Fremitus and Occlusal Overload – Dental Occlusion Geekiness – PDP160

Ever heard of fremitus? Wondering what it really means for your patient's occlusion? In this episode we're joined again by Dr. Mahmoud Ibrahim, by popular demand, for an insightful discussion on dental fremitus. We understand that this topic can be a bit perplexing, so we're here to break it down step by step.




https://youtu.be/LFZ4Uh0Y8sI
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We share how we seamlessly integrate a fremitus check into an occlusal assessment, discussing the crucial aspects of when and how to intervene effectively, all while preserving your patient’s chewing space.



Check out our upcoming webinar “Unchippable” to learn about how to prevent chips and breaks on your lovely anterior composite restorations – protrusive.co.uk/unchippable



'Weakest Link' study that Jaz and Mahmoud referred to: https://www.tandfonline.com/doi/abs/10.1080/08869634.2000.11746142



The Awake Bruxism (habit breaking) appliance that Jaz uses called MAPA.



More about Fremitus, how it's classified and occlusal trauma.



Follow Dr. Ibrahim on Instagram @drmoidental



Want to learn more about Occlusion? Head over to occlusion.online.



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



Highlights of the episode:00:00 Intro00:39 The Protrusive Dental Pearl04:17 Dr. Mahmoud Ibrahim05:17 Mobility vs fremitus08:26 What is fremitus?09:52 The PDL12:54 The weakest link theory16:21 Checking for fremitus17:19 Class 1 fremitus21:57 Class 2 and 3 fremitus23:03 Treatment27:24 Envelope of function29:21 Orthodontic treatment36:34 Final remarks39:44 Outro



If you liked this episode, you will also like PDP150 - Occlusion on Class IV Composite Restorations



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Click below for full episode transcript:



Jaz's Introduction: Fremitus is this strange thing when your patient bites together and you feel, or you see a tooth move out of the way, classically a front tooth, right? It's a sign of Occlusal Overload. And in this episode, we're going to talk everything related to Fremitus with my good friend, Dr. Mahmoud Ibrahim.



Jaz’s Introduction:Hello, Protruserati. I'm Jaz Gulati, and welcome back to another Protrusive Dental Podcast episode. If you're new to the podcast, welcome. Thanks so much for joining us. And if you're a veteran Protruserati, thanks for coming time and time again. We hope to make complex topics in dentistry tangible for you.



Protrusive Dental PearlBefore we join the main interview with Dr. Mahmoud Ibrahim, I'm going to give you the Protrusive Dental Pearl, which I always do for every main PDP episode. Today's Protrusive Pearl relates to cramp operations, and in particular, getting better impressions or scans. Look, once you've placed the retraction cord, and I know many people like to use things like Expasyl or Traxodent, which are like the pace systems.



I quite like using retraction chords and also in combination with PTFE tape, especially as I do lots of vertical preparations or VertiPreps. Now I have got lots of webinars planned in October. As part of the live series I'm doing for the Protruserati, the premium subscribers, it's going to be VertiPrep for Plonkers.



So that's coming soon. And one of the strategies I use to be able to scan subgingivally is once I've got my triple zero cord in place, I will put some PTFE tape over that. But sometimes what can happen is that the gingiva it sulks, right? It sulks on to the PTFE and sometimes even contacts the prep. So when I scan it because the tissues because the gums are touching the preparation it creates a nightmare scenario for my technician who wants that gingiva well out of the way So at that point the pearl the tip i'm giving you is if you've got a laser, fine. Great. Use a laser. If you've got any fancy burrs, use them.



But the cheapest thing you can buy is something called a Thermocut Bur.