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Protrusive Dental Podcast

Protrusive Dental Podcast

Written by: Jaz Gulati
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The Forward Thinking Dental Podcast© 2025 Protrusive Dental Podcast Hygiene & Healthy Living Physical Illness & Disease Science Self-Help Success
Episodes
  • Rotary vs Reciprocating Files – The Endo Showdown with Samuel Johnson Part 1 – PDP270

    Rotary vs Reciprocating Files – The Endo Showdown with Samuel Johnson Part 1 – PDP270
    Jun 3 2026
    Rotary or reciprocating files — which should you actually be using? Is one safer than the other? Does reciprocation really reduce file separation? Are you choosing your system because it suits the canal anatomy, or because it is simply the one you were taught? Endodontic file systems can feel like a maze of brands, tapers, alloys, motions and marketing claims. But beneath all that noise, the real question is much more practical: what is your file doing inside the canal, and what compromise are you accepting? In this episode, Dr Samuel Johnson returns to unpack the Endo Showdown: rotary versus reciprocating files. We cover file motion, glide paths, shaping philosophy, NiTi metallurgy, cyclic fatigue, torsional fatigue, and why no system is perfect. https://youtu.be/HfWDBbNgjsA Watch PDP270 on YouTube Protrusive Dental Pearl A palliative root canal can be useful for an unrestorable tooth if disinfecting the canal allows infection to heal and natural bone to recover before extraction and future implant planning. ⚠️ Do not dismiss root canal treatment purely because the tooth is not a long-term functional restoration. ✅ Where appropriate, consider whether endodontic disinfection could improve the future implant site by allowing natural bone healing. Key Takeaways The purpose of shaping is not simply to scrape canal walls; it is to create space for irrigant flow.Irrigation is the most important part of root canal disinfection.Rotary files move in a continuous 360-degree rotation.Reciprocating files cut in one direction and reverse before excessive stress builds up.Modern reciprocation is designed to cut, release and gradually progress apically.File choice is not just about motion; metallurgy, taper, design and operator experience all matter.NiTi hand files with strong shape memory may be problematic in curved canals because they want to straighten.Martensitic heat-treated files are more flexible and can better follow canal curvature.Unwinding flutes are a warning sign that a file may be close to separation.Inspect files regularly during treatment, especially in curved, calcified or difficult canals.A glide path is essential before introducing larger rotary or reciprocating files.Without a glide path, a shaping file may create its own path, risking ledging, transportation or perforation.“Grabby” files pull themselves into the canal; this can be useful in experienced hands but risky if forced.Reciprocating systems can feel simpler and safer, but they are not foolproof.Cyclic fatigue happens when a file repeatedly bends around a curve until microcracks form.Torsional fatigue happens when part of the file binds while the motor continues to turn. Highlights of the episode: 00:00 Teaser00:47 Introduction02:13 Protrusive Dental Pearl: Palliative Root Canal Treatment05:30 Main Question: Rotary vs Reciprocating Files06:31 Hybrid File Motions08:19 File Choice Is More Than Motion10:26 Purpose of Shaping in Endodontics11:10 Chemo-Mechanical Preparation11:34 Rotary Motion in Root Canal Treatment11:45 Origins of Reciprocation12:21 Balanced Force Technique18:00 NiTi K-Files vs Stainless Steel K-Files22:37 Practical Advice: Inspect the File23:40 Rotary Can Also Be a One File System24:24 Reciprocation and Sense of Safety24:47 “Grabby” Files24:53 Midroll33:54 Choosing Between Rotary and Reciprocating35:20 Cyclic Fatigue37:41 Endo Radar Pro Ads40:20 Torque and RPM in Endodontics41:41 Why Reciprocation Advances42:56 Debris Extrusion in RCT43:34 Benefits of Rotary Systems44:13 Tactile Feedback in Root Canal Treatment45:21 Outro Want more? Check out previous episode with Dr. Samuel Johnson: Working Lengths and Troubleshooting Apex Locators – PDP216 🦷 Looking for an endomotor? Upgrade your endodontic workflow with the Woodpecker Endo Radar Pro. Head to protrusive.co.uk/endomotor and use coupon code PROTRUSIVE at checkout to claim an exclusive discount and your choice of complimentary file system. #PDPMainEpisodes #EndoRestorative This episode is eligible for 0.5 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes CAGD Subject Code: 070 Endodontics Aim: To improve dentists’ understanding of rotary and reciprocating endodontic file systems, including file motion, glide path creation, file metallurgy, fatigue mechanisms, irrigation principles, and practical steps to reduce procedural risks. Dentists will be able to – Understand the clinical differences between rotary and reciprocating file motions and how these may influence endodontic workflowRecognise key risk factors for file separation, including cyclic fatigue, torsional fatigue, file distortion and inappropriate file useApply practical principles around glide path creation, irrigation, file inspection and system selection in endodontic treatment
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    45 mins
  • A Practical Guide to Modern Caries Management Part 2 – Peptides, SDF, Hydroxyapatite and Xeristomia! – PDP269

    A Practical Guide to Modern Caries Management Part 2 – Peptides, SDF, Hydroxyapatite and Xeristomia! – PDP269
    May 27 2026
    Should we still be drilling early caries lesions? Where do peptides, resin infiltration, fluoride varnish and SDF actually fit in modern practice? Is hydroxyapatite toothpaste a genuine alternative to fluoride, or just another dental trend? And when you see that suspicious grey occlusal shadow, do you seal it, explore it, or actively surveil it? In part two of this modern caries management episode, Jaz continues the conversation with Prof. Avijit Banerjee on minimal intervention dentistry. This episode moves beyond diagnosis and communication into the practical management of early and progressing caries lesions, including peptides, SDF, hydroxyapatite toothpaste, fissure sealing, xerostomia, root caries and selective caries removal. https://youtu.be/dGt7FW7C4N0 Watch PDP269 on YouTube Protrusive Dental Pearl Use the Contemporary Caries Management Implementation Pack as a chairside aid to turn the episode into daily clinical action. ⚠️ Learning the evidence is not enough if it never makes it into your patient conversations, risk assessment or treatment planning. ✅ Print it, laminate it, and use it to support communication, diagnosis, active surveillance and minimally invasive decision-making. Disclaimer: This is an educational resource produced by Team Protrusive, derived from the two-part Protrusive Dental Podcast episode featuring Prof. Avijit Banerjee. Its contents were not written, reviewed, or endorsed by Prof. Banerjee; they represent Team Protrusive’s own interpretation of the material discussed. It is intended as a practical summary and is not a substitute for primary sources. We strongly encourage all clinicians to consult the latest Clinical Practice Guidelines before making treatment decisions. Key Takeaways: Peptides are designed to infiltrate early enamel lesions and create a scaffold for mineral deposition.Peptide technologies still need minerals from saliva, toothpaste, mouthwash or other sources to work.Fluoride supports remineralisation; it acts more like the “mortar” than the “bricks”.Early E1 lesions are usually managed with prevention, fluoride, oral hygiene, diet control and biofilm control.Deeper enamel lesions, such as progressing E1 or E2 lesions, may be suitable for resin infiltration or peptide infiltration.SDF is better suited to cavitated lesions where arrest and stabilisation are needed.In the UK, SDF is licensed for dentine sensitivity, so caries arrest is an off-label use.SDF can be very useful for children, older adults, medically compromised patients and care-home patients.The main downside of conventional SDF is black staining, especially on anterior teeth.Hydroxyapatite toothpaste has more science behind it than charcoal-style fad toothpastes.Fluoride toothpaste remains the preferred baseline recommendation when patients are happy to use fluoride.A suspicious grey occlusal lesion should be assessed in the context of the patient’s overall caries risk.In selected cases, a tiny exploratory opening can act like a diagnostic biopsy.Sealing fissures on the same tooth being restored can be sensible when the fissure pattern is deep.For severe xerostomia and root caries risk, consider high-fluoride regimes, close recalls, trays or dentures as carriers for remineralising agents. YouTube Highlights: 00:00 Teaser01:17 Introduction02:17 Pearl: Caries Management Implementation Pack05:54 What are Peptides?14:42 SDF: Silver Diamine Fluoride14:55 Early Enamel Lesion Pathway15:11 When to Consider Resin or Peptide Infiltration15:51 Best Use Case for SDF20:14 Hydroxyapatite Toothpaste21:18 Fluoride Safety and Evidence27:00 Midroll40:53 Preventive vs Therapeutic Sealants42:09 Severe Xerostomia and Root Caries44:40 Using Trays or Dentures as Carriers45:48 Tooth Mousse and CPP-ACP47:11 Artificial Saliva47:46 Why the Patient Has Dry Mouth Matters49:35 Current Position on Stepwise Excavation50:09 Selective Caries Removal51:15 Deep Caries Guidelines53:01 Materials Are Not Everything in Caries Management55:59 Further Learning Resource 56:44 Outro Want more? Check out part one of this modern caries management series for communication, diagnostics, triangulating data and deciding which caries detection tools are actually worth using. 🦷 Download the Contemporary Caries Management Implementation PackHead to protrusive.co.uk/MID to access the free implementation pack, including key communication points, diagnosis guidance, management flowcharts and evidence links. Professor Avijit Banerjee’s recommended reading and ongoing work: New textbook: A Clinical Guide to Advanced Minimum Intervention Restorative Dentistry (Banerjee A., Elsevier, 2024) — the most comprehensive single reference for modern MIOC and MID. 👉 uk.elsevierhealth.com (ISBN 978-0-443-10971-3) Resources mentioned in this episode: S3 Guidelines: https://pmc.ncbi.nlm.nih.gov/articles/PMC13099699/ 🦷 Interested in Proximal Resin Infiltration? Explore The Iconic Method with Cat Edney: a free 1-hour ...
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    57 mins
  • A Practical Guide to Modern Caries Management – MIOC and MID Part 1 – PDP268

    A Practical Guide to Modern Caries Management – MIOC and MID Part 1 – PDP268
    May 20 2026
    If you showed the same bitewing to 10 dentists, would they all agree on whether to pick up the drill? Why does the word monitoring mean nothing to a patient — and how does swapping it for active surveillance change everything from your notes to your indemnity to your government policy meetings? Is it overtreatment to act on an E2 lesion — or is “watch and wait” actually the lazy answer dressed up as minimally invasive? And what should you actually do with AI caries detection that flags shadows your eye doesn’t see? In this episode, Professor Avijit Banerjee — Professor of Cariology & Operative Dentistry at King’s College London, Honorary Consultant at Guy’s & St Thomas’, and First Dean of the Faculty of Dentistry at the College of General Dentistry — sits down with Jaz for what is genuinely one of the most important caries conversations on the podcast. Part one of two. Avijit doesn’t do soft answers. The drill-fill-bill model is broken. “Monitoring” needs to go. “Treatment planning” is antiquated terminology medics dropped twenty-five years ago. And AI in caries diagnosis? Useful — but the moment it gets things wrong, you are the one with indemnity, not the software. What you walk away with is a framework (MIOC), a decision filter (three factors that decide whether to pick up a bur), and a vocabulary shift you can implement tomorrow. Part two covers peptides, SDF, hydroxyapatite, stepwise excavation, and managing caries in xerostomia. https://youtu.be/YriLo8_hXNw Watch PDP268 on YouTube Protrusive Dental Pearl: Delete the Word “Monitor” from Your Vocabulary Stop saying monitor. Start saying active surveillance. ⚠️ Active surveillance must not mean passive delay — document your reasoning, risk assessment, and what would trigger intervention. ✅ Explain it to patients as structured, proactive care: clinical checks, radiographs, risk review, behaviour support, and timely action if things change. Key Takeaways Minimum intervention oral care is bigger than minimally invasive dentistry.MIOC is prevention-based, person-focused, susceptibility-related, and delivered by the whole oral healthcare team.MID is only one part of MIOC: operative dentistry when a tooth actually needs intervention.The four MIOC domains are: identify the problem, prevent lesions and control disease, provide minimally invasive operative care, then reassess.A care plan is more useful than a treatment plan because it includes justification, prevention, behaviour change, and review.Ask patients what matters to you, not just what’s the matter with you.Cavitation, cleansability, and lesion activity should guide whether to intervene operatively.A cavitated lesion that cannot be cleaned is much more likely to remain active.Smooth surface lesions may sometimes be made cleansable without conventional drilling.Restorations are not just about filling holes; they help recreate a cleansable tooth surface.There is no single perfect caries detection technology — clinical examination and good radiographs remain fundamental.If using NIRI, fluorescence, scanners, or AI, understand how the technology works and where it fails.AI should support diagnosis, not replace clinical judgement.For uncertain early lesions, triangulate: clinical findings, radiographs, risk, technology, and patient factors.Proximal resin infiltration has a role in the right patient and situation, especially as part of a wider prevention-led strategy. Highlights of This Episode 00:00 Teaser 02:17 Protrusive Dental Pearl: Active Surveillance, Not Monitoring 09:14 Minimum Intervention Oral Care vs Minimally Invasive Dentistry 11:28 Core Principles of MIOC 11:48 Domain 1: Identify the Problem 12:46 Domain 2: Prevention of Lesions and Control of Disease 13:18 Microinvasive Care Options 14:41 Domain 3: Minimally Invasive Operative Dentistry 16:38 Why “Active Surveillance” Matters 18:24 MIOC as a Practical Framework 19:43 Applying MIOC in Patient Communication 22:38 Sustainability & Salutogenesis 29:05 When to Pick Up a Drill 30:23 Biofilm as the Engine of Caries 31:33 Purpose of a Restoration in Caries Management 36:13 Caries Detection Technologies 42:44 Watch and Wait vs Detect and Manage 01:02:52 Outro Professor Avijit Banerjee’s recommended reading and ongoing work: New textbook: A Clinical Guide to Advanced Minimum Intervention Restorative Dentistry (Banerjee A., Elsevier, 2024) — the most comprehensive single reference for modern MIOC and MID. 👉 uk.elsevierhealth.com (ISBN 978-0-443-10971-3) 🦷 Interested in Proximal Resin Infiltration? Don’t miss out! DMG Icon Proximal discount for dental professionals at protrusive.co.uk/dmgExplore The Iconic Method with Cat Edney: a free 1-hour webinar on 24 June 2026, followed by a hands-on 1-day Birmingham course on 4 July 2026 covering Icon resin infiltration, tooth whitening and NIRI-guided enamel management, with verifiable CPD available. Loved This Episode? Try this next: Is ...
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    1 hr and 3 mins
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