Last Tooth In the Arch Syndrome – 2nd Molar Conundrums – PDP130

Have you ever prepared the last molar for a crown? And just when you check the occlusal reduction, the patient bites down and as if by magic, the reduction has all DISAPPEARED?! It is the phenomenon that we call ‘The Last Tooth in the Arch Syndrome’ This episode with Dr. Mahmoud Ibrahim will give you more confidence in recognizing, screening, and managing such complications in practice. But like I say in the main episode, optimistically, this phenomenon will never happen to you AGAIN if you follow these protocols for screening. https://youtu.be/gs1r5mlefHU Check out this full episode on YouTube Protrusive Dental Pearl:  Watch out for the patient with quite flat teeth as they are more susceptible to the last tooth in the arch syndrome / bite change. They do not have good posterior coupling/stability and therefore more likely to 'forget' their bite as the cuspal inclines do not guide the mandible back in to maximum intercuspation. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: * 2:41 Protrusive Dental Pearl* 6:09 Introduction to Dr. Mahmoud Ibrahim* 9:34 What is Centric relation?* 10:45 Last tooth in the arch syndrome* 13:14 Risk assessment for Last Tooth in the Arch Syndrome* 15:52 Screening patient's CRCP and the degree of slide* 17:33 Leaf Gauge protocol for screening CRCP* 30:23 Communication with High-risk patients* 34:35 Case Discussion* 44:36 Management of space loss after preparation* 46:24 Dr. Mahmoud's top tips to prevent the 'Last Tooth in the Arch Syndrome* 58:47 Occlusion Basics and Beyond Dr. Mahmoud Ibrahim and I are currently working on a huge project called OBAB, Occlusion Basics and Beyond - it will be the best occlusion resource in the Milky Way...and that's our mission! We want to finally demystify Occlusion and make it Tangible AF! Join the waiting list HERE! If you loved this episode, you will like If You are Not In Centric Relation, You Will Die Click below for full episode transcript: Opening Snippet: Because it sounds horrible, but if it's happened with all the sequelae of you losing space and bite changing, that is a big deal. I mean, this patient that might be looking at ortho might be looking at a rehab, who's paying for that? Chances are you. So for two minutes screen that you can do. And once you get good at it, it's, it's really, really quick. Just to buy yourself that peace of mind and being able to inform the patient and gain proper consent when you're restoring the terminal tooth or maybe the one in front. That two minutes is worth it in my opinion. Jaz's Introduction:Have you ever prepared the second molar or the last molar of the patient's mouth for a crown? And when you've checked the occlusal reduction, you get the patient to bite together. And it's as if you NEVER DID ANY OCCLUSAL REDUCTION. You think what the hell is going on? I swear I just sunk a two millimeter bur into this tooth. And now it's like there's hardly any space there. What's going on? Has that ever happened to you? Has that problem bitten you? Have you had that dreaded phone call from the lab saying, 'We need a bit more space here, Doc.' If you experienced this,