Is gold really dead or making a comeback 2025?



Are zirconia and biomimetic dentistry sounding the final bell for precious metal restorations?



Is there still a place for gold in modern practice—and when is it actually the best option?



Dr. Lane Ochi joins Jaz for a rare live podcast episode to unpack the current and future role of gold restorations. From skyrocketing costs and lost lab skills, to emerging alternatives like milled cobalt chrome, this episode covers everything you wish dental school taught about gold.



They even dive into clever tricks for temporizing gold and discuss the surprising lab workaround that may save your patient money—without compromising function.




https://youtu.be/QWhY2_Oghd0
Watch PDP236 on Youtube



Protrusive Dental Pearl: You can achieve profound anesthesia for lower molars—including cracked, heavily worn ones—using Articaine buccal infiltrations instead of an ID block, even in dense bone cases.



Key nuance: Ensure blanching of the attached gingiva and infiltrate through the papillae for better effectiveness.



Watch the detailed technique breakdown (including patient feedback):




https://youtu.be/cCXacw5DE4M?si=gDmYTKiFYxhYvbj3




Articaine works—master the nuances! 



Key Takeaways




* Use gold in tight spaces, short preps, or when longevity matters.



* Simpler preps = better milling, easier seating.



* Burnish when needed—but focus on great impressions.



* Talk to your lab. Explain your margins, internal spacing, and cement plans.



* Treat the patient, not just the prep: comfort, cost, and communication matter.




Highlights of this episode:




* 0:00 Introduction



* 2:06 Protrusive Dental Pearl



* 06:19 Welcoming Dr. Lane Ochi



* 09:40 The Resurgence of Gold in Dentistry



* 14:11 The Importance of Preparation and Cementation



* 18:17 Cost-Effective Alternatives to Gold



* 21:39 Burnishing Gold Margins



* 26:53 Partial Coverage Margin Designs



* 29:04 Retention vs. Resistance in Tooth Preparation



* 43:14 Vertical Preps with Gold



* 45:05 Immediate vs. Delayed Dentin Sealing



* 47:23 Challenges with Temp Bonding and Solutions



* 49:13 Recap



* 50:02 Lab Considerations for Gold Crowns



* 54:53 Perforated Gold Crowns



* 57:24 Temp Bond Troubles and Fixes



* 59:59 Gold vs. Ceramic Longevity



* 1:06:25 Gold Crowns on Implants



* 1:08:44 Wrapping Up and Final Thoughts 




Unlock webinars like this one by joining the Protrusive App.



Studies Mentioned in the Episode:




* Marginal Gap of Milled versus Cast Gold Restorations



* Margin...

Can you apply the Dahl technique to localised POSTERIOR wear?



Spoiler alert: hell yeah!



How can the Dahl Technique help when there is posterior wear and NO space to restore?



How predictable is building up posterior teeth (rather than the usual worn anteriors)?



In this episode, Jaz dives into the ‘Reverse Dahl Technique’, a twist on the classic method typically used for localized anterior wear. Dr. Hans Kristian Ognedal from Norway shares his insights, explaining how building up posterior teeth with composite can lead to occlusion magic! 



If you're curious about this technique and want to see a real-life case study, this episode breaks it all down, with a special visual breakdown for those watching on YouTube or Protrusive Guidance.




https://youtu.be/V8MTFfXmdlw
Watch PDP235 on Youtube



Protrusive Dental Pearl: Jaz shares insights from Hold On to Your Kids by Dr. Gordon Neufeld & Dr. Gabor Maté, emphasizing how modern children lose parental attachment too soon, turning to peers for guidance. This shift can lead to anxiety and emotional disconnection. 



Takeaway: Kids thrive when their primary attachment remains with parents, not peers. Strengthening this bond is crucial for healthy development. 



Key Takeaways




* The traditional Dahl principle focuses on creating occlusal space for anterior crowns.



* The reverse Dahl technique is a direct method for treating worn POSTERIOR teeth.



* Diet plays a significant role in tooth wear and dental health.



* Taking photographs of patients' teeth can help track wear over time.



* Understanding the etiology of tooth wear is crucial for effective treatment.



* Building up dental anatomy is essential for successful restorations.



* Occlusion should be viewed as a dynamic system rather than a static one. 



* Patients can adapt well to this treatment modality



* “Patients that wear their teeth, they don't usually have TMJ problems.”




Highlights of this episode:




* 02:22  Protrusive Dental Pearl



* 04:50 Guest Introduction: Dr. Hans Kristian Ognedal



* 07:06 Understanding the Original Dahl Concept



* 09:31 Exploring Reverse Dahl Technique



* 13:30 Etiology and Patterns of Tooth Wear



* 23:46 Facial Patterns and Occlusal Traits Linked to Wear



* 24:44 Clinical Approach to Posterior Wear



* 30:26 Patient Comfort and Staging Treatments



* 32:11 Cuspal Planes and Guidance



* 34:21 Review Schedule and Observations



* 38:44 Longevity of Treatments



* 44:04 Contraindications and Patient Selection 



* 45:24 Case Studies and Practical Tips



* 49:30 Night Guard Use



* 53:06 Final Thoughts and Education Opportunities




If you want to learn more about Dahl Technique, be sure to listen/watch:

Do you feel confident managing patients with TMD or oro-facial pain?



Are you clear on when to treat conservatively—and when to escalate?



What’s the best SEQUENCE of care for TMD patients?



Emma returns to Protrusive Students fresh from her finals, joining Jaz for an insightful episode on the basics of TMD management. Together, they explore the foundational steps of TMD care, from proper diagnosis to the logic behind a structured treatment hierarchy.



They break down conservative versus aggressive approaches, share clinical tips for muscle and joint assessment, and highlight common mistakes to avoid—especially during palpation and history taking.



Whether you’re a student, a dentist returning to practice, or just want a refresher on TMD, this episode will help solidify your approach and boost your clinical confidence.




https://youtu.be/p5VJzwSka94
Watch PS016 on Youtube



Key Takeaways




* TMD is a complex topic with various treatment approaches.



* Patient education is crucial in managing TMD effectively.



* Physiotherapy can significantly aid in TMD treatment.



* Different splints serve different purposes in TMD management.



* Bruxism can be a silent issue that affects many patients.



* Identifying the source of pain is essential for effective treatment.



* Stress can exacerbate TMD symptoms in patient cohorts



* Continuous learning and resources are vital for dental professionals.




Highlights of this episode:




* 02:35 Emma's Finals Experience and Advice



* 05:16 Deep Dive into TMD: Clinical Insights



* 09:59 Common TMD Disorders and Their Presentation



* 18:31 TMD Treatment Options



* 28:00 Medications and Appliance Therapy



* 34:25 Practical Tips for Managing TMD



* 37:19 Addressing Bruxism and Patient Communication



* 41:00 Protrusive Pathways and Future Plans



* 43:46 Protrusive Students S2




Protrusive Resources




* OPPERA Study



* Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†



* TMD Therapy Hierarchy of Management



* Effects of occlusal splint therapy in addition to physical therapy on pain in patients affected by myogenous temporomandibular disorders: A pilot randomized controlled trial



* Splints Decision-Making Flowchart 




Protrusive Pathways Structured playlists grou...

Have you heard of Photobiomodulation (PBM)? Or are you thinking... ‘photo-what?!’



Is red light therapy just voodoo science—or is it already part of mainstream healthcare?



Can PBM really help with wound healing, pain relief, and even reduce the risk of dementia?



In this episode, Professor Praveen Arany joins Jaz Gulati to break down the science and clinical relevance of PBM in dentistry. They explore how this light-based therapy works, its applications in managing oral lesions, and why it’s already standard care for cancer patients undergoing chemotherapy.



They also discuss real-world cases, practical protocols, and how PBM could shape the future of dental care. Whether you're a skeptic or just curious, this episode will open your eyes to an emerging and evidence-based treatment modality.




https://youtu.be/lQrawr3-YQA
Watch PDP234 on YouTube



Protrusive Dental Pearl: SHEEP Scoring as a practical tool to assess the prognosis and restorability of compromised teeth.



SHEEP stands for:




* S – Structure: Amount of remaining tooth structure



* H – History: Patient's dental and medical history (e.g. caries risk, trauma)



* E – Endodontics: Endodontic prognosis (ease/difficulty of root canal treatment)



* E – Expertise: Your personal skill and experience with managing such cases



* P – Periodontal: Periodontal condition and bone support




Each category is scored out of 10, and the total is doubled to give a percentage-based prognosis. This structured approach supports clinical decision-making, encourages honest reflection on the clinician's own skills, and enhances patient communication during consent. The method is backed by literature, including a paper co-authored by Martin Kelleher.



Need to Read it? Check out the Full Episode Transcript below!



Key Takeaways




* Photobiomodulation can significantly improve patient comfort and healing.



* The treatment is standard for cancer patients undergoing chemotherapy.



* There are no known adverse effects of PBM when used correctly.



* PBM can be used effectively in various dental procedures.



* The future of PBM includes personalized treatment protocols.



* Research is ongoing to optimize PBM applications in dentistry.



* PBM is distinct from other laser treatments and has unique benefits.



* The technology is becoming more accessible to practitioners.



* Awareness of PBM's benefits is growing in the wellness industry.




ResourcesProf. Praveen Arany shares papers on:




* Light buckets and laser beams: mechanisms and applications of photobiomodulation (PBM) therapy



* Photobiomodulation therapy: Ushering in a new era in personalized supportive cancer care



* Photobiomodulation Thera...

Should you be re-treating that root canal—or referring it out?



What are the red flags that scream “specialist only”?



How do you confidently remove GP without compromising disinfection?



Dr. Ayman Al-Sibassi joins Jaz in this endo-packed episode to help you navigate the tricky world of root canal re-treatments. From solvent selection and GP removal techniques to assessing case difficulty, they break down everything a GDP needs to know to make smart, confident decisions.



You’ll learn how to spot the cases you should be tackling, which ones to send to your endodontist, and what tools and techniques will make the re-treatment process smoother and safer. Because not all re-treatments are created equal—and some are surprisingly simple once you know what to look for.




https://www.youtube.com/watch?v=apMtcuNTLqI
Watch PDP233 on YouTube



Protrusive Dental Pearl: A crack in a bonded ceramic restoration isn’t necessarily a failure!



Just like we accept cracks in natural enamel, we can also accept cracks in ceramics—as long as it’s been properly bonded.



Shoutout to Dr. Pascal Magne for this powerful mindset shift!



Need to Read it? Check out the Full Episode Transcript below!



Key Takeaways




* Specialist training in endodontics includes a variety of surgical skills.



* The complexity of root canal retreatments varies significantly.



* General dentists can perform some retreatments, but should assess complexity carefully.



* Patient consent is essential, especially regarding potential unrestorability.



* Communication about fees should be clear and upfront with patients.



* Red flags for retreatment include poor coronal seal and previous treatment quality.



* CBCT imaging is becoming increasingly important in endodontic practice.



* Collaboration between general dentists and specialists enhances patient outcomes. Many referrals stem from straightforward cases that are poorly managed.



* Using solvents can aid in GP removal but should be approached cautiously.



* Single visit treatments are often preferred for patient convenience.



* Adequate disinfection is crucial, sometimes necessitating a second visit.



* The survival rate of root canal-treated teeth is comparable to implants.



* Patient age and overall health should guide treatment decisions.



* Understanding the difference between success and survival in endodontics is essential.




Highlights of this episode:




* 00:00 Introduction



* 05:02 — Protrusive Dental Pearl: Cracks in enamel vs. dentine 



* 06:34 — Guest Introduction: Dr. Ayman Al-Sibassi and his journey into Endo 



* 11:03 Assessing the complexity of re-treatments and when to refer



* 15:21 The role of CBCT in diagnosis and treatment planning



* 17:47 Ethical and financial dilemmas: charging for unrestorable teeth



* 22:05 Red flags in root canal re-treatments



* 34:55 Techniques for GP removal and file selection

Are you confident when increasing the vertical dimension?



How do you plan, stage, and sequence a full-mouth case safely?



What’s the right deprogramming method—leaf gauge, Kois appliance, or something else?



Dr. David Bloom joins Jaz in this powerhouse episode to demystify the real-world process of increasing vertical dimension. With decades of experience in comprehensive dentistry, David shares how he approaches diagnosis, bite records, temporization, and final restorations—with predictability and confidence.




https://youtu.be/gAaP0VYP84s
Watch PDP232 on YouTube



Protrusive Dental Pearl: Pick one occlusal philosophy and stick with it until you understand it well through real cases. Once you’re confident, stay open to other approaches—hearing different views will make you smarter, more flexible, and a better dentist.



If you are looking to get started with the foundations of Occlusion, check out our comprehensive Online Occlusion Course.



Need to Read it? Check out the Full Episode Transcript below!



Highlights of this episode:




* 00:00 Trailer



* 00:55 Introduction



* 04:43 Guest Introduction: Dr. David Bloom



* 10:25 Equilibration Techniques Explained



* 11:18  Interjection #1



* 15:50  Opening Vertical Dimension vs. Orthodontics



* 18:06 Interjection #2



* 23:05 Whitening and Restorative Solutions



* 25:27 Guidelines for Raising Vertical Dimension



* 25:52 Interjection #3



* 29:28 Midroll



* 32:49 Guidelines for Raising Vertical Dimension



* 36:06 Visual Try-In and Adapting Vertical Dimension



* 40:16 Case Planning and Execution



* 41:16 Interjection #4



* 43:42 Case Planning and Execution



* 50:23 Material Preference for Provisionals



* 52:00 Bite Registration and Final Adjustments



* 55:06 Do's and Don'ts for Clinicians



* 57:15 Conclusion and Resources



* 58:59 Outro




Key Takeaways




* Vertical Dimension and Adaptation: Opening the vertical dimension in dentistry can be challenging, especially for edentulous patients who lack proprioception. However, with proper planning and understanding of occlusion, the human body can adapt remarkably well.



* Occlusal Philosophy: It's important to learn one occlusal philosophy well, whether it's Kois, Dawson, or another. Understanding different approaches can make you a more rounded clinician, as different patients may benefit from different methods.



* Equilibration and Deprogramming: Equilibration is crucial for idealizing occlusion by eliminating interferences. Deprogramming helps in achieving centric relation, a stable and repeatable position for the condyles, which is essential for successful equilibration.



* Orthodontics vs. Vertical Dimension: Deciding between orthodontics and opening the vertical dimension depends on the specific case. For example, pre-aligning patients with orthodontics might be necessary to address a rest...

How do you manage patients that have ultra high expectations?



What’s the best way to communicate cosmetic outcomes before the final result?



How do you balance your aesthetic vision with what they see?



Dr. Brandon Mack joins Jaz for a deep dive into the realities of cosmetic dentistry—from subjective perceptions of beauty to practical tips that make or break a case.



They discuss how to navigate aesthetic stress, manage patient expectations, and even go into Brandon’s favorite veneer cement and occlusal philosophy. Plus, Brandon shares key failures that shaped his journey—and how you can avoid the same pitfalls.




https://youtu.be/s7puDNP3d7U
Watch PDP231 on YouTube





Protrusive Dental Pearl: When discussing smile design with patients, especially in high-end cosmetic cases, set the right expectations early by using this memorable “Eyebrow Analogy”:




* Central incisors = Twins (they should be as symmetrical as possible)



* Lateral incisors = Sisters (not identical, but related)



* Canines = Cousins (more individual)





This helps patients understand that perfect symmetry isn’t always natural or necessary — especially for lateral incisors!





Need to Read it? Check out the Full Episode Transcript below!







Key Takeaways




* Cosmetic dentistry as a lens through which all treatment should be approached—balancing patient autonomy with ethical care.



* Managing expectations begins before the patient sits in the chair. It continues through structured checkpoints: from initial consultation to provisional feedback and final delivery.



* Temps aren’t just placeholders—they are test drives. They align expectations between the dentist, patient, and lab, reducing surprises and improving satisfaction.



* Some dentists may under-diagnose due to fear of rejection—not out of true minimalism. Thoughtful planning can make “more treatment” actually less invasive.



* Patients often want teeth that are both ultra-white and natural-looking. Brandon developed the concept of believability—a visual balance that delivers a wow-factor while still appearing real.



* Creating a mathematically perfect smile can make natural facial asymmetries more obvious. Dentists must weigh beauty against harmony.



* Social media and filters have distorted patient self-perception. Dentists must learn to identify signs of body or tooth dysmorphia and respond ethically—not just clinically.



* Building relationships with ceramists over time—expecting 15–20 cases before finding synergy. Each technician has unique strengths and should be matched accordingly.



* Composite veneers are accessible and beautiful—but extremely technique-sensitive. You become the ceramist. Brandon admires them but uses them selectively due to long-term maintenance concerns.



* Panavia Veneer Cement – Translucent for its predictable handling, strength, and minimal risk to thin ceramic restorations.






Highlights of this episode:




* 01:35  Protrusive Dental Pearl



* 03:11 Dr. Brandon Mack's Journey and Philosophy



* 09:19 Managing Patient Expectations in Cosmetic Dentistry