Getting Started With Dental Implants – Is it for me? – PDP051

Jaz’s Introduction: Have you ever been on a dental course and not applied the knowledge and because he never got to apply the knowledge, you felt as though it was absolute waste because really, if you didn’t get to apply it, you didn’t get to treat a patient with that new technique you’ve learned, it really goes to waste. So sometimes, you know, we do these courses, and they can cost a lot of money. And we don’t get the best out of it. For example, I went on a laser course last year, I’ve hardly touched a laser since. So I feel it’s a waste. And I know it’s my own fault. And I take full ownership of that. But I think sometimes the states can be even higher beyond just a laser course. Imagine doing implants, for example, and investing heavily in implant costs. And they’re not cheap, let’s be honest. And imagine doing that. And I’ve got some friends who have done implant pathways and programs and have not been able to put it into practice. That can be a costly mistake is one way of putting it or a costly discovery that actually maybe implant is not the right path for you or whichever path you’ve done or invested in isn’t best for you. That’s why I’ve got Dr Hassan Maghaireh with me today for this two part episode. The first one is a mammoth topic, right? The first one is, how to know if implants is the right path for you and how to get started within dental implantology. And Part two is assessing your patient for implants. Who is the best patient for implants? What is their requirement for space dimensions, bone, delaying the implants versus immediate, all these sorts of things that will hopefully cover the very fundamentals. Even if you don’t place implants in a moment that you’ll be able to gain from these two episodes. Just a bit of news before we dive into the episode. Occlusion 2020 was a massive success. Thank you so much for all of you who took part. It didn’t feel like a zoom sort of conference if you’d like it felt more than that it was so much more energy. The chat was on fire. It was a lot of great banter, actually. And it was so so great to see everyone there. And the beauty of it is that replay function or redo think online education really is the way forward in dentistry. Who would have thought five years ago that so many of the courses in education can be delivered online. So it’s really great. And thanks so much for supporting us with occlusion 2020. And thank you to you guys listening right now for helping this podcast grow. And I’m always in a good mood to say these positive things because it really puts a smile on my face. For example, recently, about a month ago now a German dental student reached out to me and told me I always have favorite English podcast. So Sofia, thanks so much for listening. And all of you I get loads of messages of gratitude. And I really love that and it’s very great to read those messages. Sometimes a message like you rekindled my passion for dentistry like oh my god, I can’t get over that. So please, let’s keep going. If you don’t mind recommending me to a friend or a colleague who hasn’t heard about the podcast, that’s how the podcast grows. That’s how I can have more varied interesting guests. So I really appreciate all the hard work you guys have done in helping to promote my podcast organically. And funnily enough, I found out that the Protrusive Dental podcast last month was the number one ranked podcast in the category of medicine in Qatar. So shout out to all my listeners in Qatar you took me to number one baby. Hopefully, Qatar is done but hopefully the world next. The Protrusive Dental pearl I have for you is dental photography related. So whether you’re still to get started in photography, or you’re taking photos already, I think you can gain from this. It has to do with equipment, right? Like if your biggest barrier is the expense of buying a camera. Firstly, let me say it’s totally worth it no matter how much your camera costs, dental photography will really elevate your work or bring you so much more satisfaction as a dentist, so just do it. However, I know young dentists, you know, one or two years out and you feel as though it’s a big investment to make all at once. So my advice to you would be to consider buying your photography equipment secondhand. Now when I bought my camera seven years ago, I got it from Gumtree or if in the US Craigslist or whatever, you can buy used camera and camera gear from a photographer, for example, who’s looked after their equipment really well. But now because they’ve upgraded they essentially can sell their equipment, the older equipment that is really valuable to you at a much discount price. Now, as dentists, we don’t need a particularly fancy camera body, okay, the body itself can be fairly basic, the lens should be good, and the ring flash should be adequate. So really, there’s no reason to break the bank over all this and you can buy used models. And even on websites like in the UK, we have wex, w-e-x, where they have refurbished items. So I would totally explore buying equipment, whether it’s due for renewal, or your first purchase, secondhand, or as a refurbished item on these photography websites. And the sooner you get started taking photos, the better. So that’s my pearl for you today. Let’s jump in with the episode with Dr Hassan Maghaireh with getting started with dental implants.

Main Interview:

[Jaz]
Dr Hassan Maghaireh. Welcome to the Protrusive Dental podcast. How are you?

[Hassan]
Hello, hi, Jaz. Thank you very much for having me. I’m very good. And good morning to you and all our colleagues listening to this nice podcast.

[Jaz]
Yeah, thanks for tuning in, guys. We appreciate it. And today I’ve got kind of, can I call you Hassan?

[Hassan]
Yes, please do.

[Jaz]
Hassan is someone who I’ve seen a lot over the years on the social media presence, and his passion for implants and teaching really stood out to me. So that’s why I reached out to ask him because a lot of the listeners were like, Can we just have a bit more implant stuff, especially when it comes to a journey of implants so hustling. If you don’t mind we’re gonna cover a couple things today? One is getting into dental implants. And two is just you know, if you’re looking for your first couple of cases or if you’re looking to refer, you know, what is the basic sort of requirement, suitability, assessments, can you place it in smokers? What about timing of extractions? Obviously, in a podcast like this, as you can only scratch the surface I’m sure there’s so many nuances, right? But any direction you can get a dentist that would be great and Hassan. Can you just please tell us a little bit about yourself? About your working week and how you got into implants yourself?

[Hassan]
Well, thank you very much, Jaz. Basically, for me, implant dentistry is one of the most rewarding aspects or branches of dentistry. And I strongly believe that every single dentist has a duty to know something about implant dentistry. In fact, as we all know, GDC here in the UK makes it mandatory for every single dentist to offer implant option to their patients, even you know, if they think you know, a patient won’t go for it, to never judge a book by its cover. Should always offer implant dentistry as one of the treatment options. And I strongly believe that you know, people who like to go into implant dentistry, they’re going to find it very rewarding providing this start right. What goes, what starts right, goes right. Why do I say that because it’s so easy to slip into implant dentistry through the wrong doorway or through the wrong entrance and then start to mess up your career, and you lose fun. The way about implant dentistry, let’s admit it, maybe in UK and maybe other countries, undergrads don’t get enough education, about implant dentistry. Hence, every dentist you know will need to pursue a career in implant dentistry through some post continual education or continual education after graduation. And that could be either through masters if they want to get like into research and thesis. Or if they just want to reach a level where they can be say implant dentist, there are so many good courses, continuing education courses, which according to the general dental Council of the United Kingdom has to be a long course with integrated mentoring scheme. And that course needs to be completed with an assessment, hence only then someone can say now I’m safe to do implant dentistry.

[Jaz]
You mentioned that Hassan because straightaway that leads very nicely to the first overall question I want to ask which is basically when we do our undergraduate studies, like with a lot of dentistry, we scratch the surface I mean I know dentists who have done one molar root canal or even dare I say no molar root canals and they’ve got a BDS Hassan, Okay? So don’t even go like don’t even think about implants. If they have done maybe seven extractions and one molar root canal, this is the state Okay, and I don’t know how much worse the pandemics and make everything right. So we’re qualifying with way less experienced than we used to then and you don’t get to dabble or get your hands into implant dentistry. So how can you be sure it’s the right path for you and to even begin to think it’s now worth investing some money into, into the path of learning because if you quite correctly said the way to learn implants will be through a private courses or masters just like you said, but how do you know is the right thing for you? Are there certain traits that you see in someone in a clinician you think, you know what they may have a fruitful career in implant dentistry, or a certain type of individual, a student maybe should focus on something else, any sort of light, you can judge, you can share on that?

[Hassan]
I thinkJaz, it’s a decision every single person will need to make you and I know, let’s talk about dentistry in the United Kingdom. At the beginning, once you graduate, you need to make that decision. Are you going to be NHS nine to five dentists who just you know, happy to settle? Or are you someone passionate, wants to take the challenge one step forward? Do some more challenging cases? Wanting to spend more time with your patients not wanting to keep your patients in house, even wanting to, you know, upskill and upgrade your CV so you can get better jobs later on? So this is the first question every single graduate needs to make. You know, Where do you work? Where do you see yourself five years down the line? Now, should you decide that you know what NHS dentistry is not for me, I want to be someone different. I want to be above average, then the second question is, right, which part of private dentistry you think you can be enjoying that? Okay, now we know jack of all trades, master of none. So you need to somehow develop passion in one aspect of dentistry. I mean, I’m not saying don’t do the rest of dentistry, but just developed passion, where you sort of start to attend evenings, open evenings, Congress’s lectures. And if you find out that, do you know what, this is something I see myself doing in the future. This is something hopefully, in five years time, I’m gonna be doing that with passion, with confidence, safely, then you could make that decision. All right, let’s go into implant dentistry. Before going into implant dentistry, it’s always wise to find someone you look up to like a mentor or someone in your city where you know, you refer some patients to before and say, pick up the phone and say, Can I come and shadow you for a day or two, please? I’m not sure about implant dentistry. And I know that you’re someone who gets implant dentistry regularly, I just want to come and stand behind your shoulder and see how things work. I’m sure you’re going to find lots of people will come in you. And only then you could say, right, this is for me, it’s time to invest. Let’s take it forward.

[Jaz]
I think it’s great. You mentioned the role of shadowing, it had a huge role. In my career trajectory. I shadowed lots of great dentists. And that’s the reason I’m today I’m a general dentist who likes to do ortho, likes to treat tooth wear and stuff like that, because it’s a dentist that I shadowed. And that really influenced me, I also shadowed Implant Dentist and I went down and did place some implants on a course, which I shall not name, it’s an international one. And I didn’t have a great experience. And I think it was due to the education I received and that point, and I do think if I could go back in time, I would have picked a different sort of route for getting into it. But now I’m enjoying myself because I’ve got a diploma in orthodontics now, I’m doing more of that. So that’s how I went about it. But really, I think you raise a good point that if I summarize it, you have to kiss a lot of frogs before you find your prince charming, basically, you might have to go on that endo course, you might have to do some endo in practice, and then start making some dentures and maybe shadow a prosthodontist. And then eventually, maybe shadow someone who place implants. And trying to figure out which one or two micro areas within dentistry really resonate with you the most. And I think it’s so great that you mentioned the role of shadowing, which by the way has been complicated by COVID. Unfortunately, there have been a few dentists who have messaged me you want to shadow I missed a few dentists I want to shadow. And because of the whole COVID we just don’t know whether to go or not. But obviously, this will pass. But it’s a great advice you give to find someone in your city, potentially someone you refer to. Shadow them and see if that’s a career for you. Is there anything you want to add to that progress? Before the next question, Hassan.

[Hassan]
Perfect point where you’ve mentioned, I mean, obviously COVID is temporary, and hopefully it will not continue. But you know, you don’t have to invest in courses, maybe congresses, conferences, and don’t look at it as a waste of time. Because you as a dentist has a duty to develop basic knowledge about every aspect. You know, so a patient comes in and say, am I suitable for an implant? You can’t say just to be honest, I don’t know. You have a duty to know the basics about implant dentistry, at least, you know, to be able to answer these questions. So we have in the United Kingdom, ADI, ITI. They’re both two big organizations and they offer annual congresses and conferences. And I think every dentist should go and give it a try. And only then you could decide this is for me or not.

[Jaz]
Brilliant. The next thing I want to ask you then is that there are some dentists who end up doing some implant training and investing their time and money into it. And then they don’t fly with it. They don’t run with it. Happens in anything like, you know, you have some people who do an orthodontic diploma, and they don’t do as many orthodontic case afters, they do an endodontic program, and then they decide not to sort of not specialize or they don’t make their practice limited to endodontics. Because they just don’t get around to doing it. And they spent all their time and money into that field, for example. So how can you ensure that if you want to do some implant training, what’s the way to make sure that you can hit the ground running, and get some cases under your belt? And actually not then just give up implant dentistry a few years later, despite investing time and money?

[Hassan]
Jaz, this is an amazing question. And as you might know, I mean, we run a course here in Leeds, through the British Academy from time to start in dentistry. And I get a lot of people calling me asking about the course. And actually, the more important question is, what support the delegates going to get after the course. Because there are so many good courses here. And you know, there are the differences can be minute between one course and the other. But what really makes it or break it for you is what support you’re going to get after the course. And I think every person who’s going into ortho, or implants or endo, continuing education, try to link yourself to a group in that field. And only then after the course, the discussion, the mentoring, the encouragement comes from the family. So in the [?], the Bridge Academy, we like to feel like we’re a family. And we have annual meetings where we can encourage each other. I mean, whenever someone has a challenging case, we have a mentoring scheme, integrated mentoring scheme, where someone can come to your practice, and help you to do this challenging in case. You’ve got a simple case, we have this platform where people discuss these cases together. So I think in general, in dentistry, whether it’s implants, ortho or endo, whenever you want to look into course, especially if we’re talking about a serious course leading to course certificate or diploma, you need to be asking the question, what support I’m going to get after the course? So I can start to enjoy, you know, get the reward of my investment. You’re absolutely right. I mean, it’s sad. I’d also teach the one of the university’s masters. And I can tell you people did MSc in implant dentistry, and they’re not placing implants. And it’s sad, because I know they have the knowledge, but they did not get the after sales support.

[Jaz]
I guess that’s it, Hassan. Thanks so much. The next question I have then is there’s a school of thought with that. With implants, you should go all in because to me, there’s so many systems, so many complications, surgical and restorative, that if you just dabble an implant, you will never reach your true potential or you may not be as successful as someone who just dabbles. So where do you think the the humble GDP fits into it? Firstly, do you believe that? And how does the GDP then dabble? You know, maybe a GDP places six implants a month? Is that a decent amount? Is that okay to practice in that sort of field where you’re placing that number? Or does it really need to be either zero or 50?

[Hassan]
Yes, 100%. Let me take just one step backward. Now, as a general dentist, you have a choice of going into implant dentistry, as at three levels, let’s say level one, which developed the knowledge and I think this is now becoming mandatory, every single dentist needs to have enough knowledge. So whenever you’re doing a consultation with someone coming to you with the failing teeth, or missing teeth, you need to have the knowledge talking to your patient about implant dentistry as an option, and I strongly believe this is mandatory. Okay? Now the next level is to refer your cases to someone you trust, so they can place these implants and then you restore them in house. And the advantage of that, that imagine you having a central incisor missing tooth, you’re gonna want to refer that for an implant, but the adjacent front teeth needs some veneers or crowns. So it will make sense for you as a general dental practitioner to have one impression for all of them, you get the nice matching color, the everything all in one scheme. And also, you as a general practitioner will have the knowledge to be able to follow up this patient, okay, but you need to be trained to do that, you know, training how to restore implants and link yourself to someone you trust, where they can place implants up to the standards you expect. Now, the third level is to say, right, I want to provide the service, in house service for my patients, where I don’t want my patients to go somewhere else, because like it or not, you know, I’m a dentist who accept referrals from colleagues. And I think I might regret saying this later on. But patients like it, when they have all the treatment in their own practice, you know, for a patient they develop over the years, they’ve developed this comfort zone, this trust relationship with their dentist. And when you say, when you go to them and say, do you know what I’m gonna need to refer you to see someone else in another practice. So then this is completely unknown, and they’ll take your word for it. So it will be nice and amazing if you use for them, the dentist they trusted over the years who can continue this treatment. So you as a clinician need to make that decision. Where do you see yourself? Now, the moment you said, right, I’m going to start placing implants, then we forgot another three levels. According to the ITI classification, which is available on the ITI website for free, you could feed all the information about the case on that website, and then you’re going to get a classification whether it’s simple, advanced or complex, mean, no one would expect you to go and jump into complicate complex cases within the first three, five years of your implant career. So what I mean by simple like a case where it’s a lower molar, we’ve got loads of bone, away from the nerve, simple flap, no challenges, you could place that implants. Now, obviously, you need to have the training to be able to do that simple treatment. And then you do simple cases, by yourself for the first few years, couple of years. And whenever you have an advanced case, rather than referring this case to someone else, you could call your mentor and your mentor can come to your practice, and you and your mentor do that advanced case together. So you’re learning one to one through this mentoring session, your patient having treatment in house, so no need to, you know, disturb the patient journey. And you know that you’ve done the best of, you know, of treatment for your patient. Now, the third level, which is complex, and that’s when you mentored or someone really advanced in their training, we’re talking about atrophic jaws, about science of grafting, that’s when you can refer your patient. But these are not very common cases, we’re talking about 10, 20% of the cases. So personally, I am a big advocate for every practice to have their in house Implant Dentist. And if you that associate, or that practice owner, who has passion for perfection, for surgery for you know restorative work, I think you should go for it and give it a go. And yes, you will hear people telling you, it’s either all or none. My advice, it shouldn’t be like that. It’s gradual, like anything else in our life, we don’t go all or none, you don’t go from no driving license to driving Aston Martin, start with a Ford. And then you go up until you reach your dream.

[Jaz]
When you start moving up again. And you start doing more complex cases that you have the mental common, and you do the case together. I think some of my best learning experiences as a student, as a learner have come from that sort of arrangement. Like I remember being in the DCT position in Oral Surgery at a Guys hospital. And I had this complex surgical wisdom tooth. And I was struggling. So one of the registrar’s came and held my hand and she was retracted the cheek and she was telling me what to do as I was doing it, you know, hold it like this, hold it at that. And those have been the most powerful learning experiences for me. So I think that’s a really good point, you make that and that can be applied to any field of dentistry, if you can have someone to hold your hand, not just like over Facebook and send them photos and give you advice because that is really valuable as well, by the way, and by email relationship, but what I actually mean is that someone being by your side and seeing the patient together, and for them, just give me those little little micro tips that will just make your dentistry go a long way. So that’s a great point. And the last question to wrap up this theme of getting started in implants is the following, when we qualify, at what point should you decide? Okay, now is the time, I know you mentioned that level 123 which I really liked by the way, and you I think the way you described it so good because you can do level one very soon after qualifying because it just the core knowledge which we need to have even acquainted GDC but let’s say you want to start taking things again forward. Here’s my perception, my perception is you should be able to take teeth out comfortably enough before you even start think about placing implants. Because for me, that was around about three to four years afterwards. Now when I see any sort of extraction, it doesn’t faze me as much before then I was like, I’m not gonna be okay, am I not? Now I reach a position after the four year point where I thought, okay, now I can do some simple surgicals, happy to section and elevate. Whereas some dentists might jump straight into the deep end without even mastering extractions. For me, that’s how I was once taught is a good point to consider about the surgical aspects of implant dentistry. What do you think about that? How do you know is the right time? And do you need a good restorative background? Before you start going into level two and level three of the implant pathway described?

[Hassan]
Okay, that’s another very good question we always get from people who are passionate, they want to do something as quick as possible, but then they want to check, is it a good time for them? Or are they doing it too early or too late? Now, my advice would be after you finishing your dental degree, obviously, you’ve got to have one or two years of general dentist experience, dentistry experience. And you’re absolutely right, you need to have some knowledge about restorative techniques in general. You need to know how to take a tooth out, and not only taking a tooth out, you need to be learning and focusing on how to be gentle in taking teeth out. Because when it comes to implant dentistry, it’s all about the bonds all about that maybe a plate, which is in 87%, less than one millimeter thickness in dentin [inaudible]. So you could see we’re talking about very thin structure. And it will make or break your implant case in the future having that labial plate intact or not. So absolutely with you that you need to have good skills, the minor and all surgery skills, good some restorative understanding. But on the other side nowadays, you know, people like me and other co directors of other courses, whether it’s University lead or private lead, we acknowledge that and we started to integrate this as part of the education we offer to our participants. So our implant course is a 24 day over eight months. And in a part of this 24 days, we do lots of hands on teaching and taking feedback on managing little tiny, simple flaps, suturing techniques. So we take people assuming they haven’t ever done a suture before, they haven’t ever done a tooth out. And we sort of put that as part of the course. Now you could decide to learn how to do Oral Surgery by yourself and your patient by after taking 100 teeth out, or you could come and attend a one day course, which saves you the trouble of putting yourself and your patient through the stress and the trauma of trying to take a tooth out. So again, the question is, you know, you need to look at what sort of things is going to be covered in that course. I mean, in our course, it’s an implant course. But we also have a full module on occlusion, because we acknowledge the importance of occlusion in implant dentistry. Exactly.

[Jaz]
I was celebrating on there. For those driving, they didn’t see that I was very happy to hear that.

[Hassan]
He was jumpingup and down. So yes, definitely. Because, you know, to learn an implant is not only about this crew, it’s all about you know, stabilizing the map, stabilizing the whole structure, the pink structure, the bone, the adjacent teeth. So some courses will just teach you how to place an implant and other courses will have more like holistic approach where you go from A to Z. Look at the whole thing. And I would like to think in my course, or in our course, we covered all that. One of the brightest graduates we had were people who came to a request two years after graduation. And I mean, I wish I can mention someone called [delegate’s name]. [Delegate’s name] came to me he was the youngest participant.

[Jaz]
He’s very dear friend of mine. [delegate’s name] is a very dear friend of mine. And yes, I didn’t know it was your course that he did. That’s brilliant. He’s loving it. Amazing.

[Hassan]
And now, you know, he’s at his young age, he’s a mentor. So what I’m trying to tell you, it’s up to you to decide when you want to start and I go to people say because I do have some of my colleagues and very respected colleagues, they say, you cannot go into implant dentistry too early. You have to be 5,10 years of experience before giving into implants and I beg to differ because imagine yourself 35 years old this is I would like to think when you’re 35 you should be at the top Okay? If you’re certified with five years or 10 years experience in implant dentistry, it will make a huge difference compared to if you were 35, with one year experience of implant dentistry. So the earlier you start, you know, and you do the course doesn’t mean you’re going to finish the course and go and do full arch. Now you do the course and start with the simple cases. And that put you the first two steps in that pathway. And then from there, you develop your passion, you attend conferences, courses, continual advanced courses. So by the time you’re 35, you can do full arch with confidence. And that’s what I would prefer to do if time goes back.

[Jaz]
That’s a great way to look at the pathway. But I’m so happy you mentioned [ ? ], it’s unexpected, actually. It’s so great to celebrate the success of one of my dear friends. And I mean, if you ask him, he’s very humble, he will say success. That’s the wrong word for me, you know, he’s very humble guy. But I remember because we’re in the same you know, we’re best buds. And I remember what he was saying, so soon at dental school, I want to go to implants. But he’d been thinking about that for a while. And he went into it, knowing that he’d be one of the youngest, least experience. And he was very grounded. He said, that Look, I know, I have so much to learn. And the way he took it, he, I remember, he actually got extra mentorship, he actually, you know, I believe he paid for it, or whatever you need to do. But he did it the right way. He went the right way about it. And I love what he’s doing now. And he’s dedicated. He’s got a purpose. So that is a great case study. And I’m so glad you mentioned him. So it shouldn’t put anyone off if you’re too young, but you have that desire, and you have the willingness to put the hard work in. It’s all very achievable. So I think that ends this part one in a very nice way. So this was all about getting into it. We asked some questions like, at what point, what core skills you need, what to look out for, is it right for you. Any closing words on this segment Hassan? Before we move to the next one.

[Hassan]
Jaz, you’ve just mentioned an important thing and you said he did the course but you had to invest more. And this is the other message, you know, please don’t be diluted or deceived thinking that you’re doing the course, that’s it you’re going to be a perfect implpant dentist. Any course whether it’s even master’s degree, or one of the private courses like the [12 course] which we do over 24 days, which is an intensive and we offer patients as part of the cost our delegates even that it’s only your first step, you need to be willing and ready to invest. You have to invest into mentoring after the course, you have to invest into attending like advanced soft tissue and bone management courses after the course. So it’s a continually, it’s a marathon rather than a sprint. If you ready and if this is something you want to go, go for it. Don’t let anyone stop you pursuing your passion. Otherwise, you might as well just leave implant dentistry to another colleague.

[Jaz]
Well said and another great point that you reciprocated there about having the need to continually invest more and learn more advanced techniques. And a great example I can give you is I’ve got lots of good friends of mine who have Mclindent in prosthodontics or Mclindent in periodontics. And guess what they go abroad to America to Brazil or to wherever to do advanced soft tissue courses. My prosthodontics colleagues, they’re the biggest CPD junkies I know even though they have you know this, they made it, they’re prosthodontic specialist. But no, they’re still going for these advanced courses techniques. They’re continually investing in themselves, so it doesn’t stop. So I’m sorry, if you’re listening to this, and you’re thinking, oh my god, it never stops. You need to actually see that as a beautiful thing that you know, otherwise you get bored, you become stagnant. This is the beauty of dentistry there’s, you know, there’s not a single day that goes by they don’t learn anything new and that that will never stop. So I think that ends is part one really well. So Hassan, thanks so much for covering for us getting into the implant journey.

[Hassan]
Thank you, it’s a pleasure.

Jaz’s Outro: Protruserati, thank you so much for listening all the way to the end, I always appreciate you listening all the way till the outro. Really appreciate that. So hope you found that useful with Dr Hassan Maghaireh. Watch out for part two of this where we actually get a little bit more clinical, how to assess your patient and the spaces whether they’re suitable for dental implants. So catch on that one. The is an update in terms of social media. We do now have an Instagram page, it’s @protrusivedental. So I’m going to use my own Instagram for my own things now. If you follow the podcast, you like the content and you want to keep in touch with the content, join the @protrusivedental Instagram. Give us a follow and we’ll follow you back. Thank you so much as always and I’ll catch you in the next episode.