Let’s demystify what is often considered an ‘advanced’ Restorative technique: Shell crowns. My guest Dr. Basil Mizrahi is known for Comprehensive Dentistry and teaches Dentists the art of perfect provisionals- we go from A to Z of Shell Crown, how to reline them and cover all the nitty gritty details of this useful technique.
Protrusive Dental Pearl: Preventing Bisacryl Temporary Crowns from cracking: Hollow out the inside of the temporary crown (just enough space for the cement) and therefore create the space for the temporary cement to flow and exit, preventing cracking of the temporary crown. Check out @Dental.Story IG page
“You should become familiar with acrylic before shell crowns” Dr. Basil Mizrahi
Highlights of this episode:
- Preventing Bisacryl Temporary Crowns from cracking 5:35
- Temporary Crowns 12:08
- What is a Shell Crown? 13:59
- Technician role in creating Shell Crowns 15:22
- Acrylic Shells vs Bis-acryl Temporaries 20:07
- ‘Relining’ an Acrylic Temporary Shell 21:20
- Using Bisacryl instead of Acrylic inside a Shell 24:14
- Relining Acrylic Shell with Fresh Acrylic 25:00
- Use of Vaseline? 35:41
- ‘Fit Checker’ for shell crowns 38:26
- Anterior vs Posterior relining 39:23
- Shell Crowns vs Lab Made Acrylic Crowns 40:19
- Shade decisions in relining the shells 42:47
- How to Remove shell crowns 44:08
- Polishing after relining 45:59
- Multiple Shells at increased OVD 46:49
Head over to protrusive.link for the one-page summary of this episode and for the other summarized infographics of the past episodes
If you enjoyed this episode, be sure to check out the Adhesive Full Mouth Rehabs in 11 Appointments (Part 1)
Click below for full episode transcript:Jaz's Introduction: Hello, Protruserati. I'm Jaz Gulati and welcome back to the Protrusive Dental Podcast. If you follow me on the socials, you'll have seen that I've been quite busy these last few weeks.
In fact, the whole of last week I was nonclinical because I took some time off for my brother-in-law’s wedding. Now this is the same brother-in-law who you saw in that famous, has become pretty famous now, the IPR video I made. So, I did this whole experiment with using different types of IPR, burs and oscillating handpiece, disks, et cetera. And that got greatly received on YouTube and all the platforms as a helpful aid. Now, if you haven’t seen that yet, just Google search for IPR Ultimate Review video. You’ll find it. It’s like number one on Google at the moment. And in that video, my guinea pig patient was my brother-in-law. And there we are. He got married. I was his dentist. I was proud. And also his wife, I whitened her teeth and they both had wonderful smiles.
And it made me really happy. But I was experiencing a different type of stress. Now, usually it’s clinical stress. This was non-clinical stress. What I mean by that is this was life. The thing I was stressed about was having to do a performance on the wedding reception. And actually at that wedding reception, 700 people, in attendance and me and my wife were like hosting it and going around, make sure everyone had their seats, okay, food and drink.
So it was a really big affair in there. Lots of stress. But it went well. Performance went down really good. We streamed it live on Instagram actually, so you can follow @jazzygulati. That’s my personal account. If you want to catch our little Bollywood dance. I’d also booked out a Spider-Man for the kids, so I kept Ishaan, my son busy.
So it’s been a pretty eventful week and I kind of feel like I need a week off just to recover from the wedding. But hey, ho, life goes on and tomorrow I’m back to work clinically. And now it’s 11:00 PM at night, my son is asleep and I’m able to record this intro to a phenomenal episode with a quite remarkable condition.
Guys, you’ll listen today to Basil Mizrahi. Dr. Basil Mizrahi is one of the most famous dentists in the world, he is known for really high-end comprehensive dentistry. He’s a wonderful educator, just a great all round clinician. So it’s an absolute honor to have him on the show, and I’m looking forward to demystifying a kind of confusing topic when you are starting out with this stuff, it’s called SHELL CROWNS.
You may be wondering, okay. What is a shell crown? So if you don’t know what a shell crown is, essentially, instead of doing the crowns the usual way, ie you take a putty and then you prep the tooth, and then you fill the putty with the bisacryl, and then you put it in the mouth. By doing a shell crown, the lab have already sent you the temporary crown, and you haven’t even prepared the teeth yet.
So you’re thinking, well, how are you going to fit this crown on if the technician wasn’t able to fit it on the model? The technician sends you these ultra thin shell crowns, like eggshell thin. And then once you do the prep, the shell crown will sit on your prep and it’ll be really loose, right? It’s not going to be falling off.
It’s not going to be staying on because now there’s too much air inside. So what you do then is you reline it with acrylic and we’ll hear more about the protocol and how to do it, when to do it, the A to Z of shell crowns being covered today. And then essentially you have a lab made crown that was relined chairside.
So there’s lots of advantages of doing this. And we’ll discuss all about the nitty gritty details of techniques and I think this episode had so many gems that just like we did for the episode with Dr. Ed McLaren on ceramics, which was really popular and the infographic we made for that was downloaded over a thousand times.
So for this episode as well, we’re summarizing this entire episode because there’s a lot of details that in case you are multitasking, you might miss it, and there’s lots of like good juice in here. So we made this infographic. Now you can download as like, once you’ve listened to this episode or watch this episode, you’ll have a nice little, like a revision if you like.
And all the key details are on there, so if you want to check that out, as well as any of the infographics I’ve made in the past, I made a brand new page. It’s called protrusive.link. So protrusive.link. If you visit protrusive.link on your browser, it’ll take you to this page and just scroll down a little bit.
Protrusive Dental Pearl:
You’ll see infographic section, and you’ll be able to access all of them from there. As for the Protrusive Dental Pearl, it’s only right that I share with you a pearl that is relevant to temporary crowns. So sometimes, and it’s happened to me loads of times and it may have happened to you, is you are seating your chairside made, you know, your bisacryl, your protemp, integrity, you know, pick your poison, you are seating your temporary crown.
And then you try and place it, you feel a bit resistant. You get the patient to bite together. And then now that temporary crown has cracked. So that often happens because of impurities, porosities, it wasn’t made the right way. It had an air bubble inside. But sometimes because there’s not enough space inside for cement, so the cement, it could be too thick.
And then as you seat the temporary crown, it just splits it apart and you see that temporary cement ooze out of the crack. And so that, you know, you have to do the whole thing again. So one way to prevent it, if you feel as though that it’s just too tight and there’s not enough space for the cement, and you worry that the cement’s going to split the temporary crown.
And this tip is by the way, from Dr. Salman Pirmohamed’s instagram and his Instagram handle is @dentalstory. Now, Salman, he did episode 97 about facebows, so do check that out. And he’s coming on again soon for resin bonded bridges, we have recorded already. We’re going to bring it out soon in the content calendar.
But the tip is to, instead of just accepting it and playing roulette and then thinking, okay, which ones are going to crack, which one’s on what you could do is the inside or the intaglio surface of that temporary crown, you can get like a coarse diamond bur something like a rugby ball shape, and on the inside just start DRILLING AND HOLLOWING out just a tiny bit hollowing out the inside of this temporary crown so that now the temporary cement has space to flow and exit.
And it’s not going to build up all this pressure that’s going to break your temporary crown. So if in doubt, and if you worry, maybe it’s happened once and you’re going to make a new one and you’re thinking, okay, how do I prevent this from happening again? Then you can hollow out the temporary crown to make space for the cement.
So thanks Salman for that tip, and look forward to presenting the RBB episode for everyone with yourself. Now let’s check out the main episode with Dr. Basil Mizrahi, this episode was aired live on Facebook. So there’s the odd shout out here and there. So do excuse that, but this, it’s just absolutely jam packed.I can’t wait to share it with you. I know you’ll gain so much value from this. And remember, go to protrusive.link to check out the full page summary.
Hello everyone, and welcome to this very rare Live Protrusive Dental Podcast, it’s great to have you guys on. We’ve got none other than Dr. Basil Mizrahi, Basil, thank you so much for making time for us today.
Hey Jaz. Hi, everybody out there. Looking forward to this.
It’ll be a really tangible, very wet fingered sort of episode. I told Basil, I promised Basil that while we are waiting, hello Cosmin. While we are waiting for people to join today, now I would tell Basil and you all a very interesting thing that you may have never considered about Sikhs who wear turbans, and something you can tell about me just by looking at me and the position of my turban. So you can see the apex of my turban, right? So it’s like an apex right here. And by Monday it’s like, the turbines really low. Cause I’m fresh, I’m full of energy, right?
And then as the day goes by, as the week goes to the end, the turban gets higher and higher and higher. But it’s, I change my turban every day. But the point is I just get more exhausted and you’re more exhausted. The turban just gets loose and it rides higher. So if ever you see me and my turban’s really high, you say, ‘Jaz, just go to sleep, man. Let’s not do this anymore.’ So you can see it’s getting to that point where I might start revealing like my hairline, if I get any more tired. So interesting, fun fact to you. It is so amazing to have you on. Guys, before we hit record button, before we went live, I was just telling how I was telling Basil if I even become half the dentist he is in my career, that would be the best thing ever. And then you said something really beautiful. What did you say?
You know, be half the dentist. I’m, you want to be the full dentist you are.
That’s so special. I love that. Well, please, tell us Basil for the few people who are, who might be there, maybe like literally they qualified yesterday, which could have happened because it’s June, right? So they qualified yesterday and they entered this big bad world of dentistry and they haven’t quite seen your amazing work and what you do. Just give us that little introduction if you don’t mind.
You’ll hear from my accent, I’m South African. So I did my dentistry in South Africa, worked for about four years, got bitten by the specialization bug. In my days, we’d never had guys like you giving all content out on social media. There weren’t courses that you could do. So, you had to go specialize. I’m talking 22 years ago. So I went over to the states, and I did my prostho and implant training there for three years in New Orleans. With a guy called, Gerard Chiche, a great guy.
If any of you have ever read his book, if you haven’t, highly recommend. He was one of the forefathers of aesthetic dentistry and a lovely person. And then I had the decision, do I stay in the states or do I come to the UK? I licensed in the states, ended up coming to the UK for family decisions. My family had come over from South Africa.
So about 21 years ago, I set up a squat practice in Harley Street. I just kept it cheap and cheerful. Rented a little room with a basic chair and a brown oil stain carpet and a desk. And I had a nurse who was my secretary and receptionist and all in one everything. And gradually over time, built up the practice that I have today.
Still small. It’s still me. And I work with Jurgita, my associate. But it’s a very small volume practice. I’ve always said, Jaz, small volume, high quality. That’s sort of my little niche. Just very personal, maybe three patients a day. On a busy day.
Well, you are all about comprehensive, detail dentistry.I’ve seen some of your webinars and how you walk the patient. And what I love about your webinars, Basil, and guys, if you ever get a chance to go on one of the Basil webinars or live courses, Basil’s really good on teaching communication. Like how do you actually discuss comprehensive dentistry with patients? Which is a real plus point with Basil.
It’s not just showing the beautiful dentistry. It’s about, okay, what is the diagnostic element and the talk that goes behind it? One question I had, Basil, if you don’t mind. Any regrets? Now, do you sometimes think, I wish I was in LA or something like that? Like in US, do you ever have that feeling? I mean, you know, I don’t imagine you do, but do you have that little voice inside of you?
Not dental wise, I think, career wise, the UK or London specifically, I’m very fortunate that I’ve managed to carve out the kind of practice I have because it’s quite rare that you have a full referral prosthodontic practice, which I’m fortunate to have that about 95% of our patients are all referral, which is rare here and in the States.
I think coming here with an American degree, with a realistically or not put me on a little bit of a pedestal in the beginning. And so I was sort of a big fish in a small sea here, whereas in the States, I would’ve been a small fish in a big sea. I don’t know how it would’ve turned out. Hopefully I would’ve turned out the same.
But I’ve got no regrets from a practice point of view, lifestyle, I don’t know, you could say South Africa, America, but I always say to people, just choose, you know, people say, where to set up practice, I’m specializing. Where should I go? I say, just go where you want to live and the dentistry will follow.
Brilliant advice. And speaking of all over the world, people from Pedro, from Portugal, today we have Tom from Ireland Alex from Peterborough. We have Shabana from Malawi. We’ve got Sarah from Sunnyside, so we got a nice little international audience today. So guys, you’re here for shell crowns, you’re here for Basil Mizrahi, you’re here for shell crowns.
Before we actually touch on shell crowns, just a minute on the following, I want to know, does Basil Mizrahi still do the bog standard temporary crown? You take your putty or your alginate or whatever, and then you prep the tooth, and then you put your bisacryl inside your protemp, your integrity, whatever, and you plonk it back on and you trim it. Is there still a place in your practice for this kind of work?
If you’re asking me personally, I don’t use bisacryl, not because it’s bad, and the first thing I say whenever I give a course is don’t throw out your bisacryl because it’s a good material and it’s got a good indication. I don’t use it because I grew up on a critic. I’ve got used to it, but I know I’m the first one to tell you that don’t create complications when you don’t have to.
So, for a single tooth, bisacryl is cheap. Well, not cheap, but easy to use and efficient. So if you try and make a single acrylic crown, you’ll be there for 35 minutes where you can push one out with bisacryl in five minutes.So I’ll say, always say, look at the criteria, what you’re looking for, bisacryl can give you what you need from the temporary on that specific case.
Well, it was that mentality, Basil, because you’d said that before on a webinar. I remember listening. And then that inspired me in 2016 to do my first onlay, and then decided based on being inspired by you to use acrylic for me, I was using trim, Bosworth trim, to make an emax onlay temporary out of acrylic.
And I made such a mess of it. I then quickly got the bisacryl out, let just fix it. Right? And what I didn’t do stupidly was that once I had the putty inside with the acrylic on my prep, okay, I didn’t do that really important thing. Remove, insert, remove, insert, remove, insert. To get that path of draw, I just let it lock in.
And that was a shambles. So, we’ll talk a little bit about that today in these nitty gritty details, but, so tell us, you obviously have been using acrylic. You’re comfortable with acrylic, and that’s a good reason to do what you do in your practice. When it comes to shell crowns, what are the indications? So actually let’s take it one step back further. What is a basic, what is a shell crown for the dentist listening out there?
So shell crown is like those Directa crowns you get from Schein or Dental Directory, just a hollow piece of temporary crown that looks like a tooth that’s customized by your lab. So you get back a shell and then you reline it.
So what it does, it saves you having to use a matrix because when you use a matrix, you can’t see what’s going on under the matrix. It’s a lab putty or it’s alginate. So, you know, especially with multiple teeth, you can’t really see what’s going on. So the timing is difficult. Firstly, you’ve got a soft piece of material, then you’re sliding it up and down, and it’s difficult to get the timing right.
So a shell takes you halfway to where you want to get, because you’ve already got the backbone. You don’t have to work under a matrix, so you have a hard backbone that you can grab with your fingers without worrying that you’re squashing or distorting it. So it’s just a hybrid. Between, it’s not a full, what I call laboratory provisional, which is when you take an impression and the technician makes a temporary that literally comes off the model onto the tooth. This is a hybrid between chairside and a little bit of help from your technician. So that’s essentially what a shell crown is.
Sure. Now, when you started to use it and started to work with labs or when dentists may be inspired today and maybe go on your course and learn more about this or read up on it, and then they want to use it in practice, and then when they start liaising with their technician, do you think most technicians are well versed with this? It’s my first question and my second question leading on from that is, traditionally I imagine what you would have to do is the lab would have the model and then they would prep by hand on the model and then make it. But now with digital, I imagine that’s very different. So, firstly, technician experience and also has anything changed from the traditional techniques digitally? I’m sure there’s clever ways to do that now.
To be honest, yeah. Digitally you can, but I think analogs still actually works better because you’re going to have a study model or a scan model anyway. So the technicians, they have ways of doing it. I personally don’t mind how they get it to me. So, I’m not too worried if your technician has a way of doing it digitally, let them do it.
Essentially, you want it to be very thin and, but the indication, just going back to one of your questions, you got to understand where you need to use shells because firstly, shells are biased towards acrylic. So I use shells because I use acrylic, which is pushed me in to that area. So when would I use shells?
I would probably need a shell more than anybody using bisacryl, because the reason I use a lot of shells, more shells than you guys using bisacryl is because my aesthetics on my acrylic is horrible compared to your bisacryl. Your bisacryl looks much nicer. I have dark, medium and light in acrylics, so if I’m doing two front teeth, you may see in some of my lectures I use a shell.
Whereas if you were doing bisacryl, you would say, ‘Basil what are you using a shell for?’ One of the main reasons there would just be almost pure aesthetics because the technicians can get me much better aesthetics with acrylic. in a lab, then I can get chairside. They all use their enamel shells and they can give me a thin shell of enamel and I reline it with my ugly yellow.
But then it actually comes out quite nice. If you are using bisacryl, you probably wouldn’t need a shell there. So that’s why I keep saying work. Don’t do shell because Basil Mizrahi does shells look at your limitations and say, actually could I do this with bisacryl? Yeah, I don’t need a shell. So where I use shells is, if I got, and where I think everybody can benefit from shells is if you’ve got four or six anterior teeth, I often don’t you shells on the back because again, for aesthetic reasons on back teeth, there’s no real benefit to using a shell.
If my temps come out a little bit dark or light it’s not the end of the world, but on anterior teeth, I want nice morphology, and I want good aesthetics, and I want ease of handling. If I’ve got six preps and then I’ve got to start, whether it’s bisacryl or acrylic, taking a putty matrix, working blindly, lifting it on and off, it’s messy.
It can be toxic to the teeth underneath. Another reason why with acrylic, I have to be a bit more careful than bisacryl. It’s more toxic. It gives off more heat. It shrinks more. So the last thing I want is to fill a putty matrix or an alginate matrix full of acrylic on six anterior teeth and worry about heat parallelism.
So the shell takes, gets me a lot of the way there, and then there’s still a good 45. A lot of people think oh you’re doing a shell, okay, reline it and it’s done. I always say when I’m prepping and fitting temporaries, it’s 50% prep, 50% temporary time-wise of the appointment. So if my appointment’s two hours, one hour is getting the old crowns off or prepping the teeth, relatively, roughly, not taking to the end and one hour to get those temps because that temporary appointment is the make or break.
That’s the first time or often where your patient is getting to know you, you’ve talked the talk, and told them how good you are, and showed them all your pictures. Now you’ve got them in the chair. It’s a big step. You’re taking the old crowns off, which often are quite decent and they got to walk out that surgery.
Not with yellow, ugly temps, which are sensitive and falling off. They want to walk out with teeth, whether they’re bisacryl or acrylic, that look good. And that takes all the pressure off of you time-wise. So that’s a make or break appointment. So you never short sell yourself on that at that first appointment because that’s when the patient buys into you. And then eases up and becomes putty in your hands to carry out the more comprehensive dentistry.
So food for thought for us, because the way we are doing it in the real world is we’ve got that two hour appointment, we’re doing two hours of preps and then we’re running late, then an extra five minutes to quickly do our bisacryls.
But I totally agree with everything you said, and where I am in my journey with shells is using it more and more in the last couple of years. As I’m slowly, incrementally becoming more and more comprehensive, moving beyond single tooth, doing a few full mouths now, saving me time, but at the same time I am doing lots of polishing, finishing.
I do a lot of vertical preparations at the moment, so really important to get the gingiva level where I want it. So I do spend a lot of time with that. I initially made a mistake and I think this is a mistake and one of the question I wanted to ask you, Basil is, can you reline a shell, an acrylic shell from the lab with bisacryl? A) why would you want to? Because I did that and I was like, why am I doing this? I should just skill up and learn acrylic. But any reason in why a dentist should not or cannot? I’m sure there are a few.
Yeah, you want to reline with acrylic, because one of the nice properties with acrylic, if you’re doing a shell, you’ll probably be working on four, five, or six teeth.
So you needed to go through a long doughy stage. Acrylic has a much longer doughy stage and it gives you the time to slowly work that shell up and down. Bisacryl is basically composite and it sets rigidly, so you want to, the acrylic gives you the chance to move it to, it goes through a longer setting time. It takes longer to work.
And then also you want that flexibility when you’ve got the shell. Another reason, why I use acrylic in comprehensive cases because when you’re doing single tooth dentistry, the temporary’s on and then it’s off and the crown’s fitted. So it’s short. It’s a stop gap between impression and fitting.
When you do more comprehensive, you can’t squash everything into two hours. Okay? You want to be able, but that temporary needs to come all the way through treatment with you. You don’t want a temporary, next visit, take it off, break it, make a new one. And that’s sort of what happens with bisacryl. It’s on, break it to get off.
I’ll make a new one quickly. So you’re taking two steps forward one step back. So if I spend the time and invest the money in getting good temporaries with shells up front, those temporaries, because they’re acrylic as well, acrylic relines and modifies it’s much better than bisacryl. So if I remarginate, if I drop a margin, I can remarginate. So that’s another reason why I wouldn’t want to reline.
I said it once and people like, oh, what’s remargination? Just explain that a little bit.
Okay, so you get relining where you take a shell and you fill the whole shell with acrylic and shove it over the tooth. That’s relining. You may do that. You need to do that the first time you get a shell.
Subsequently, remember I said you don’t always get, most times I don’t get to the end of the prep on day one because you run outta time. You want to just have enough time to get temporaries on. As you modify your preps at subsequent visits, then you’re only really worried about the margin. I don’t care that the inside of the shell of my temp is not fitting.
I’ve reduced the incisal edge or I’ve reduced the labial edge. And now do I have to reline a temporary every time I modify the actual prep? The answer is no. When I modify the margin, you want to remarginate. So what you do, you paint a little bit around the margin on the tooth, not in the temporary, because if you reline, every time you reline, the temporary just gets longer and longer and longer.
So you again, on day one, you’ve made your nice shells. Patient comes back, you say, okay, I’m going to reline , fill everything with acrylic, your temporary won’t seat all the way. And you have then the incisal edges drop. So remargination is really the important part, once you’ve relined at subsequent visits, most times I’m just remarginating.
Yes. If you change a whole, if you fit a post or you change something on the side of the tooth then you’ll reline. But if you’re changing a margin and you’ve just done minor modifications to the tooth prep, don’t reline just focus on the margins.
I want to ask you a question which I hope it doesn’t offend you, but let’s say you’re a dentist. We’re really running outta time and we want to be all fancy. We’ve got the, not fancy, but we want to do the appropriate thing. We’ve got a sick, three to three, we’ve got the shell crown. Some of these might be linked, maybe one to three, one to three, whatever. And then you just realize that your nurse is giving you the looks because it’s lunchtime and then instead of working with acrylic, because you’re not experienced with acrylic, you want to use bisacryl.
What I’ve done before, ask me how I know is air abrade, put some bond then put some bisacryl. Is there any advice you can give to make it work in those get out of jail scenarios?
What’s the problem? What hasn’t worked? Let me ask you, what went wrong when you say make it work?
Great point. The main problem I find is, one time I did it and then I took it off. And parts of the bisacryl on the intaglio inner lining delaminated in certain areas. So it was a larger cement gap in that area for that patient at that time, basically. So how can we get a more predictable bond between the bisacryl and the inner lining or the intaglio of the acrylic?
Okay, so first to answer that directly, don’t use bonding agent. Use acrylic monomer. Anytime you want a bond acrylic to bisacryl, use the monomer from the acrylic, not the bisacryl bonding agent. I know they all come with bond.
Yeah, just use the monomer. Okay. And that’ll attack the acrylic and your bisacryl bond better. But you do have a compromised bond between bisacryl and the acrylic. But normally if if you’re filling the, if you’re relining a whole acrylic shell, there’s enough surface area that it shouldn’t pull off. So especially, so I would say to use the monomer instead of the bonding agent.
Very good. And then if you are doing it the proper way as you should do i.e., relining the acrylic shell with acrylic, do you still need to bother with the monomer? Just describe the process.
You got your shells back. How do you verify that it’s seating well aesthetics wise and that you don’t need to prep any more in any areas? How do you verify that and then how do you seat it? Do you always need a seating jig?
Okay, so firstly, whenever you get shells back from a technician, they’re not going to go down. It’s one of the hardest things for a technician is to get them thin enough and to go down. So always expect that they will need some adjustment. It doesn’t mean you’ve got a bad technician, because I hear this time and time again, oh, I tried shells, I got them back from my technician, and they wouldn’t seat. That’s normal for me as well. Very difficult for a technician to get them. So that’s why you do need, and even if you think they’re seating, you always want to check the seating jig, because if you’ve gone to the time and effort to get a nice looking set of shelves, if your technician’s gone to that time and effort, and it looks perfect on the model
and then incisal edge where it should be, the last thing you want is you want to make sure that you copy that exact seating location that the technician’s made on the model in the mouth. If you don’t bother with the seating jig, and I’ll explain that in a minute. There’s a very hard chance that you think it seats, you’ve put it on.
Say, okay, that’s good. The technician’s done a good job, seats. Okay. Then you reline it and you trim everything. You spend your half an hour trimming, 40 minutes trimming and patient smiles, and you’ve got a cant. Or you say, oh, it didn’t look like that on the model. And then you take your soflex disc and all the nice work you have to reduce the labial edge because now it’s proclined and it wasn’t proclined on the model.
So you end up taking the nice enamel layer off, or it’s longer you take off the incisal translucency, the technicians put off. So it is an important step and do it every time as much as tempting as it is to shortcut the step-
Seating jig wise, what kind of jigs? The last case I did, I used essix retainer type jigs. Do you like those or do you like putty or do you like duralay jigs? Like what kind of jigs do you favor?
I like a hard, the two jigs I’ll use is either get the technician to just extend the shell onto the adjacent two teeth. So say you’re doing canine to canine, I’d say go back occlusally on the two pre molars on each side.
So, and I want it rigid as opposed to putty or to essix. That’s one way where it’s actually attached to the shell and you just trim the wings off afterwards. But you want some kind of definite seating. So not tiny little sort of Maryland wing kind of bridge. You wanted to go over the actual premolars. A little bit over the buccal and lingual, if I’m not using it, I’ll use a separate, duralay jig, which is sort of a separate piece of plastic, which once again engages the pre-molars and the edges of the shell.
I do want to get access to the edges of the shell, so that would put me off putty or essix retainers especially because unless you cut your essix right back, you can’t. When you reline, I do go, as soon as I reline, I go with some wet monomer. And I’ll do what’s called welding that joint so you don’t see the joint.
So I need access, I reline and seat it. And then quickly I’m taking my brush of almost pure monomer and getting access to the margins. So if I’ve got an essix I can’t get underneath it. So I do like to weld it so you get an invisible joint.
That is a top tip right there, Basil, because I’m going to relay that back to my technician. And request the way that you do it so that I can have that effect. This is the news to me. This is new to me. I’m not very experienced in shells. I’m learning as much as everyone else is, so it’s great to have this tip. So when you dip the brush in the monomer and then you sort of paint around the margin and that blends the shell crown, the recently relined shell crown into the tooth. Is that right?
No, you don’t want to dilute it too much. It blends the new reline material with the existing shell. So you don’t get sort of a stark joint. And another tip, you should always sandblast your shells on the outside, not only the inside, on the outside around the margins, because you want that new acrylic to bond.
So I would sandblast, paint it with monomer, then reline and then be careful when you take your wet brush of monomer, acrylic is a messy material. You don’t want to work neat. So a lot of people are tempted like or bisacryl to quickly wipe off all the excess. So it’s a nice, neat shell. You do that with acrylic, all you’re doing is diluting that margin where you’ve added, so it’ll never set, it becomes doughy.
You take it on and off and it looks floury, and that’s why acrylics get that bad name. Very technique sensitive, but don’t over dilute. So I’m painting, but not to wipe off all the excess. I’m painting to blend.
Top tip right there, guys. I’m just saying that we’re approaching that point where I will be doing the questions basically.
So we’re almost there. We know what a shell crown is now, we know when is a good idea to use it, these shells, instead of using bisacryl, like the standard way that we do it. We discussed a little bit about the technique and the protocol. We talked a little bit about jigs, which is important.
How to condition the intaglio surface. So we put the monomer a really great tip shared by Basil. In case you missed it was air abrasion inside and outside to allow the acrylic to stick. And we also know Basil’s favorite type of seating jig. So we’ve covered all the important questions I wanted to ask. Anything you want to add, Basil, before we now start taking questions from the Protruserati?
This is one thing doing shell crown. You should become familiar with acrylic before. Shell crown is a relatively advanced technique. So not something you want to jump into before you’re sort of quite comfortable in turning out a single acrylic crown, not just do-
I’ve been there and I’ve locked it and it’s messy. Definitely go on a course or learn more. Not just on this podcast, take consideration of that.
Yeah, so get familiar with acrylic first. Make sure you can stamp out an acrylic single crown, even if you don’t think I’m ever going to do it. But you need just to get comfortable with acrylic, otherwise you will run into problems and give yourself a lot of time. If you do want to try just like any new technique, add on another hour to the appointment. It’s not a shortcut, it’s a long cut.
Very good. And the reason I am more familiar with acrylic, I was happy to advance to shell crowns is because I do a lot of FOS splints basically. The flexi orthotic system. They use the acrylic to reline the intaglio these direct splints. So I got very happy working with acrylic even three years ago, I got one locked in someone’s mouth, so I know that, how that room smells when you have to cut all this off. So yeah, I made, I’ve been there, I made my mistakes, so I’m much happier with acrylics.
And one last question I’ve got to ask you, just for the young dentist to realize, because a lot of young dentists, I say to them, okay, this patient will be in temporaries now for six months or nine months, whatever, and their jaw drops. Like wait, isn’t a temporary supposed to be there for two weeks, so just give perspective.
When you’re doing these shell crowns, what’s the longest they’ve ever been in someone’s mouth until they come back for their definitive?
Be careful. You don’t want to leave any temporary in for too long a time, whether it’s shell temps, or a good temp. So I won’t let them go for longer than two or three months probably.
Don’t forget, when you’re doing these temps you’re normally in a comprehensive case, you’re doing other stuff. You would never just put temps in so people get confused and say, well, okay, so I’ll do the temps now I’m going to leave them for six months. There’s got to be a reason for everything you’re doing.
So I’m not sure what the reason would be. I would never leave temps in just for six months because for the sake, either I’m trying to get the tissues healthy. That can happen in four to six weeks. Otherwise they’re coming back, you know, every four weeks I’m doing some endo under the teeth. I’m maybe putting an implant somewhere.
But I’m seeing that patients so those shells. And that’s why I use acrylic. Acrylic lets you take the shells on and off without breaking putting them back. So, they may be in the mouth for six months, but I’m not leaving a patient unsupervised for six months because that’s asking for problems. And if you are going to leave them, use polycarboxylate if for any reason you think they’re not coming back or just be safe and you may have to do a little bit of cutting, but otherwise go with polycarboxylate. Otherwise, I use tempbond for 99% of my cases because I’m seeing the patient throughout treatment, but if for any reason, it’s going to be over like two or three months. Just play it safe and go.
So what brand of polycarb? Durelon is a good one. Poly-F is another brand. You don’t like Durelon? Okay. I was giving brand names in case someone’s like, I don’t know what polycarb is. So you don’t like Durelon? I didn’t know that. So tell us why you don’t like Durelon and what do you like instead?
Durelon I just can’t get on, the reality, the irony is I like the cheapest and cheerful poly from Henry Schein cause it’s water based. Okay. Anything else? Anything else? Impression, materials. I say go for-
Are you Indian in disguise?
But this is for temporaries. Jewish. Same. Same blood.
Brilliant. Okay. That’s good to know. So yeah, long term don’t use. If your preps look like Basil’s, yeah, you can use tempbond. I hate tempbond because my preps don’t look like Basil’s. And that’s why when I use tempbond bad things happen. Can you just tell everyone how they can learn more from you? I want to know all about your courses, your webinars. You did a wonderful series during lockdown I saw as well. Please tell us more about how we can learn more about these techniques from you.
Yeah, I mean, acrylics is a big learning curve and the only way you can learn, it’s one of the things I don’t think you can do online because you got to get your fingers wet. So we do a three day. I do a 15-day course on comprehensive dentistry, and three of those days is intense temporaries, just working with acrylics, doing onlays, crowns, bridges, shells, and we do veneer temps.
Just a quick thing with veneer temps, I don’t use acrylics, so be careful. Veneer temps is bisacryl, crown and bridge. Traditional acrylic is conducive to traditional mechanical dentistry, so even onlays, you mentioned onlays. That would probably be the last thing that needs acrylic because there’s no advantage putting an acrylic temporary on an onlay.
So there, you know, bisacryl, you’ve got to look where your temporaries, your usual temporaries aren’t giving you what you need. Subgingival margins, acrylics better, long time in the mouth, acrylics better, on and off, acrylics better. Otherwise stick with the bisacryl. So yes, we do a, probably one of the only courses, we actually teach a lot of acrylics because it has got a niche. It’s not for your everyday-
Your single tooth dentistry, but when you want to progress to comprehensive, I don’t think that bisacryl is as good in uses as the acrylic. So that’s where the acrylic comes into its own in more comprehensive cases. But for single tooth dentistry, bisacryl-
What’s the website? Is it your, just type in Basil Mizrahi in Google and find your courses or?
Yeah. Type in Basil Mizrahi or Mizarahi Dental Teaching.
Excellent. And I think, are you doing tubules congress this year?
No, I’m not. I’ll probably be there.
Oh, amazing. But it’d be nice to catch up guys. I heard great things about the one that you did recently. When I mentioned earlier about the many years ago, doing an onlay and messing it up, cause I was a new to acrylic, it was, the reason I did it in acrylic was to actually just get some experience.
I had a bit of time, so let me play with this acrylic stuff, you know, so that was for that time. Right, so. We got a question, from Jhann Marco, a very loyal Protruserati. Just before remarginating, can you use another material, eg Vaseline to aid cleanup or acrylic from surfaces you don’t want acrylic additive? So how can you actually make sure that your remargination of acrylic goes where you want it to go?
I’m not sure if you mean on the actual shell. I don’t really use Vaseline. You could, you know, if you don’t want the reline material to go all over the front of the shell that the technician’s made and ask for you, you could use a little bit of Vaseline on the actual teeth. I’ll never use Vaseline because saliva is normally good enough. If you’ve got a composite core that’s the only time I would use Vaseline, because you’re acrylic will bond but on a normal tooth, saliva is normally good enough as a lubricant, so I generally don’t use Vaseline.
What about when you’re happy with your relined shell crown and then a few weeks later you then refine the margin. You only because you’re really happy with everything else. You only want the acrylic to remarginate at the marginal area and you don’t really want it to run up and become messy on the labial surface. Is that just you being good with your control of the material or is there a place for Vaseline there?
Well, there’s different ways of using acrylics. So if I’m just looking to remarginate a little area, say the labial margin that’s dropped and then I may use the powder liquid technique, which is just lifting up the shell and just putting a bit of powder liquid under the margin. You don’t want to reline remarginate on the shell I always put the material on the tooth. Because otherwise you, the less material that goes up inside the shell, the better.
So, but most times if I’m remarginating, I’ll cut back and it is a little bit messy. There’s a lot of chairside. That’s another thing with acrylic, you have to be get comfortable working chairside. So half the time when I say to a patient, I need two hours, and I will, they’ll say, oh wow. I’m going to say half the time you’re going to have your mouth open.
I’ll be in there the other half, I’m working next to the chair. So there is a lot of chairside. Elbow grease needed for acrylics. Much, much more than bisacryl. And that’s another big paradigm that delegates on the course can’t get their head around because bisacryl sort of goes on and off and you get a good copy.
Acrylic shrinks when you add to it. It’s messy. It has to set hard. You can’t neaten it up so it sets hard in excess. Then you got to sit there cutting it back again. So it’s a good material, but it, you need to see the benefit. Why am I doing this? And if you can’t, you’re over complicating your life. That’s what we teach in the course where you see, okay, I can’t get this from bisacryl. This is where I need my acrylic, let me do acrylic.
Brilliant. Thank you. And Michael Davies has asked, and the reason I brought up that photo of the Fit Checker is for posterior shells, do you use Fit Checker? And two, is there any difference in technique compared to anterior shell reline? So, difference between anterior relining and posterior relining was the second question.
But, let’s hit the first question. This is a photo of me using Fit Checker for when that time I got some shells back, which were just way too thick. My preps were very minimal cause I was making, working with vertical margins, so I had to go back and really make them, thin them out. And then they were still binding somewhere.
So then I use GC Fit Checker to see, okay, where is it binding, color it up with the pencil. Made it thin, end up, perforating certain areas. There we are. So do you use Fit Checker, Basil?
I use a fit checking technique. I just use a light body impression material.
So I’ll squirt it up and when I’ve got my seating jig. And the same as you I’ll mark it through there. So, you were using the essix, that’s where you-
No, that was the jig was separate on the inner lining. Oh, was it in the essix okay. That was a soft one. Yeah, you’re right. That was a soft, that was a soft seating that, that particular time.
But yeah, it was where to figure out just where it was binding and then to thin it out the area to allow it to seat. So fine. So you use light bodied, and is there a difference between anterior and posterior relining technique of shells?
Not really, as I say often posteriors I will just use a matrix cause there’s much more leeway that doesn’t have to look great. And if you hoover out half, half the occlusal surface just to get it rough it really doesn’t, you’re not missing the incisal edge. So you can be a more forgiving if you are going to use a posterior shell I won’t use a seating jig because if I get the seating slightly wrong, it just means when a patient bites at the end
I have to hoover off a bit more occlusal surface on a molar, which is not the end of the world. I just don’t want to do that and mess up aesthetics. So in the back teeth, I may get a shell temp, but I’m not going to mess around with jjgs.
I love that you said that you have to hoover off the occlusal. I love that Basil says that. Tom Murphy. Hi Tom. He says, okay, I will typically have a wax up done. Prior to preps. Fine. That’s good. And use this for bisacryl temporaries and transfer this into PMMA temporaries one week later. Okay. Outside of that first week’s aesthetics, what are the additional benefits of the shell temps over lab made PMMA temps?
Okay, so he’s going from bisacryl, but he’s taking impressions that day to get lab made PMMA temps. So is there any benefit of doing the shell temps and not going for lab made acrylic provisionals?
I like to get the shell temps. I like to take them a long way through the case before I go to lab provisionals, which is what you were describing, is done the next week.
So there are two ways of doing it. You can either put your rough and ready bisacryls on and move quickly to lab made provisionals, which will look nicer and they’ll be acrylic. The problem though is in a comprehensive case, you don’t want to be messing around and then remarginating and relining. And then when I get to my lab provisionals, I’m quite close to the end of the case because I’ve brought my chairside shells with me all the way through.
And I’ve done all the rough and ready stuff, the hollowing out because the temporaries start to look a little bit shoddy after time, after you’ve hollowed them out in a comprehensive case. So there’s no real disadvantage. You can do the technique that was described. But you don’t want to mess up the lab provisional so that by the time you’ve done all the foundation work, you say to the patient, smile,
now let’s look at the aesthetics, and the lab provisionals have got margins that have been added to and you’ve chopped the incisal and so they’re looking shoddy, you can’t really focus on the aesthetics. Cause one of the main reasons I’ll go to lab provisionals is when I’m getting towards the end of the case, I’ve done all the rough and ready, the implants, the post and cores, now I want to start focusing on aesthetics and now I get rid of the shell temps.
They’ve done their purpose and now I’ll get the lab because there’s nothing lost in translation. When you go from lab provisionals, it comes off the model onto the teeth. There’s no reline, there’s no adjustments. Don’t forget, with shell temps there’s a lot lost in translation, relines, even with jigs in there there’s a lot, it never looks the same as the wax up.
But yes, you can initially when you’re starting out you’ll move quicker to the lab provisionals. And as you get better chairside, you’ll able to bring your chairside temporaries longer through the case. And then, move to the provisionals. That’s what will happen in your career and as your skills improve with chairside temporaries, but there’s nothing wrong with that.
Brilliant. Thanks so much for that question, Tom. Now you mentioned aesthetics. So we have an aesthetic based question about shade. So this is from Michael Davies. Hi Michael. When relining, do you do anything in particular to match the shade? Or reline the acrylic to the shell? Now you mentioned you had light, medium, dark. Just tell us more about shade decisions and actually relining the shells with shade in mind.
Well, firstly, when you’re doing shells, it’s normally going to be four or six teeth, so the shade is not matching to a single. I would get the shell always made in enamel acrylic, generally an enamel shade, A1 or A2, relatively light, and then I’ll reline it again, it’s four or six teeth, so it’s going to look uniform.
I’ll probably reline it with A2 or A3, which would be medium, dark medium, that kind of region. If I’m trying to match a single tooth, sometimes a patient comes in and you need to nail a single tooth temporary, which is pretty hard. Again, there I will use a shell. You guys can use bisacryl because you’re comfortable with it and you get better shade straight away, and if you get the shade wrong it takes five minutes. Using acrylic, I could never do that chairside, so I’m at a disadvantage in that specific aspect. So I’ll use a shell made in enamel and then I’ll reline it with either a light or a medium. Again, if I get it wrong, it sometimes happens. I’m in a little bit of trouble. Either the stains can get me, I do sometimes can have to stain.
I’d rather come out too light than too dark. And every now and again you get caught out and you reach for that sort of emergency stain kit and you’re toning the temporary down.
Excellent. We’ve had a really nice wet fingered question here, which I like, but there’s two facets to this question. Very simple question, like six words.
How do you remove shell crowns? Now do you mean Tuli, thank you Tuli for the question. Do you mean how do you remove it once you put the reline material inside and then how do you remove it? Or the patients had shells in for like, you know, three months, and then how do you remove it? Tackle both of you don’t mind.
So while you’re relining, you are using your fingers just to slide up and down cause there’s doughy acrylic, so that should be relatively easy. I think the question was aimed at, I mentioned that in a comprehensive case, the temporaries are coming on and off every couple of weeks and you don’t want them to break.
So the question is, well how do you take these off? That’s one of the big advantages of acrylic. I can take all my temporaries off with big aggressive artery forceps and they won’t crack cause they’re acrylic. It has some give. The problem is bisacryl, and now you’re starting to see from some of your questions and bells ringing in people’s heads.
Well, I can’t do that with bisacryl. And that’s what happens. Bisacryl, you grab it with artery forceps and either it doesn’t come off cause it’s got no give. It’s like trying to get a porcelain crown off and it’s just not giving. Or you squeeze a bit harder. Sometimes you break the tooth inside or most often, what happens when I say to my delegates, how are you getting your temporaries off?
Oh, we are putting a flat plastic under the margin or an excavator, you’re cracking the temp. So bisacryl are hard to remove. Ideally, you want to take your temps with artery forceps so they don’t break. Acrylic is conducive to that. Bisacryl is not that conducive to taking them off without breaking cause when you squeeze them with artery forceps, it’s so rigid it’ll crack. Especially if they’re thin like your verti, you were saying verti preps. Those ones you try get on and off, you’re liable to crack the margins. With the acrylic, you’ve got lots of give in it, it’s more elastic so it doesn’t break.
Brilliant. So guys, I have time just for two more questions and that’s what we’ll take. So, we’ll take the very last one from Michael. Michael, you’re very lucky to get two questions today and then we’ll take Pedro. So, Michael’s question again is, last question. Sorry Saeed, I might not get time for yours. What burs do you use in the mouth to adjust the acrylic and get it polished back up? So polishing and making it look pretty after you’ve done some relining.
Well, I would never use, I never say never, but all the temporaries, and that’s the beauty of temporaries is you’re working outside the mouth. So I have a temporary kit on a straight handpiece. Very seldom do I work inside the mouth. Put them in, look, take them out.
So it’s different to doing a composite where you’re forced to work in the mouth. If I do need to do a little bit of adjustment in the mouth, it’s often a soflex disc on an incisal edge, but 99% of the work with temporaries are polishing. The embrasures, all done with that sort of little kit I put together, but outside the mouth, so I don’t do much, not the polishing or anything inside the mouth.
So it’s all outside the mouth. Perfect. I will take one more question. ‘Cause Saeed’s is really good. If you’re raising the OVD in a comprehensive case and you’ve prepared multiple posterior units, how would you temporize them? How do you ensure you get the shell temps in a correct position to conform to the new desired OVD. So essentially where it may not be as conducive to put the jig because there aren’t enough teeth for a jig. How do you work that scenario?
Well, very seldom would I ever prep and temp a full arch. Most of my cases I do open the OVD, so I would build up the, I won’t try to do too much in one appointment. Okay. And you lose quality there. Okay. Everything in dentistry you can’t rush. You have to break up. And that’s again why I use temporary so much because it allows me to break up the case, so I would never prep and temp a full arch, and I know many people do. I would do the front six the same way I’ve just described. They would be at the increased vertical dimension. The patient would go away for a week, almost got a dhal appliance in, not dhal, they’ve got an anterior deprogram, so their jaw is relaxed and I’d come back.
Then I’ll do the upper right quadrant and I’ll do the upper left quadrant. Okay. If I’m worried about space, I may put a bit of composite on the occlusal surfaces. So that’s the way I would tackle it. Increasing OVD I would do it segmentally.
I guess if ever you had to do it that way. Again, I asked these really naughty questions. In my mind, one way that you could perhaps work it would be use any teeth as a guide to rest on that you can, but also maybe the pallet to get the lab to extend onto the pallet maybe.
Ah, yeah. I have done, yeah, sorry. Now I see the question. Yeah. I’ve not often but if there’s any teeth to rest on, you can. The second best is a pallet and then cut it off.
Perfect Saeed. Brilliant. So now genuinely last question, guys so the last question from Pedro, can you consider a shell crown if it’s made by the clinic between appointments? So presuming you have some time between the practice days, now I imagine what he means is a scenario where you, yourself will prepare the teeth on the models and then make the shells yourself. Do you think that’s what he means? Do you think that’s what Pedro means?
I’ve got a feeling he may mean you take an impression of the preps before you put your temporary on, then during, before the patient comes back, you make your own temps.
Yeah. Yeah. You’re making you’re lab then. Okay, fine. But I have seen this before, Basil, on that note, that dentists will prep their own teeth and make their own shells out of bisacryl. Interestingly, I’ve seen that on Facebook and whatnot, and then just use that on the day to reline. I have seen that, so.
Yeah, you can do that. Again, you’re not relying on the lab, which is good. Any time a dentist can do more lab work and less reliant, I encourage it because I think that’s also what’s evolved. There’s too much of a line between what a technician does and what a dentist does with temporaries.
Okay. And too much we think dentist is intraoral and technician is anything outside the mouth. So most often my appointments, I’m working outside the mouth with temporaries. So that’s, I would encourage people, pour your own models, make your own temporaries. Okay. Just makes you less reliant on a technician, but also gives you more comfort in handling situations that you know, nothing ever goes smoothly.
Okay? And if you flummoxed a bit or you get something back from a technician and think, oh, it doesn’t fit, so I better add some acrylic. You don’t want to think, I better send it back to the technician. If you are a little bit familiar with waxing up, with pouring up a model with using acrylic, modifying, you know, it’ll get you out of so many, your confidence grows and you know, you can handle most situations and when things go wrong, you don’t get too flummoxed.
So, yeah, I’d encourage any kind of temporaries you can make. During between appointments, make your own temporaries, make your own shells. It’s all simple stuff to do.
Amazing. Basil, it’s been absolutely brilliant having you on. You’re one of my heroes and it’s been so nice to speak to you and bring on the podcast.
And I’m actually going to, I’m going to do this. I’m actually going to make the apex of my turban lower to signify how much more rejuvenated I feel from speaking the conversation. So if you missed the beginning bit, guys, you have no idea why mentioned my turban. If you were here from the beginning, I hope that made you chuckle.
How about turban recession was the same as gingival recession. I thought turban recession was the same as gingival recession.
Oh, I’ve just done some surgery. So there we are. So guys, it was, I’m sure you agree everyone. It was amazing. We got some thank you’s and some love on Facebook. Basil, I’m going to make a little email infographic that I’ll email everyone, just the key points, the key lessons that you shared today.
But guys, remember what we said today barely scratched the surface when it comes to all the different techniques with temporaries, different indications. I would definitely encourage you to look into Basil’s course, so I’ll send you a link in the email as well to check that out. He has got quite, from delegates have been on it.
It’s not like hundreds of people. It’s probably like 12 people. How many people? It’s quite limited attendance.
Yeah, yeah, we keep it to 10 or 12.
So one of those courses where you want to get in early. So I will email you that when I email the infographic or guide or the key learnings. My favorite thing today was learning that I’m going to start using the cheaper polycarboxylate cement, which I do already.
I think I use the Dentsply one, so not the Durelon so there we are. I’m going to go even cheaper now. So thank you so much for that and everything. Basil, I really appreciate it. Thank you. Have a good evening my friend. And thank you guys for tuning in.
Thank you guys. Thanks, Jaz.
There we have it guys. As Basil said, don’t worry about being half the dentist that he is. Be the best dentist that you can be. Be the full version of the dentist that you truly can be. So, I love that sentiment. Do check out the show notes either below on YouTube or on the blog, which is protrusive.co.uk/122. So any of the episodes I’ve ever done, if you just do forward slash and then the number of the episode, you can get to the blog post, which usually has a lot more information, how you can learn from our guests. So for example, if you go to /122, you’ll find all information about Basil’s courses and all the things that he’s up to if he’s teaching near you and how to learn more from it. Or his restorative programs.
Stay tuned for the next few episodes. The next one’s actually TMD and botox. You know what I mean? I couldn’t go too long with having something TMD or occlusion related. So that was Sheila and Yuen. It’s a cracker. It answers all the key burning questions that we have when it comes to botox and the use of it for the management of TMDs. And the one after that, oh my goodness. I’ve got Linda Greenwall on again, and this time we’re discussing ICON resin infiltration for white patches. So, we’re going to really make it crystal clear, step by step, how to use ICON how to charge appropriately for ICON, how to know if your ICON’s going to work or not. Right. That’s a big question I get asked on social media and I’m still carving some time to figure out how I can get out Pasquale Venuti’s series out to you.
It’s just taking a lot of time to do that. But thanks for sticking with me guys. I really appreciate you listening all the way to the end. Thank you so much my friend, and I’ll catch you in the next one