on this too. It has to 356 00:12:39,122 --> 00:12:39,680 be extracted. 357 00:12:40,317 --> 00:12:42,150 So these are the things, you know, in 358 00:12:42,150 --> 00:12:44,221 terms of your workflow, you kinda wanna find 359 00:12:44,221 --> 00:12:45,098 these things out early, 360 00:12:46,149 --> 00:12:48,950 get assessments done early by any other parties 361 00:12:48,950 --> 00:12:51,429 that you need to involve and then move 362 00:12:51,429 --> 00:12:51,669 on. 363 00:12:52,549 --> 00:12:54,070 Another reason why we strip the tooth is 364 00:12:54,070 --> 00:12:55,522 if we strip it right back and we're 365 00:12:55,522 --> 00:12:57,676 like, more, this carries as way worse than 366 00:12:57,676 --> 00:12:58,713 it looked on the bike. 367 00:12:59,272 --> 00:13:00,468 It can't be restored. 368 00:13:01,585 --> 00:13:03,985 Again, Wanna know that before I've just wasted 369 00:13:03,985 --> 00:13:06,209 the patients 2 and 3 visits on an 370 00:13:06,288 --> 00:13:06,788 Rc, 371 00:13:07,321 --> 00:13:08,751 then they go and see the dentist and 372 00:13:08,751 --> 00:13:09,386 the dentist like, 373 00:13:10,593 --> 00:13:11,389 what do you want me to do with 374 00:13:11,389 --> 00:13:11,469 this? 375 00:13:12,424 --> 00:13:12,924 So 376 00:13:13,299 --> 00:13:15,368 that's kind of the mentality and the approach 377 00:13:15,368 --> 00:13:16,425 to workflows 378 00:13:16,880 --> 00:13:19,121 and why it's you know, the earlier, you 379 00:13:19,121 --> 00:13:20,893 can you can get all this stuff 380 00:13:21,267 --> 00:13:22,403 sort of found out 381 00:13:22,936 --> 00:13:24,049 the better. Right? 382 00:13:25,003 --> 00:13:25,162 Okay. 383 00:13:26,053 --> 00:13:28,686 Very nice. So we've done the composite or 384 00:13:28,686 --> 00:13:30,861 in your preference, the composite overlay 385 00:13:31,399 --> 00:13:32,617 and where 386 00:13:33,247 --> 00:13:34,914 go back into the tooth now and do 387 00:13:34,914 --> 00:13:38,247 our instrumentation now, and then we're doing our 388 00:13:38,247 --> 00:13:40,016 interim, I guess, temp 389 00:13:40,786 --> 00:13:41,286 interim 390 00:13:42,470 --> 00:13:44,538 restoration. Is that just with a G over, 391 00:13:44,856 --> 00:13:47,981 like the access cavity? And then when we're 392 00:13:48,769 --> 00:13:50,623 doing is that always a covered in Gi 393 00:13:50,680 --> 00:13:53,787 for, like, the interim stages, like, between appointments? 394 00:13:54,185 --> 00:13:56,176 Yeah. So it's a really good question. 395 00:13:56,813 --> 00:13:57,313 So 396 00:13:57,865 --> 00:13:58,365 We've 397 00:13:59,065 --> 00:14:01,625 stripped the tooth. We decided to take a 398 00:14:01,625 --> 00:14:03,785 peek at the pulp chamber, put some cabo 399 00:14:03,785 --> 00:14:05,384 there and we've done out build up. 400 00:14:06,358 --> 00:14:07,554 We have sort of adjusted it and got 401 00:14:07,554 --> 00:14:10,346 a nice flat, stable reference table that we 402 00:14:10,346 --> 00:14:11,542 can use for all our measurements. 403 00:14:12,659 --> 00:14:14,334 We then go back into the tooth and 404 00:14:14,334 --> 00:14:15,211 take that cabo out. 405 00:14:15,943 --> 00:14:17,694 And we're we're ready to to rock and 406 00:14:17,694 --> 00:14:17,853 roll. 407 00:14:18,570 --> 00:14:20,480 We find all our canals we take our 408 00:14:20,480 --> 00:14:22,015 lens. We do whatever 409 00:14:22,629 --> 00:14:25,198 instrumentation we need to. We've then dressed the 410 00:14:25,669 --> 00:14:26,388 the canals. 411 00:14:27,505 --> 00:14:29,661 How do you temp it at this point? 412 00:14:30,140 --> 00:14:32,236 Again, what is the point of the temporary 413 00:14:32,455 --> 00:14:32,615 restoration? 414 00:14:33,573 --> 00:14:34,392 It should be? 415 00:14:35,821 --> 00:14:36,639 And it should 416 00:14:37,095 --> 00:14:37,333 again, 417 00:14:38,448 --> 00:14:41,871 maintain our seal. That's the primary concern here. 418 00:14:42,030 --> 00:14:44,913 Is between appointments I do not want contamination 419 00:14:44,913 --> 00:14:45,471 getting in there. 420 00:14:46,428 --> 00:14:46,928 So 421 00:14:47,464 --> 00:14:50,014 I would never ever ever place a cotton 422 00:14:50,014 --> 00:14:51,051 pellet in the pulp chamber. 423 00:14:51,624 --> 00:14:52,501 We got we got we gotta think of 424 00:14:52,501 --> 00:14:53,459 2 things we're the thing of what we're 425 00:14:53,459 --> 00:14:54,735 gonna put in the pulp chamber and what 426 00:14:54,735 --> 00:14:56,411 are we gonna put in the access cavity. 427 00:14:57,528 --> 00:14:59,773 So in the pulp chamber, common things people 428 00:14:59,773 --> 00:15:01,679 are putting in there is cotton pellets, 429 00:15:02,315 --> 00:15:03,109 teflon tape, 430 00:15:04,301 --> 00:15:04,801 sponge 431 00:15:05,651 --> 00:15:06,151 and 432 00:15:06,525 --> 00:15:06,763 cabo. 433 00:15:07,573 --> 00:15:07,733 Alright? 434 00:15:08,450 --> 00:15:09,806 Of all of the ones I mentioned, 435 00:15:10,523 --> 00:15:12,755 only 1 of them is a rest restarted 436 00:15:12,755 --> 00:15:13,074 material. 437 00:15:13,712 --> 00:15:16,277 The others are just kinda space pillars. Where 438 00:15:16,277 --> 00:15:18,104 did this cotton and pellet thing come from? 439 00:15:18,342 --> 00:15:20,487 Because I've heard of it, and I'm surely 440 00:15:20,487 --> 00:15:21,679 a dental school you should be at the 441 00:15:21,679 --> 00:15:22,553 forefront of, like, 442 00:15:23,204 --> 00:15:24,823 Danielle Yeah. Well, here 443 00:15:25,362 --> 00:15:27,279 you're a university you're sydney student, so you 444 00:15:27,279 --> 00:15:28,798 would never use a cotton fill, of course. 445 00:15:29,517 --> 00:15:32,428 But, yeah. You know, it's it is a 446 00:15:32,566 --> 00:15:34,103 common thing because people 447 00:15:34,641 --> 00:15:36,077 want something that can put in and take 448 00:15:36,077 --> 00:15:36,795 it out easy, 449 00:15:37,354 --> 00:15:39,363 and, you know, it's not gonna block they 450 00:15:39,363 --> 00:15:40,877 can say are, what if it blocks my 451 00:15:40,877 --> 00:15:41,674 canals blah blah but. 452 00:15:42,471 --> 00:15:44,884 My concern is, what if your Gi 453 00:15:45,579 --> 00:15:46,216 excess seal? 454 00:15:47,107 --> 00:15:48,560 Your class 1 Gi, 455 00:15:49,886 --> 00:15:51,792 d bonds or fractures or whatever, 456 00:15:52,348 --> 00:15:53,936 you know, if I got Cabo, that's a 457 00:15:53,936 --> 00:15:54,412 double seal. 458 00:15:54,984 --> 00:15:57,221 If I've got cotton pellet. I mean, that's 459 00:15:57,221 --> 00:15:59,538 just a sponge that's gonna fill up with 460 00:15:59,538 --> 00:16:02,015 saliva and food and and so on, You 461 00:16:02,015 --> 00:16:04,185 know? Same thing with Teflon. I mean, what's 462 00:16:04,264 --> 00:16:06,577 Teflon tape? It's not a restoring material. It's 463 00:16:06,577 --> 00:16:08,811 just a space filler. There's each the space 464 00:16:08,811 --> 00:16:11,283 around it? It's not gonna provide any corona 465 00:16:11,283 --> 00:16:12,501 seal. It's just 466 00:16:12,813 --> 00:16:13,528 providing space. 467 00:16:14,164 --> 00:16:16,310 Same thing with any form of sponge that 468 00:16:16,310 --> 00:16:18,376 you put in there. So I would I 469 00:16:18,376 --> 00:16:20,840 would have always advise use started material that 470 00:16:20,840 --> 00:16:23,563 can be retrieved, so that's gonna be Cabo 471 00:16:23,563 --> 00:16:26,035 in my view. And that's easy to retrieve. 472 00:16:26,274 --> 00:16:27,948 You just break it up with an ultrasonic. 473 00:16:28,426 --> 00:16:30,315 The common question I get is all, but 474 00:16:30,514 --> 00:16:32,434 what if it went down the canal and 475 00:16:32,434 --> 00:16:34,434 block the canal. So, you know, you're gonna 476 00:16:34,434 --> 00:16:36,195 you're gonna use some common sense, and you 477 00:16:36,195 --> 00:16:39,490 gotta roll your c into a sausage that 478 00:16:39,490 --> 00:16:42,450 sort of suits the access cavity size. So 479 00:16:42,450 --> 00:16:43,649 if you gotta a if you got a 480 00:16:43,649 --> 00:16:45,809 upper central inc, which would be the time 481 00:16:45,809 --> 00:16:47,410 where the cabin might go down with a 482 00:16:47,410 --> 00:16:50,297 b massive canal. And you roll a teeny 483 00:16:50,297 --> 00:16:52,446 tiny sausage. Yeah. It's gonna go down the 484 00:16:52,446 --> 00:16:53,879 canal. So you're not gonna do that. You're 485 00:16:53,879 --> 00:16:56,506 gonna roll it an appropriately size 1 that 486 00:16:56,506 --> 00:16:58,336 have some resistance when you push it, it's 487 00:16:58,336 --> 00:17:00,733 gonna hit the walls, and it's gonna stay 488 00:17:00,733 --> 00:17:02,399 it. And then when you come back with 489 00:17:02,399 --> 00:17:03,669 your ultra ultrasonic it, you're just gonna break 490 00:17:03,669 --> 00:17:04,700 it up and it'll wash out. 491 00:17:05,573 --> 00:17:07,821 So that's my my view on what you 492 00:17:07,821 --> 00:17:08,699 put in the chamber? 493 00:17:09,896 --> 00:17:12,132 What you put in the access cavity itself. 494 00:17:12,531 --> 00:17:14,846 I mean, in Australia, typically, we're just gonna 495 00:17:14,846 --> 00:17:16,059 use Gi. 496 00:17:16,458 --> 00:17:18,057 If you wanna make it really easy for 497 00:17:18,057 --> 00:17:19,974 yourself, you're gonna use a colored Gi. That's 498 00:17:19,974 --> 00:17:21,413 different to the rest of the 2. So 499 00:17:21,413 --> 00:17:23,591 when next time would you come. It's just 500 00:17:23,890 --> 00:17:24,130 obvious. 501 00:17:24,864 --> 00:17:26,778 What to remove you might use a fruity 502 00:17:26,778 --> 00:17:29,352 pink, for example, you might use Ir 503 00:17:29,968 --> 00:17:32,521 restart material. There's no real right or wrong 504 00:17:32,521 --> 00:17:34,355 as long as it's a rest restrictive material. 505 00:17:34,769 --> 00:17:36,849 That's can't get a hold up to oc 506 00:17:36,849 --> 00:17:39,829 cl forces and and, sort of, 507 00:17:41,009 --> 00:17:43,109 corona seal insult like 508 00:17:43,490 --> 00:17:46,056 fusion so on. I wouldn't just do straight 509 00:17:46,056 --> 00:17:47,091 cabo because again, 510 00:17:47,887 --> 00:17:48,842 cabo seals, 511 00:17:49,399 --> 00:17:51,946 but over time, over 6 months over 12 512 00:17:51,946 --> 00:17:53,711 months. It's gonna break down. So if that 513 00:17:53,711 --> 00:17:54,507 patient disappears, 514 00:17:55,461 --> 00:17:57,927 whatever reason they got sick or they forgot 515 00:17:57,927 --> 00:17:59,121 their appointments or whatever, 516 00:17:59,692 --> 00:18:00,965 I wanna know that when they come back, 517 00:18:01,204 --> 00:18:02,874 I don't need to start again. I can 518 00:18:02,874 --> 00:18:04,306 just pick up where I left off because 519 00:18:04,306 --> 00:18:05,181 it's all sealed up. 520 00:18:06,136 --> 00:18:07,409 So, yeah, most of the time I'm doing 521 00:18:07,568 --> 00:18:07,807 Cabo, 522 00:18:08,379 --> 00:18:11,330 and then Gi in the class 1. Cool. 523 00:18:11,888 --> 00:18:12,048 Okay. 524 00:18:13,563 --> 00:18:15,159 Anything else that I guess we move to 525 00:18:15,159 --> 00:18:17,791 the observation now following that restoring that now. 526 00:18:18,443 --> 00:18:20,434 I I think 1 other thing. When you're 527 00:18:20,434 --> 00:18:23,061 planning your pre build up? 1 other question 528 00:18:23,221 --> 00:18:23,619 I get is, 529 00:18:24,574 --> 00:18:26,619 is it okay to just seal that 530 00:18:27,058 --> 00:18:29,372 class 1 with composite at the end, and 531 00:18:29,372 --> 00:18:31,526 then just have a big build with a 532 00:18:31,526 --> 00:18:33,201 tiny composite in the middle, You know? 533 00:18:34,094 --> 00:18:36,012 So I think the question is where did 534 00:18:36,012 --> 00:18:37,611 your margin prep come to. 535 00:18:38,570 --> 00:18:40,488 So if you're if you were to prep 536 00:18:40,488 --> 00:18:41,047 that tooth, 537 00:18:42,326 --> 00:18:43,465 and then you would 538 00:18:43,779 --> 00:18:46,736 after you've finished everything you prep it, and 539 00:18:46,736 --> 00:18:49,373 then you're left with a very thin wall 540 00:18:49,373 --> 00:18:51,211 of composite that would fracture easily. 541 00:18:51,851 --> 00:18:52,910 I would advise 542 00:18:53,542 --> 00:18:55,209 you would need to redo the whole thing. 543 00:18:55,923 --> 00:18:57,988 So in that situation, it wouldn't make sense 544 00:18:57,988 --> 00:18:59,893 to spend a lot of time doing a 545 00:18:59,893 --> 00:19:00,393 beautiful 546 00:19:01,337 --> 00:19:04,122 pre endo composite buildup. In that situation, you 547 00:19:04,122 --> 00:19:05,951 might do, Stainless steel band and then come 548 00:19:05,951 --> 00:19:07,144 back and do it at the final visit 549 00:19:07,144 --> 00:19:07,303 lit. 550 00:19:08,352 --> 00:19:10,258 You know? So you kinda got to think 551 00:19:10,258 --> 00:19:12,403 strategically. Again miss. It's just more a time 552 00:19:12,403 --> 00:19:14,309 sake, You you you can do a beautiful 553 00:19:14,309 --> 00:19:15,579 pre end up build up every visit that 554 00:19:15,579 --> 00:19:17,426 if you want. But you're gonna be wasting 555 00:19:17,426 --> 00:19:19,421 your time, so you need don't wanna do 556 00:19:19,421 --> 00:19:20,378 that. Okay. 557 00:19:21,176 --> 00:19:21,676 Beautiful, 558 00:19:23,250 --> 00:19:24,702 my friends were telling me the other day. 559 00:19:24,941 --> 00:19:26,936 So they were finishing off their observation, 560 00:19:27,735 --> 00:19:28,235 and 561 00:19:29,251 --> 00:19:31,587 they didn't know what to put between 562 00:19:32,379 --> 00:19:33,118 the Gp 563 00:19:33,735 --> 00:19:36,606 and then their restoration. And different shooters were 564 00:19:36,606 --> 00:19:38,940 telling them different things. So Ir 565 00:19:39,477 --> 00:19:41,413 or Fuji or like a Gi, 566 00:19:42,523 --> 00:19:44,679 there was 1 friend in particular, I said 567 00:19:44,679 --> 00:19:46,434 that there was an air bubble that start 568 00:19:46,434 --> 00:19:48,270 happening because, you know, there's the canal, and 569 00:19:48,270 --> 00:19:50,686 then you're trying to seal that, and then 570 00:19:50,839 --> 00:19:53,385 the nozzle can't fit down or how do 571 00:19:53,385 --> 00:19:55,612 you restore that part then when you get 572 00:19:55,612 --> 00:19:57,624 to that point? And your 573 00:19:58,253 --> 00:20:00,485 holding on, you've done the. You put your 574 00:20:00,485 --> 00:20:02,580 blood sweat and tears into this, and then 575 00:20:02,797 --> 00:20:04,232 you don't know when this tooth is gonna 576 00:20:04,232 --> 00:20:04,732 be 577 00:20:05,188 --> 00:20:08,017 definitively restored how should we approach this final 578 00:20:08,075 --> 00:20:10,071 step of restoring the endo? 579 00:20:10,709 --> 00:20:13,662 Yeah. Great question. The area ton of ways 580 00:20:13,662 --> 00:20:15,590 you can approach this? Like you know, so 581 00:20:15,590 --> 00:20:18,476 many approaches. Right? The things you gotta think 582 00:20:18,691 --> 00:20:20,281 is we're working quite deep now. 583 00:20:21,076 --> 00:20:23,700 There's no enamel. It's just dent. 584 00:20:24,908 --> 00:20:26,044 And also, 585 00:20:26,736 --> 00:20:27,634 you know, as 586 00:20:28,008 --> 00:20:29,541 as you sort of get more and more 587 00:20:29,836 --> 00:20:32,062 advanced in your Endo, you're probably gonna be 588 00:20:32,062 --> 00:20:32,515 quite 589 00:20:32,875 --> 00:20:34,634 aiming or we hope. You'll be aiming to 590 00:20:34,634 --> 00:20:35,914 be more and more conservative. 591 00:20:36,474 --> 00:20:38,494 So your access cavities might be quite 592 00:20:38,954 --> 00:20:41,275 fairly modest, not not tiny, but, you know, 593 00:20:42,006 --> 00:20:42,324 conservative. 594 00:20:43,039 --> 00:20:45,207 And so there are limitations to 595 00:20:45,739 --> 00:20:47,645 access to... When's that deep? Like, like you 596 00:20:47,645 --> 00:20:50,124 said, do the nozzle on the attack ones 597 00:20:50,124 --> 00:20:52,197 that you use go that b, do the... 598 00:20:52,516 --> 00:20:55,148 You know? So it really depends what you 599 00:20:55,148 --> 00:20:56,184 have available to you. 600 00:20:56,902 --> 00:20:59,135 The simplest thing you can do, I guess, 601 00:20:59,628 --> 00:21:01,881 in, for example, student clinic 602 00:21:02,416 --> 00:21:02,974 is Cabo. 603 00:21:03,691 --> 00:21:06,717 You could just get Cabo and introduce it 604 00:21:06,717 --> 00:21:09,445 into the space and packet it we define 605 00:21:09,445 --> 00:21:12,404 endo plug, and you should always be able 606 00:21:12,404 --> 00:21:14,565 to to work with that. And that'll do 607 00:21:14,565 --> 00:21:16,884 what's called the Or first barrier or base 608 00:21:16,884 --> 00:21:17,125 layer. 609 00:21:18,252 --> 00:21:19,760 We've gathered you do need to have a 610 00:21:19,760 --> 00:21:22,777 certain thickness. Typically 3 to 4 millimeters thickness 611 00:21:22,777 --> 00:21:24,523 of cabo for it to actually work as 612 00:21:24,523 --> 00:21:25,078 a ceiling. 613 00:21:26,604 --> 00:21:29,157 Thing. The the benefit of Cabo, of course 614 00:21:29,157 --> 00:21:29,896 is it's. 615 00:21:30,354 --> 00:21:33,067 So let's say, you know, we're humans are 616 00:21:33,067 --> 00:21:35,635 living a lot longer So this may not 617 00:21:35,635 --> 00:21:37,708 be the only endo of treatment that that 618 00:21:37,708 --> 00:21:39,622 tooth gets. It might need a retreat 1 619 00:21:39,622 --> 00:21:42,094 thing. Well, Cabo can be retrieved quite easily. 620 00:21:42,572 --> 00:21:43,210 That's that's good. 621 00:21:43,942 --> 00:21:46,248 And the color is obviously different from dent, 622 00:21:46,407 --> 00:21:47,839 which again makes it good. So there are 623 00:21:47,839 --> 00:21:49,430 people who will use cabo as that lit. 624 00:21:50,719 --> 00:21:53,030 In my office, we use glass, so we 625 00:21:53,030 --> 00:21:54,146 use fuji g 7 pink, 626 00:21:54,944 --> 00:21:55,444 and 627 00:21:55,900 --> 00:21:59,422 that brand actually has an extrusion nozzle Oh, 628 00:21:59,661 --> 00:22:01,411 that clips onto the capsule, 629 00:22:02,127 --> 00:22:05,467 which allows you to introduce the Gi very 630 00:22:05,467 --> 00:22:05,967 deep 631 00:22:06,279 --> 00:22:09,400 at the Or level and avoid the air 632 00:22:09,400 --> 00:22:11,480 bubbles or voids that you talked about. 633 00:22:12,119 --> 00:22:15,259 Another way is, you know, some form of 634 00:22:15,574 --> 00:22:16,074 flow 635 00:22:16,451 --> 00:22:16,951 or 636 00:22:17,647 --> 00:22:18,844 dual cure composite. 637 00:22:19,801 --> 00:22:21,954 Again, you may need a special tip on 638 00:22:21,954 --> 00:22:24,427 it. So there are things called pac tips 639 00:22:24,427 --> 00:22:27,413 or centric tips where you actually 640 00:22:28,028 --> 00:22:30,736 introduce the composite, and there's an extra long 641 00:22:30,736 --> 00:22:33,462 tip that allows you to go deep. I 642 00:22:33,462 --> 00:22:34,979 can send send you some links you can 643 00:22:34,979 --> 00:22:36,974 add it to the notes or something if 644 00:22:36,974 --> 00:22:38,353 you want for the show. But 645 00:22:38,810 --> 00:22:41,306 but these sort of things enable you to 646 00:22:42,015 --> 00:22:43,602 deliver the material deeper. 647 00:22:44,315 --> 00:22:46,719 Personally, I'm not a huge fan of using 648 00:22:46,774 --> 00:22:47,567 composite of that depth. 649 00:22:48,281 --> 00:22:49,495 As I mentioned, it's 650 00:22:50,044 --> 00:22:52,516 no enamel. So it's just dent bonding at 651 00:22:52,516 --> 00:22:52,915 that depth. 652 00:22:53,712 --> 00:22:54,531 It's ci 653 00:22:55,068 --> 00:22:57,062 dent, so a fairly high c factor. 654 00:22:57,860 --> 00:22:58,759 And also, 655 00:22:59,868 --> 00:23:01,456 Once you've done a lot of endo, you'll 656 00:23:01,456 --> 00:23:02,885 see that, you know you can dry the 657 00:23:02,885 --> 00:23:05,903 pulp chamber. And for whatever reason, it's just 658 00:23:05,903 --> 00:23:08,523 hydrate again, be some very moist environment at 659 00:23:08,523 --> 00:23:10,996 that depth. It doesn't stay dry. Come back 660 00:23:10,996 --> 00:23:12,184 in a minute later and you look at 661 00:23:12,184 --> 00:23:13,769 it and like, yeah. I just tried that. 662 00:23:13,927 --> 00:23:14,323 What's up? 663 00:23:15,037 --> 00:23:17,671 So I'm not sure entirely why that is. 664 00:23:17,909 --> 00:23:19,181 In my view, it could be, you know, 665 00:23:19,261 --> 00:23:20,612 we just spent 90 minutes, 666 00:23:21,248 --> 00:23:23,474 hydrating that tooth. Like soaking it in all 667 00:23:23,474 --> 00:23:25,405 these solutions. Maybe it's just 668 00:23:26,112 --> 00:23:26,612 saturated. 669 00:23:27,064 --> 00:23:29,207 I'm not sure, But that's just what I've 670 00:23:29,207 --> 00:23:31,112 observed in my experience and that's what sort 671 00:23:31,112 --> 00:23:33,176 of makes me feel not too comfortable about 672 00:23:33,176 --> 00:23:35,898 using bad depth. So in my office, we 673 00:23:35,898 --> 00:23:39,174 would typically use Gi with that extrusion nozzle, 674 00:23:39,893 --> 00:23:42,050 place that as a base and then build 675 00:23:42,050 --> 00:23:44,683 composite higher up where we got enamel and 676 00:23:44,683 --> 00:23:45,555 intent to bond to. 677 00:23:46,189 --> 00:23:49,542 Another 1, at some schools they teach, 678 00:23:50,490 --> 00:23:52,570 the name escapes me. I'll come back to 679 00:23:52,570 --> 00:23:55,309 it. But there's a another type of Gi 680 00:23:55,529 --> 00:23:56,029 style 681 00:23:56,650 --> 00:23:59,244 material that you can... A dura on. Dura 682 00:23:59,542 --> 00:24:00,181 is a 683 00:24:01,218 --> 00:24:02,915 box cement that you can 684 00:24:03,294 --> 00:24:05,289 mix and you can actually attach it to 685 00:24:05,289 --> 00:24:07,339 a... Because it's kinda liquid liquidy. You can 686 00:24:07,538 --> 00:24:09,845 spin it in with a lent spiral or 687 00:24:09,845 --> 00:24:11,754 another paste filler style, so we can get 688 00:24:11,754 --> 00:24:12,550 it a little bit deep. 689 00:24:13,345 --> 00:24:14,163 Again, it's 690 00:24:14,634 --> 00:24:16,075 so many ways you can approach it. So 691 00:24:16,075 --> 00:24:18,315 it really just depends what you've got in 692 00:24:18,315 --> 00:24:18,815 your 693 00:24:19,275 --> 00:24:20,154 armament mater material. 694 00:24:20,714 --> 00:24:22,714 So for dental students or people working in 695 00:24:22,714 --> 00:24:25,368 your standard stock and and clinic without, you 696 00:24:25,368 --> 00:24:27,445 know, you don't have access to these delivery 697 00:24:27,445 --> 00:24:29,443 tips and so on and, you know, someone's, 698 00:24:29,603 --> 00:24:31,441 you, the clinic manager saying that and we're 699 00:24:31,441 --> 00:24:32,080 not getting those. 700 00:24:33,132 --> 00:24:35,442 At a minimum, you can deliver catheter it 701 00:24:35,442 --> 00:24:38,388 and just pop packet it and avoid get 702 00:24:38,388 --> 00:24:40,140 rid of the v. Yeah. Yeah. Nice. I 703 00:24:40,140 --> 00:24:41,509 didn't know you could just use cover. For 704 00:24:41,509 --> 00:24:43,110 that. And that's for the defendant well... 705 00:24:44,070 --> 00:24:46,309 Yeah. You can leave that in for however 706 00:24:46,309 --> 00:24:48,870 long. Yeah. It's it's a base layer. I 707 00:24:48,870 --> 00:24:51,043 mean, it's not it's not it's not as 708 00:24:51,043 --> 00:24:53,277 good as if you were to use other 709 00:24:53,277 --> 00:24:55,033 materials because it doesn't have that sort of 710 00:24:55,033 --> 00:24:56,548 strength. It's not bonding. 711 00:24:57,107 --> 00:24:58,006 It's just 712 00:24:58,399 --> 00:25:01,032 filling the space, but it's appropriate in the 713 00:25:01,032 --> 00:25:03,586 absence of anything else. Alright? Yeah. Sure. 714 00:25:04,623 --> 00:25:05,762 Alright. And then 715 00:25:06,393 --> 00:25:08,383 I guess now that that's there, you've closed 716 00:25:08,383 --> 00:25:10,611 up with your composite and you're leaving this 717 00:25:10,611 --> 00:25:12,918 tooth now, can we restore it straight away 718 00:25:12,918 --> 00:25:15,799 with, crown or full cost coverage or Yeah, 719 00:25:15,958 --> 00:25:18,053 Kinda kinda depends. So 720 00:25:18,510 --> 00:25:20,902 of course, you know, your comment there crown 721 00:25:20,902 --> 00:25:22,896 or full customer coverage. So we gotta to 722 00:25:22,896 --> 00:25:24,570 think what what are we trying to achieve 723 00:25:24,570 --> 00:25:27,693 yet. Of course, for posterior teeth, that's where 724 00:25:27,693 --> 00:25:30,800 we want full custom coverage. For anterior teeth, 725 00:25:31,677 --> 00:25:35,117 the literature does not support indirect restoration, for 726 00:25:35,117 --> 00:25:36,969 up endo antibiotic treatments. So that's a common 727 00:25:37,185 --> 00:25:37,503 misconception. 728 00:25:38,299 --> 00:25:40,765 People say, oh, all teeth after endo need 729 00:25:40,765 --> 00:25:44,277 a crown. No. It's only posterior teeth, and 730 00:25:44,277 --> 00:25:45,628 it's not that they need a crown. It's 731 00:25:45,628 --> 00:25:47,535 that they need full cost coverage. So in 732 00:25:47,535 --> 00:25:50,807 the modern era of high quality composites and 733 00:25:50,807 --> 00:25:54,065 high quality bonded restoration, you know, the putting 734 00:25:54,065 --> 00:25:55,653 a full crown on the truth is gonna 735 00:25:55,653 --> 00:25:58,054 sacrifice a lot more tooth structure then if 736 00:25:58,054 --> 00:26:00,372 you were to do an on an overlay 737 00:26:00,372 --> 00:26:02,609 or something like that. So that's a very 738 00:26:02,609 --> 00:26:04,687 good point that you make. In terms of 739 00:26:04,687 --> 00:26:06,685 when it really has to tick a few 740 00:26:06,685 --> 00:26:07,005 boxes. 741 00:26:07,579 --> 00:26:08,079 So 742 00:26:08,695 --> 00:26:10,311 is the patient asymptomatic 743 00:26:10,847 --> 00:26:11,347 sweet 744 00:26:11,724 --> 00:26:14,276 can... That's a good tick. Am I confident 745 00:26:14,355 --> 00:26:15,631 I found all the canals? 746 00:26:16,599 --> 00:26:18,976 That's another good day. So for example, upper 747 00:26:18,976 --> 00:26:19,793 first mo 748 00:26:20,323 --> 00:26:21,457 notoriously have 749 00:26:22,066 --> 00:26:25,177 NB2 canal. In the majority of teeth and 750 00:26:25,177 --> 00:26:27,084 that can be very difficult to locate. So 751 00:26:27,084 --> 00:26:29,468 am I confident I I got that down 752 00:26:29,468 --> 00:26:30,501 pat. Okay. Great. 753 00:26:31,232 --> 00:26:33,702 For the canals, was Able to get all 754 00:26:33,702 --> 00:26:36,092 the way down each canal? Okay. I'm I'm 755 00:26:36,092 --> 00:26:37,287 pleased with that great. 756 00:26:38,163 --> 00:26:40,966 If it had a lesion Is that lesion 757 00:26:40,966 --> 00:26:43,038 getting a little bit smaller. Now for that, 758 00:26:43,277 --> 00:26:45,052 you're gonna have to wait about 3 months 759 00:26:45,109 --> 00:26:46,623 typically, to be able to observe, 760 00:26:47,500 --> 00:26:49,651 a, distinct change in the size of the 761 00:26:49,651 --> 00:26:49,731 lesion. 762 00:26:50,621 --> 00:26:51,814 So that 1, 763 00:26:52,610 --> 00:26:55,098 no, hard and fast rule just depends how 764 00:26:55,155 --> 00:26:56,348 brisk ave you are, really? 765 00:26:57,400 --> 00:26:59,080 Other ones though that happened a lot faster 766 00:26:59,080 --> 00:27:01,000 is, okay. This tooth had a sinus tracked 767 00:27:01,000 --> 00:27:01,880 when we first started, 768 00:27:02,519 --> 00:27:04,840 has that gone, and that typically disappears within 769 00:27:04,840 --> 00:27:07,489 4 to 6 weeks of either a disinfection 770 00:27:07,489 --> 00:27:10,193 of the canal system. So if all these 771 00:27:10,193 --> 00:27:12,340 things are ticked, you can go ahead with 772 00:27:12,340 --> 00:27:12,817 the restoration. 773 00:27:13,612 --> 00:27:15,702 What I normally say to my patient is, 774 00:27:15,838 --> 00:27:16,157 you know, 775 00:27:16,888 --> 00:27:17,685 give it about a month. 776 00:27:18,322 --> 00:27:20,872 If you feel really comfortable, you know, not 777 00:27:20,872 --> 00:27:22,784 troubling you, feels like it, you know, really 778 00:27:22,784 --> 00:27:25,033 happy with that tooth. Go ahead and... Anytime 779 00:27:25,033 --> 00:27:26,472 after that, go ahead and get the. 780 00:27:27,191 --> 00:27:29,050 The supervisor, of course, is that 781 00:27:29,509 --> 00:27:31,586 I've taken all those steps we talked about 782 00:27:31,586 --> 00:27:35,030 so that my interim restoration is good. So 783 00:27:35,030 --> 00:27:36,382 that I can wait a month, but I 784 00:27:36,382 --> 00:27:37,813 can wait 3 months. I can wait 6 785 00:27:37,813 --> 00:27:39,800 months. I can wait 12 months, and I'm 786 00:27:39,800 --> 00:27:42,741 confident there's good seal and cost coverage protection. 787 00:27:43,393 --> 00:27:45,722 So I always place that core 788 00:27:46,177 --> 00:27:48,564 restoration with Overlay to make sure the patient 789 00:27:48,564 --> 00:27:49,280 is protected, 790 00:27:49,996 --> 00:27:52,477 till date, get around to getting the the 791 00:27:52,477 --> 00:27:54,937 crap. Because in the real world, how many 792 00:27:54,937 --> 00:27:56,286 patients turn around to me and say, hey, 793 00:27:57,000 --> 00:27:59,143 you know, my health fund benefit doesn't tick 794 00:27:59,143 --> 00:28:02,042 over till January 1. I wait till January 795 00:28:02,100 --> 00:28:03,535 1? And I'm, you know what you can 796 00:28:03,535 --> 00:28:05,049 because I gave you a good interim restoration? 797 00:28:05,288 --> 00:28:07,281 No problem. See you dentist January second and 798 00:28:07,281 --> 00:28:09,765 get that crown. That's cool. Nice. 799 00:28:10,639 --> 00:28:12,649 Okay. I think that was a really good 800 00:28:12,705 --> 00:28:14,238 overview of everything with 801 00:28:14,771 --> 00:28:16,463 restoration in between interim 802 00:28:16,917 --> 00:28:17,394 appointments. 803 00:28:18,204 --> 00:28:19,803 Think all of my questions have been answered 804 00:28:19,803 --> 00:28:21,561 and just like little practical things have been 805 00:28:21,561 --> 00:28:22,840 really awesome to hear about. 806 00:28:23,559 --> 00:28:25,557 I guess just for, like, dental students in 807 00:28:25,557 --> 00:28:28,009 general as they're beginning their endo journey. It's 808 00:28:28,210 --> 00:28:28,789 kind of 809 00:28:29,170 --> 00:28:30,470 for me, Endo really 810 00:28:30,849 --> 00:28:32,369 stressful I find because I'd... 811 00:28:33,009 --> 00:28:34,849 This is very small and you're, like, looking 812 00:28:34,849 --> 00:28:37,424 down these tiny canals and then There's always 813 00:28:37,424 --> 00:28:39,264 this fear in dental school they're, like, you're 814 00:28:39,264 --> 00:28:41,585 gonna per and all these things like the 815 00:28:41,585 --> 00:28:42,404 file is gonna, 816 00:28:42,784 --> 00:28:42,944 like, 817 00:28:43,585 --> 00:28:44,784 crack everything's gonna happen. 818 00:28:45,359 --> 00:28:47,111 What do you think we should, like, be 819 00:28:47,111 --> 00:28:49,421 working through at dental students in particular? 820 00:28:49,979 --> 00:28:51,810 Like starting our endo? What should we really 821 00:28:51,810 --> 00:28:53,483 be looking out for and how do we 822 00:28:53,483 --> 00:28:54,063 sort of 823 00:28:54,533 --> 00:28:56,916 set ourselves up for, like, a good general 824 00:28:56,916 --> 00:28:58,028 endo Career. 825 00:28:58,664 --> 00:29:00,888 Yeah. I couldn't agree with you more. It 826 00:29:00,888 --> 00:29:03,850 is really hard. It's 1 of the 827 00:29:04,958 --> 00:29:05,437 harder, 828 00:29:06,555 --> 00:29:10,147 disciplines of our of our profession. I per 829 00:29:10,147 --> 00:29:10,866 my first end. 830 00:29:11,983 --> 00:29:12,702 It's so. 831 00:29:13,181 --> 00:29:15,353 So What, I would like to hear about 832 00:29:15,353 --> 00:29:16,791 that. It was a dental school. 833 00:29:17,510 --> 00:29:19,508 As you, no. Sorry. My first endo is 834 00:29:19,508 --> 00:29:20,787 at as a clinician. Oh. 835 00:29:21,665 --> 00:29:24,080 Yeah. So my coast cool endo. 836 00:29:24,559 --> 00:29:26,320 Oh, wow. And look where I am now. 837 00:29:26,480 --> 00:29:28,640 So, yeah. Do don't lose, don't don't get 838 00:29:28,640 --> 00:29:30,972 too upset about it. You know, own new 839 00:29:30,972 --> 00:29:32,249 mistakes, but they happen. 840 00:29:32,967 --> 00:29:33,627 I think 841 00:29:34,723 --> 00:29:36,638 kinda... It all comes back to what I 842 00:29:36,638 --> 00:29:37,857 saying about is just 843 00:29:38,648 --> 00:29:41,679 plan everything out. Plan everything out so that 844 00:29:41,679 --> 00:29:44,709 you find out everything about that tooth as 845 00:29:44,709 --> 00:29:45,507 early as possible. 846 00:29:46,065 --> 00:29:47,022 So for example, 847 00:29:47,994 --> 00:29:49,593 Okay. You gotta you gotta to use it. 848 00:29:50,392 --> 00:29:52,630 Sd has a cone beam Ct. 849 00:29:53,509 --> 00:29:54,068 Order a com, 850 00:29:54,867 --> 00:29:57,105 you know, find out more about that tooth, 851 00:29:57,838 --> 00:29:59,115 before you need to get in there so 852 00:29:59,115 --> 00:30:01,986 you can sit at home or, home, but 853 00:30:01,986 --> 00:30:03,182 you can set up this clinic, 854 00:30:03,980 --> 00:30:05,735 you know, you can look at that too. 855 00:30:05,894 --> 00:30:07,904 If you can know how many routes You 856 00:30:07,904 --> 00:30:10,222 can know how many canals. You can have 857 00:30:10,222 --> 00:30:11,580 an estimated length, 858 00:30:12,140 --> 00:30:12,879 you can 859 00:30:13,259 --> 00:30:15,816 talk to your supervisor before the patients in 860 00:30:15,816 --> 00:30:18,625 the chair, learn as have as much information 861 00:30:18,625 --> 00:30:19,981 on hand as possible. 862 00:30:20,858 --> 00:30:22,852 Seth, why do I say strip the tooth. 863 00:30:23,730 --> 00:30:26,442 Get as much information about the tooth as 864 00:30:26,442 --> 00:30:27,813 possible as early on, 865 00:30:28,451 --> 00:30:31,003 so that you don't have any ugly surprises 866 00:30:31,003 --> 00:30:33,316 later on. You know? So I think it's 867 00:30:33,316 --> 00:30:37,086 just following a logical sequence of steps. And 868 00:30:37,239 --> 00:30:37,978 In endo, 869 00:30:38,354 --> 00:30:40,981 it's not a, you know, there's like you 870 00:30:40,981 --> 00:30:42,653 said, a lot of small canals and this 871 00:30:42,653 --> 00:30:44,722 and that. But what's the crux of it? 872 00:30:45,613 --> 00:30:47,385 Is get the bugs out 873 00:30:47,918 --> 00:30:48,792 and keep them out. 874 00:30:49,508 --> 00:30:51,654 So get a good corona seal, so they 875 00:30:51,654 --> 00:30:52,926 don't get can't come back in, 876 00:30:53,737 --> 00:30:55,488 And then when you're in there, try and 877 00:30:55,488 --> 00:30:57,102 get find all the canals 878 00:30:57,557 --> 00:30:59,945 and get down all the canals and get 879 00:30:59,945 --> 00:31:01,298 them as clean as you can. That that's 880 00:31:01,298 --> 00:31:02,731 it that's the crux of it all. 881 00:31:03,540 --> 00:31:06,552 And the main things I see clinicians not 882 00:31:06,552 --> 00:31:08,376 just suited. So in student cli, we see 883 00:31:08,376 --> 00:31:10,437 it too, but even even in general practice, 884 00:31:11,167 --> 00:31:12,918 the patients are I referred to our care? 885 00:31:13,713 --> 00:31:15,305 What are some of the things that are 886 00:31:15,305 --> 00:31:16,362 overlooked is 887 00:31:17,692 --> 00:31:19,858 seal? People not stripping the tooth. 888 00:31:20,496 --> 00:31:22,967 People spending 2 free visits and they send 889 00:31:22,967 --> 00:31:24,481 the patient to me and still I can 890 00:31:24,481 --> 00:31:24,981 see 891 00:31:25,358 --> 00:31:26,177 there's remnants 892 00:31:26,489 --> 00:31:28,640 carries on, you know, old restoration. And when 893 00:31:28,720 --> 00:31:29,995 I take... When I take it out, they're 894 00:31:29,995 --> 00:31:33,124 still carries underneath. What else people getting in 895 00:31:33,262 --> 00:31:35,433 and not finding all the canals what's the 896 00:31:35,433 --> 00:31:36,252 main reason 897 00:31:37,190 --> 00:31:39,587 is because typically they're not in the pulp 898 00:31:39,587 --> 00:31:41,765 chamber. Often it may be the 899 00:31:42,079 --> 00:31:44,960 there's some degree of cal classification. And so, 900 00:31:45,039 --> 00:31:46,960 you know, the pulp chamber floor is here. 901 00:31:47,519 --> 00:31:49,849 There's still somewhere up here. And there's a 902 00:31:49,849 --> 00:31:52,014 whole bunch of cal classification here the canals 903 00:31:52,069 --> 00:31:54,527 are always in the top chamber floor. So 904 00:31:54,685 --> 00:31:56,850 I think it's just understanding some 905 00:31:57,639 --> 00:31:59,257 principles even learnt at University, 906 00:31:59,956 --> 00:32:02,533 and then following through on the on every 907 00:32:02,593 --> 00:32:04,990 case, not skipping steps. Now, of course, as 908 00:32:04,990 --> 00:32:07,633 I said, that first visit the emergency appointment 909 00:32:07,633 --> 00:32:09,884 where you're left with like 10:15 minutes to 910 00:32:09,941 --> 00:32:10,657 work miracles. 911 00:32:11,055 --> 00:32:13,067 Of course, you you do what you can 912 00:32:13,204 --> 00:32:14,318 to get the patient out of pain. 913 00:32:15,846 --> 00:32:17,995 But the rest of the time, you know, 914 00:32:18,075 --> 00:32:20,225 once you've done that, you've then got time 915 00:32:20,225 --> 00:32:22,534 to set aside enough time to to get 916 00:32:22,534 --> 00:32:23,091 it all done. 917 00:32:23,903 --> 00:32:25,737 And then once you do it enough times, 918 00:32:26,375 --> 00:32:30,044 you it it automate things and your your 919 00:32:30,044 --> 00:32:32,596 workflow becomes faster and and you become faster, 920 00:32:32,755 --> 00:32:34,995 but don't try and and sort of race 921 00:32:34,995 --> 00:32:37,695 through things. So, you know, for for students, 922 00:32:38,251 --> 00:32:40,475 I think, you know, if it's if it's 923 00:32:40,475 --> 00:32:42,222 mo or or prem mo endo, 924 00:32:42,794 --> 00:32:45,034 allocate the whole session session. You know, I've 925 00:32:45,034 --> 00:32:45,914 seen some students. 926 00:32:46,554 --> 00:32:48,474 I'm gonna I'm gonna take this impression for 927 00:32:48,474 --> 00:32:50,315 my patient, and then I'll... In the rest 928 00:32:50,315 --> 00:32:51,855 of the session, I'm gonna do a mo. 929 00:32:52,568 --> 00:32:52,964 I mean, 930 00:32:53,599 --> 00:32:54,630 you end up doing, 931 00:32:55,105 --> 00:32:57,405 half of a mall, you know, the first... 932 00:32:58,119 --> 00:32:59,784 You just don't have the adequate amount of 933 00:32:59,784 --> 00:33:00,022 time. 934 00:33:00,594 --> 00:33:02,667 And particularly at at a student level, you 935 00:33:02,667 --> 00:33:04,502 know, not only are you guys a bit 936 00:33:04,502 --> 00:33:06,017 slower because, you know, you're learning. 937 00:33:06,815 --> 00:33:08,591 But, you know, the clinic has all these 938 00:33:08,649 --> 00:33:10,897 limitations. You gotta spend 5 minutes queuing up 939 00:33:10,897 --> 00:33:12,969 for x rays, another 5 minutes queuing up 940 00:33:12,969 --> 00:33:15,360 for Gp points. So as a student, I 941 00:33:15,360 --> 00:33:17,751 think you need to give yourself time. Perfect. 942 00:33:18,324 --> 00:33:20,717 Thank you so much, Doctor. Harry Mo. I 943 00:33:20,717 --> 00:33:22,631 know you also have an event coming up 944 00:33:22,631 --> 00:33:23,290 that you're 945 00:33:23,668 --> 00:33:24,545 organizing, I believe? 946 00:33:25,263 --> 00:33:26,539 Would you like to talk a little bit 947 00:33:26,539 --> 00:33:27,815 about that for our listeners? 948 00:33:28,308 --> 00:33:29,896 Before we head off for the day. Yeah. 949 00:33:30,055 --> 00:33:32,754 I love too. So I run an annual 950 00:33:32,754 --> 00:33:35,374 event. It's called Dental Aid. It's a not 951 00:33:35,374 --> 00:33:37,932 for profit Cp event. It's a whole day 952 00:33:37,932 --> 00:33:41,519 of lectures where we invite speakers from all 953 00:33:41,519 --> 00:33:43,352 disciplines of dentistry and sometimes, 954 00:33:43,990 --> 00:33:45,345 non dental disciplines as well. 955 00:33:45,998 --> 00:33:47,992 It's a live event in Sydney, but it's 956 00:33:47,992 --> 00:33:51,740 also live streamed around the world, and all 957 00:33:51,740 --> 00:33:54,771 our attendees get access to the material for 958 00:33:54,771 --> 00:33:56,861 4 months to review in their own time 959 00:33:56,861 --> 00:33:58,219 of the recording. So if you're not free 960 00:33:58,219 --> 00:34:00,294 on the day, it's kinda cool. You can 961 00:34:00,294 --> 00:34:01,832 watch it later. And 962 00:34:02,210 --> 00:34:04,685 it's unique in the sense that 100 percent 963 00:34:04,685 --> 00:34:08,757 of your registration fee goes to addressing poverty 964 00:34:08,757 --> 00:34:09,313 in Asia. 965 00:34:10,028 --> 00:34:10,528 So, 966 00:34:10,903 --> 00:34:13,025 yeah. It's it's a it's a really unique 967 00:34:13,541 --> 00:34:15,291 not a property event been doing some good 968 00:34:15,291 --> 00:34:17,438 work. And over the years, we've raised over 969 00:34:17,438 --> 00:34:19,585 a hundred thousand dollars so far, and we 970 00:34:19,585 --> 00:34:22,289 hope to raise another 50 or 60000 dollars 971 00:34:22,289 --> 00:34:22,607 this year. 972 00:34:23,497 --> 00:34:26,206 Thanks for students. And for recent graduates in 973 00:34:26,206 --> 00:34:28,835 the first 4 years out. It's just 90 974 00:34:28,835 --> 00:34:31,225 dollars for the for the day, and, 975 00:34:31,942 --> 00:34:33,706 you join us Obviously, you get the whole 976 00:34:33,706 --> 00:34:34,921 day lectures plus 977 00:34:35,294 --> 00:34:37,596 meals. But otherwise, yeah, you can watch it 978 00:34:37,596 --> 00:34:40,137 online from wherever you are. Awesome. And when's 979 00:34:40,137 --> 00:34:42,625 that happening. It's soon isn't it. Yeah. So 980 00:34:42,625 --> 00:34:45,738 it is soon. That's August 17. So on 981 00:34:45,738 --> 00:34:46,457 midway through August. 982 00:34:47,175 --> 00:34:47,654 It's 983 00:34:48,133 --> 00:34:49,990 you can check it out at 984 00:34:50,302 --> 00:34:51,911 try booking dot com 985 00:34:52,679 --> 00:34:55,161 slash CRC 986 00:34:55,374 --> 00:34:58,007 zed x, but I'll I'll I'll send you 987 00:34:58,007 --> 00:34:58,246 a link. 988 00:35:00,079 --> 00:35:01,832 We'll have the link in now, and I'll 989 00:35:01,832 --> 00:35:03,744 show nice. This year me. 990 00:35:05,112 --> 00:35:07,596 Professor Ortho from U. Lane mit Gun. 991 00:35:08,048 --> 00:35:09,897 Got 2 fantastic pros. 992 00:35:10,587 --> 00:35:11,619 I'm Lewis Kaye, 993 00:35:12,349 --> 00:35:15,630 And Chris Small. We've got an endo, Sally 994 00:35:15,789 --> 00:35:16,190 Cochran, 995 00:35:16,829 --> 00:35:18,210 and we've also 996 00:35:18,829 --> 00:35:20,369 got a a really interesting 997 00:35:20,750 --> 00:35:21,250 speaker 998 00:35:21,724 --> 00:35:24,594 from outside the dental industry who is 1 999 00:35:24,594 --> 00:35:27,624 of Australia's leading wealth investors, and he's gonna 1000 00:35:27,624 --> 00:35:30,038 be talking about the sort of relationship between 1001 00:35:30,668 --> 00:35:31,644 money and happiness 1002 00:35:32,096 --> 00:35:35,111 and also sort of, you know, generating wealth, 1003 00:35:35,269 --> 00:35:37,673 but feeling good about it and and and 1004 00:35:37,729 --> 00:35:38,523 how that makes it feel. 1005 00:35:39,175 --> 00:35:41,255 And we've got Joe Ryan and an Oral 1006 00:35:41,255 --> 00:35:43,275 medicine specialist will be talking about T. 1007 00:35:43,815 --> 00:35:45,414 So, yeah. It's just it's a really it's 1008 00:35:45,414 --> 00:35:47,738 a really nice day. Seems really good. Yeah. 1009 00:35:48,214 --> 00:35:50,777 Alright. Awesome. Well, we're looking forward to it 1010 00:35:50,833 --> 00:35:52,500 and all the best for it as it 1011 00:35:52,500 --> 00:35:53,452 comes closer, 1012 00:35:54,024 --> 00:35:55,778 Thank you so much for your time coming 1013 00:35:55,778 --> 00:35:57,954 on the Dental Head stop Podcast. We really 1014 00:35:58,012 --> 00:35:59,447 appreciate it. That's my pleasure. 1015 00:36:00,963 --> 00:36:02,478 Thank you so much for listening to the 1016 00:36:02,558 --> 00:36:03,776 Dental Head podcast 1017 00:36:04,170 --> 00:36:06,250 I genuinely hope this is helping you become 1018 00:36:06,250 --> 00:36:08,410 a better dentist. So if you like what 1019 00:36:08,410 --> 00:36:10,090 you're hearing, make sure you subscribe on your 1020 00:36:10,090 --> 00:36:11,849 podcast player, and I want you to do 1021 00:36:11,849 --> 00:36:13,384 me a favor. I want you to go 1022 00:36:13,384 --> 00:36:16,280 to social media and share something that you've 1023 00:36:16,340 --> 00:36:17,938 appreciated from us with 1 of your friends. 1024 00:36:18,338 --> 00:36:19,935 That's how the word gets out. That's how 1025 00:36:19,935 --> 00:36:22,259 more people gain and benefit from what we're 1026 00:36:22,259 --> 00:36:24,246 doing. And if you're a dental student or 1027 00:36:24,246 --> 00:36:25,756 a graduate, and you wanna get a head 1028 00:36:25,756 --> 00:36:27,981 start, go to dental head start dot com 1029 00:36:27,981 --> 00:36:30,641 to everything we're doing to help dental students 1030 00:36:30,697 --> 00:36:31,571 become great dentists.