Stop Blaming Bruxism Part 2 with Sandra Hulac – PDP142

After the cliffhanger from Part 1, Dr. Sandra Hulac is back to share more information about Frictional and Constricted Chewing Patterns (CCP) with cases shared and explanations given.



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The Protrusive Dental Pearl: Overjet is King. We don't want tight bites. We want a bit of overjet that gives chewing space - this will reduce the chances of a functional attrition and avoid 'too much anterior guidance' or locking the patient in.



“It's important to know why things fail and try and avoid failure the next time”



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



Highlights of this episode:



0:28 PDP141 - Stop Blaming Bruxism Part 1 Recap6:34 The Protrusive Dental Pearl: Overjet is King6:56 The role of pre-restorative orthodontics9:24 Case #1: Extremely traumatic deep bite14:10 Case #2: Crowding of the lower anterior segment19:41 Case #3 Lot of wear on the front teeth 23:54 Case #4: Chipped and worn front teeth 27:06 Case #5: Worn front teeth 32:41 Case #6: Patient had an extraction ortho



Dr. Mahmoud and I are also excited to share the occlusion that we learned over the years –  in a way that you have never seen before! 



Occlusion: Basics and Beyond is the most tangible, real-world, and comprehensive occlusion training on the planet.



LIMITED DELEGATE SPOTS DUE TO STARTER KIT STOCK – AVOID DISAPPOINTMENT! Occlusion Online Course



Be sure to watch Part 1: Stop Blaming Bruxism! How to Spot Frictional and Constricted Chewing Patterns (CCP) 







Click below for full episode transcript:



Introduction: Hello, Protruserati. I'm Jaz Gulati and thanks so much for coming onto the app for part two or what was quite a brilliant part one with Dr. Sandra Hulac. Her energy is just absolutely amazing.



Jaz's Introduction:Now, just a recap, we left you on a bit of a cliffhanger last time. We talked about, I asked Sandra about orthodontics. You know, how often does orthodontics come into it?



Is it every single time? And the answer she gives is really pragmatic. So you'll hear that or see that in just a few minutes. But I just want to do a bit of a recap, what we talked about last time, right? So, a constricted chewing pattern is someone who really wants to bite here, but the teeth meet together here, so the condyle gets sort of pushed back, if you like.



Right. So for this patient, the centric relation is actually further forward. So who's at risk? People who've got upright or retroclined upper incisors, right? And their jaw wants to be further forward, right? Maybe cuz of growth, the jaw wants to be further forward, which is why Sandra said that people who've had orthodontics and upper pre-molars extracted.



The maxilla gets smaller if you like, and mandible start continues to grow and those patients may be at risk. So if you see those kind of traits, then maybe we shouldn't be using like a leaf gauge for centric relation on those patients. We should be using like a deprogramming appliance Lucia Jig or a Kois deprogrammer.



If you fancy that one because that's what Dr. Sandra does. And what you find with these patients with a CCP is yes, their jaw gets shifted back, but you might get more wear on their edges. And that's not from bruxism. That's because the outside in movement. Right? Their jaw wants to be further forward.



Now, this is similar. The cousin of this is the frictional chewing pattern who their condyle isn't getting forced back, right? Their MIP is okay. It's just that as they're chewing the outside in is causing this. So, let's say that's normal, the incisal edges are not worn here. Can you see?



They're a bit jaggedy over here, right? It's just, to over here and over here. We see this all the time and let me show you some photos actually on th...