Ferrule Effect and Biologic Width

[@mentaldental]

This is my video on ferrule effect and biologic width, concepts that come up often in operative dentistry and prosthodontics. Let me know what you want to see next!

[@allexayare5459]

Do you have videos on fixed partial dentures?

[@allexayare5459]

By the way, all your videos are very helpful! Thank you so much for that 😊

[@ksdharmareddy1043]

What is the difference between core ferrule and crown ferrule

[@LA-jd4uk]

Mental Dental, could you add a video of "determine restorability"? As a dental student I am sometimes still confused of when or not we can crown a tooth. Thanks.

[@rebeccaharris9961]

Hi there .. I’m a dental student and have this issue too. May I ask what you’ve learnt since you posted this q please

[@redmouse6346]

‘Natural attachment that shouldn’t be interrupted’- that was well worded, now I know how to tell it to my patients. Thank you

[@robertomichienzi-n6n]

Hands down the best explanation I’ve ever seen. God bless you.

[@mentaldental]

Wow, thank you! God bless you as well! 🙏🏼

[@jcheung763]

That was very helpful! I appreciated that you were drawing lines and reiterating the concepts in relation to what you were talking about (e.g. drawing arrows to indicate the consequences of lateral pressure just on the core instead of tooth + core, ferrule is specifically 1.5mm of natural tooth, etc). It's a much more active form of learning and I wish more professors taught like this because concepts get confusing when we don't know their reference points and powerpoints are just full of images. Thanks again!

[@mentaldental]

Thank you for that excellent feedback. I really appreciate it!

[@lucid212]

I'm very thankful for having you in youtube dental community! you made it very easy for me, thanks again!

[@mentaldental]

I appreciate you watching my videos! You’re welcome! 💯

[@LA-jd4uk]

Mental Dental, could you add a video of "determine restorability"? As a dental student I am sometimes still confused of when or not we can crown a tooth. Thanks.

[@jeanthaigengmei7809]

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[@jeanthaigengmei7809]

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[@jeanthaigengmei7809]

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[@jeanthaigengmei7809]

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[@jeanthaigengmei7809]

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[@minasolanki59]

Mental dental never fails to deliver! Amazing video, thank you!

[@tariqalqunayan4948]

Wish you were one of my teachers .. you have a special way to explain things so clearly, thanks .. keep it up

[@Ann_Dental]

this is so well explained and easy to understand! thank you so much for your effort!!!

[@mentaldental]

Thank you for the great feedback! 😄

[@thilleliavehri1219]

Oh thank you! I finally understood what the ferrule effect means!

[@mentaldental]

You're welcome, that's awesome! :)

[@khankhan-xd8ij]

Very good video on explaoning the ferrule effect and biological width. However I don't understand why you would need such a large crown placed over that last restoration. Why not remove the amalgam, reassess the tooth structure after caries removal. Then consider a composite core and prepare the tooth for an onlay or even an overlay. That would be a lot more conservative and you could place it on sound tooth structure with retentive features incorporated. Also if the tooth were to flare-up or become symptomatic and require endodontic treatment, it would be easier to carry this out through an onlay than a crown for obvious reasons.

[@joebug8984]

Thank you so much! you saved my dental school lyf

[@farhanaahmed7163]

Very useful video, you simplify concepts which are otherwise hard to grasp, thank you very much! :)

[@stuntdrag0n]

Thank you very much, this is a very well explained concept that i was struggling to understand. I liked the way you introduced each concept and used a clinical case to wrap it together!

[@mentaldental]

Thanks for the positive feedback, glad to hear you found the video helpful!

[@jamesntoumenopoulos5894]

i suggest you go to Ray Bertolotti adhesion website ..this is over treatment here on the last molar example ...the biologic width needn't be invaded if the amalgam is removed and a Bonded resin core placed and then the restoration may finally be placed as an occlusal overlay and all the margins are in composite and supra gingival..that would be clinically the best choice here and in most posterior deep margin situations

[@dentistry7116]

thanks for sharing your thoughts .. to my knowledge there is a principle that goes the finish line of a prep should be placed on sound tooth structure regarding crowns so i doubt if what u are suggesting violates that .. what do you think? i'm gonna check the website u mentioned, just wanted to discuss

[@jamesntoumenopoulos5894]

when the margins are so deep and the best crowns have a fit gap of say 30 to 100 micrometers ..you are asking for gingival irritation this deep ..by sealing a resin core with say a SE system like Liner Bond SE or Prelude SE or Premio bond with a DC Light cure core material you know you will have a stable margin deep with no GAP too be filled by a cement with a crown at the same margin...you then place a crown preparation or occlusal overlay as the definitive restoration..I feel this is the way dentistry is now being taught ...and attempting to move away from crowns totally and using modern adhesive dentistry at its best ...theonly crowns we should be placing are replacing crowns ...occlusla overlays like veneers for occlusion on the posteriors is whats being advised in most Biomimetic principles ...Pascal Magne...

[@dentistry7116]

yes i agree with you regarding your treatment plan occlusal veneers or onlays or full coverage it is up to you .. i also agree with your choice of composite core and sealing the indirect restoration with light cure resin cement.. what i wanted to comment about is placing ur prep margins on composite itself u are saying "all margins are in composite" if the case is so deep i still want to place my margins on sound tooth structure and that's whats going to determine if the tooth is restorable, because preparing on composite gives weak margins and very low thickness of composite at the finish line, going against resistance principle .. on the other hand if my margins were to be put on sound tooth structure it will have better resistance to occlusal forces because of the remaining root structure. force distribution is hence better whereas in composite margins,okay forces will be transmitted to tooth structure but passing by composite interphase first makes composite vulnerable to fracture at margins

[@jamesntoumenopoulos5894]

Pascal Magne and his philosophy of Biomimeticdentistry will have a lot to say to u about resistance and retention form when sandblasting and bonded restorations are your primary motivating philosophy...height and width of the core etc had a lot more input as to restorability in the days of Zn phosphate cements in the days of sandblasting then etch wash bonding ...am / dentistry is entering a paradigm shift in thinking ....biologic widths needn't be invaded as per your molar example is my whole point and margins can and must be made in composite resonant placed supragingivally ...regard sJames

[@dentistry7116]

ahh..i got you and i'd love to hear about prognosis studies that back up this approach .. it would make life much easier. thanks for the discussion

[@keziavarghese2055]

Thanks for this amazing video. Finally understood these terms

[@nidazehra6165]

... excellent explanation doc 👍🤠

[@mentaldental]

Glad it was helpful! 🙌🏼😄

[@ingitv360]

Nicely explained 👍

[@mentaldental]

Thank you! 🙂

[@SamadAli-q6u]

I love you Dr Ryan You made the dentistry interesting When I find your lecture,I become too excited ❤❤❤❤❤❤ But at same time when I don't find your lecture I kind of hate you because your lectures are so addicting.......

[@mentaldental]

Thank you (I think 😂). What lectures are you looking for that I don’t have?

[@SamadAli-q6u]

@@mentaldental like most of the topics from prosthodontics, orthodontics I know you cover the high yield ones but in Pakistan they teach whole thing but please don't mind me You are the best 💓💓💓💓 you are my motivation ❤️

[@josephhirmiz468]

Thank you. Great video

[@khudeja8273]

That was so helpful. Thank you so much :)

[@mentaldental]

Glad it was helpful! ☺️

[@AudienceAT]

Its nice explanation, however if we do crown lengthening on that tooth, bifurcation will be exposed which is one of contraindications for crown lengthening and ortho extrusion. Always have to look at bifurcation when you started thinking about crown lengthening.

[@violinFantasy]

Thank you, this was very helpful, could you do some videos about how to make a crown step by step(metal-ceramic, zirconia etc)?

[@walkingdeadangel]

Thank you so much for your work !

[@mentaldental]

You're very welcome! Thank you for watching!

[@mohammadhosseinaliasgharza8136]

That was really really great THANK YOU

[@AhmedKhaled-eh8fi]

Thank you very much! Your video is so helpful

[@dr.saivaila7829]

If a tooth has an inadequate ferrule, which of the following is an effective strategy to increase tooth structure available for crown preparation? A. Cementation of the restoration with a glass ionomer cement. B. Sub-gingival preparation and prolonged temporization. C. Orthodontic eruption. D. Elective endodontic treatment and a post core. Hey dr. Ryan what might be the answer for this question?

[@mentaldental]

Surgical crown lengthening or orthodontic extrusion (answer C) would be the best ways to increase ferrule.

[@Itsnegar]

Great video✨ Thank you🙏🏼

[@SS-bu8ez]

You also have to consider the biotype, whether it's thick or thin for gingival recession

[@amt6847]

Thx, finally I understant it 👏👏

[@hellogoodbyeapplepie]

in the above case, what about partial ferrule? if you had ferrule everywhere else except the distal box area, would that be considered low risk enough to not have ferrule in that location and proceed with the crown?

[@deerumusic7651]

Thank you very much

[@lilinayatplayzone2651]

Thank you very helpful😌

[@adriatikgrada7987]

Thank you it was very helpful

[@mustafazalat810]

It’s amazing, thank you bro for your help

[@m7sen_sama841]

ty sooo much for this video it helped me alot

[@user-qt5dg9ig4u]

Super helpful!!

[@joyjoyw810]

Thank you so much Your video so helpful

[@drsukh7177]

Sir how can we give it in a case where we have just root stumps and no crown structure

[@maalmaevangelista7560]

Great video

[@drsaraa3155]

Thank you so much .

[@mentaldental]

You're very welcome!

[@leenjomaa1554]

Thank you so much, you are greeaat!! 😀

[@mentaldental]

You're welcome! Thank you for the kind words :)

[@SmSaifullahVlogger]

Thank you

[@angelicafoster670]

do you have a video about different types of ceramics and their classifications

[@mentaldental]

I have a video on All-Ceramic Crowns (kzbin.info/www/bejne/iZemm2l8gah6hq8) but not one on the different types of ceramics specifically. Sounds like a good topic for a future video!

[@angelicafoster670]

@@mentaldental yeah i'm looking forward for it, quite a complicated one.

[@rezakia9677]

excellent

[@keziavarghese2055]

After crown lengthening procedure, if the bone level is at the furcation and crown root ratio is not enough. Is it worth going thru all these procedures, or will u do extraction n implant??

[@mentaldental]

kezia varghese Excellent question! And your reasoning is exactly right. If the furcation were to be exposed or if there would be an inadequate crown root ratio after crown lengthening then the tooth is generally planned for extraction, and considering all other patient factors, may or may not be replaced with something like an implant, bridge, or removable prosthesis.

[@jjjccc987]

So what’s the scientific limit to stay away from biological width when prepping a tooth for a crown in mm?

[@chantolpringle]

I really loved this video

[@mentaldental]

I’m glad you enjoyed it!

[@yenhsiang0814]

Great!!!

[@azouz5675]

how much long tooth without ferrule comparatively with tooth with it ?

[@IpWnMuSh]

Thanks!

[@mentaldental]

You're welcome! Hope you found the video helpful.

[@garrettschneider5430]

So I understand the concept of biological width. But what is the consequence of violating it. Maybe we have a patient that cannot pay for ortho/crown lengthening but still wants a crown. Can it still be done? What is the consequence of only leave 1mm of biological wide? Mobility? Thanks for the video.

[@mentaldental]

Great question. There is some debate about this, but the potential consequences of violating biological width are gingival inflammation around the restoration, bleeding on probing, gingival recession, pocket formation, clinical attachment loss, and alveolar bone loss. All of these can contribute to an unpredictable effect on the gingival levels leading to a potentially unesthetic restorative outcome if performed in the anterior.

[@ioana4697]

All of this bone you’ll loose through violating biological width is bone support you won’t have for a later implant.

[@amytamaratrixie5278]

thank you thankyouuuu

[@mentaldental]

You're welcome!

[@andrew-isac]

which playlist is this video in???? plz help

[@mentaldental]

This video is not in a playlist! It is a standalone video to describe a difficult dental concept.

[@andrew-isac]

Mental Dental thank u dr, glad to be one of the patreons as well m thanks for your continuous output & help

[@drsalam3494]

Lovely

[@MelvinMansoor]

Why doesn't the right one say "crown"?

[@mayelshobary3756]

What about BW IF I REMOVE THE BONE IT WILL BE VOLATILE?

[@drmr260]

👌👌

[@fernandodelarosa9752]

welcome to implantology

[@raahimafarhan6635]

i love you

[@mohamedabdelnaser3320]

Thanks !

[@mayamasyita5345]

Thank you❤❤