Cracked Teeth and Dentistry's Tough Questions with Dr Lane Ochi - PDP175

Dr Lane Ochi is such a legend that I wanted to throw ALL of Dentistry’s tough questions at him - and as you guys requested, it’s MOSTLY about CRACKS!
Dr Ochi practiced in Beverley Hills for 43 years and embodies the Protrusive values of a lifelong learner, avid sharer and with so much humility.
Dr Lane Ochi and another of my mentors Dr Michael Melkers will be visiting London on 27th and 28th July in London for a 2 Day course. Visit the link below to book on!
web.cvent.com/event/c460d825-...
The Protrusive Dental Pearl - Intraoral Photographs: encourage your patient to capture intraoral photos on their phone, giving them a copy for reference. This empowers the patient to stay informed, facilitating their understanding and ownership of the situation
Highlights of this Episode:
00:00 Introduction
01:24 The Protrusive Dental Pearl
03:40 Dr. Lane Ochi
09:11 Amalgam Restorations
16:16 2 Types of Wearers
19:27 Virgin Teeth
20:00 Mechanical Failures in Dentistry
27:33 Force Management to Prevent Cracks
34:35 Micro Leakage - When to and When Not to Intervene?
39:32 Should you chase cracks?
45:17 Second Molar Problems
48:41 Posterior Severe Wear without Anterior Tooth Surface Loss
53:42 Management of Symptomatic Cracks
57:42 Direct Composite Overlay Protocol
If you liked this episode, you will also like I Hate Cracked Teeth with Kreena Patel - PDP028: protrusive.co.uk/cracked-teeth
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[@DentalGeek967]

Hello all. I’m happy to address any questions you may have about my “chat” with Jaz :)

[@protrusive]

Ladies and Gents: Dr Lane Ochi - the ORIGINAL Dental Geek!

[@Cavanho]

The right honourable dentalman, mayor of dental town

[@proimpressionsmarketing]

Great podcast!

[@neekolai223]

Love this podcast Jaz super informative. Cracks are something I see alottt of. As a dentist in regional Australia, I see plenty of asymptomatic teeth restored with amalgams that have marginal ridge cracks. Almost all of these patients are bruxers and many of them come to me a few months or years down the road with cuspal fractures (possible confirmation bias). I find that almost all the marginal ridge cracks are going into dentine and even if they don't cause a microleakage problem, I find they lead to nasty oblique fractures that are hard to restore. I find myself thinking that it may be more conservative to just replace these amalgams with moderate-high risk profile patients than to wait for a problem to occur and try and salvage a subgingival fracture. What is your take on prophylactic restoration of marginal ridge cracks in restored teeth with moderate-high risk profiles?

[@Cavanho]

If it’s 1/10 patients who end up with these cuspal fractures… tell your next patient that’s what their risk of fracture is. Their risk appetite is theirs alone, not yours

[@sallysmith6728]

Great video again Jaz! Just wanted your thoughts on going straight to a ceramic restoration (CEREC) in a patient presenting with cracked tooth syndrome (fracture finder positive on certain cusps), large existing restoration but positive pulp vitality test and nil periapical pathology on the x-ray? Would you still prefer to start with a composite overlay, re-assess then "upgrade" to ceramic in 9-12 months time?

[@protrusive]

Hi Doc! I think access to cerec does change things here a bit - the ability to go indirect from the start is awesome. In such a case my threshold would probably go higher (ie more likely to go definitive in the scenario you mentioned) However, other factors I look at: How nasty the crack is (wider with plaque is reduced prognosis) Pocketing that indicates crack extension? The patient is more cautious time and maybe have never had RCT before Proximity of previous restoration to the pulp etc