Dental Digest Podcast with Dr. Melissa Seibert

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How do you restore a severely worn dentition without committing a single bur to the tooth? Dr. Dennis Hartlieb walks through CPR for the Worn Dentition (Concept, Prototype, Restoration), a reversible, additive composite bonding workflow that lets patients test drive a new vertical dimension, tooth length, and smile design for months before any definitive dentistry. After nearly 40 years in practice, he explains why prototyping in direct composite is safer for both the patient and the dentist than going straight from a wax-up to porcelain veneers or crowns.

In this episode, you'll learn:

• What CPR means for worn teeth: concept, prototype, restoration
• Why direct composite prototypes on unprepared teeth are reversible, faster, and more affordable (single-shade composite, no layering)
• How a three-month prototype phase exposes bruxism, parafunction, failing bonding, loose teeth, and TMJ-related bite changes before you prep
• Why porcelain veneer provisionals can't reliably test anterior guidance and function
• Night guards during the prototype phase, airway considerations, and patients who won't wear an occlusal splint
• The habits that break bonding and porcelain, and how he coaches patients that teeth are not tools
• Why repairable composite beats chipped lithium disilicate or feldspathic porcelain in high-risk patients
• His records workflow: photographs, intraoral scan, facebow, analog wax-up, CBCT when joint or airway issues are suspected, and a centric relation bite with a leaf gauge
• Using a bis-acryl trial smile to test aesthetics and phonetics, including catching a lisp before treatment
• Bonding prototypes over existing crowns, zirconia, lithium disilicate, gold, and amalgam with the right surface treatment

Questions answered in this episode:

Can you open vertical dimension reversibly? Yes. Additive composite on unprepared teeth can be removed with carbide burs and discs if the patient isn't happy, returning them to where they started.

How long should a patient wear composite prototypes? Dr. Hartlieb asks patients to live with them for at least three months to watch for failures, bite changes, and aesthetic concerns.

Why not go straight to veneers or crowns? Once a bur touches the tooth, you are committed. Prototypes let the dentist and patient find common ground on function, aesthetics, and phonetics first.

About the guest: Dr. Dennis Hartlieb is a restorative and cosmetic dentist who has practiced for nearly 40 years and teaches the CPR for the Worn Dentition approach to prototype-driven, minimally invasive rehabilitation.

Hosted by Dr. Melissa Seibert, DMD, MS, FAGD, ABGD. The Dental Digest Podcast is a top 1% podcast for general dentists focused on clinical dentistry: restorative dentistry, occlusion, endodontics, implants, imaging, and practice growth. For CE, case discussions, and a community of GPs who love clinical dentistry, join Elevated GP at theelevatedgp.com.

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In part two, oral and maxillofacial radiologist Dr. Chris Matessi shows general dentists how to read a CBCT more like a radiologist: the best views for endodontics, the limits of CBCT for cracks and caries, how to tell benign from malignant lesions, how to measure accurately for implants, and how to interpret common TMJ findings.

In this episode, you'll learn:

• The views he uses to evaluate endodontically treated teeth and find missed canals like MB2
• Assessing canal configuration, calcification, dilacerations, and apical anatomy
• Why CBCT is poor at detecting cracked teeth, and its limits for diagnosing caries
• Benign versus malignant lesions: zone of transition, displacement, root resorption, and the floating tooth appearance
• Why you should review the teeth last when reading a scan
• Placing the virtual implant before measuring bone to avoid parallax error
• Is CBCT the standard of care for implants and endodontics, and where to find position papers
• Why ear pain and TMJ pain are so easily confused
• Condylar osteophytes, beaking, and flattening: what they mean and when to act
• Bifid condyles and other anatomic variants
• Why clinicians and radiologists should collaborate more closely

Questions answered in this episode:

Can CBCT detect a cracked tooth? Not reliably. Incomplete cracks limited to the crown are a clinical diagnosis. Imaging helps once there is bone loss or a separated fragment.

Why place the implant in the software before measuring? Measuring along the planned implant axis avoids parallax errors that can overestimate available bone.

Does a condylar osteophyte need treatment? Usually not. It is often an adaptive remodeling response. Treatment is driven by symptoms, but it's worth weighing before major occlusal or orthodontic changes.

About the guest: Dr. Chris Matessi is an oral and maxillofacial radiologist who practiced clinical dentistry for seven years before specializing in radiology. He reads CBCT scans for general dentists and specialists and built a collaborative case-sharing platform for referring clinicians.

Hosted by Dr. Melissa Seibert, DMD, MS, FAGD, ABGD. The Dental Digest Podcast is a top 1% podcast for general dentists focused on clinical dentistry: restorative dentistry, occlusion, endodontics, implants, imaging, and practice growth. For CE, case discussions, and a community of GPs who love clinical dentistry, join Elevated GP at theelevatedgp.com.

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Oral and maxillofacial radiologist Dr. Chris Matessi answers the cone beam CT questions general dentists ask most. From TMJ imaging and crown-root fractures to airway screening and legal liability, this episode clarifies what CBCT can reliably tell you, where it falls short, and how to choose the right scan for the right question.

In this episode, you'll learn:

• Open-mouth versus closed-mouth CBCT scans for TMJ assessment, and why a chin cup beats a bite stick for joint position
• Scan positioning for implant planning and full arch cases
• The limits of CBCT for the TMJ and when to order an MRI for soft tissue, disc position, and inflammation
• The narrow, U-shaped bone loss pattern that points to a crown-root fracture when you can't see the fracture line
• Why a brand-new fracture can look completely normal on a CBCT
• What affects image quality: manufacturer, resolution, field of view, metal and motion artifacts
• The CBCT units he likes for endodontics and general practice, and why
• Airway screening with minimum cross-sectional area, and why CBCT cannot diagnose obstructive sleep apnea
• Your legal responsibility for everything in the scan volume, and the value of a radiology report
• Choosing the smallest appropriate field of view for better resolution and lower radiation dose

Questions answered in this episode:

Can a CBCT diagnose sleep apnea? No. OSA must be diagnosed by a physician with a sleep study. CBCT is a screening and risk stratification tool.

Am I responsible for incidental findings on a full field scan? Yes. You are responsible for everything in the volume, so review it thoroughly or have it read by a radiologist.

When should I order a TMJ MRI instead of relying on CBCT? When conservative TMD therapy hasn't worked and you need to evaluate the disc, joint spaces, or inflammation.

About the guest: Dr. Chris Matessi is an oral and maxillofacial radiologist who practiced clinical dentistry for seven years before specializing in radiology. He reads CBCT scans for dentists and specialists and taught a CBCT course for Elevated GP.

Hosted by Dr. Melissa Seibert, DMD, MS, FAGD, ABGD. The Dental Digest Podcast is a top 1% podcast for general dentists focused on clinical dentistry: restorative dentistry, occlusion, endodontics, implants, imaging, and practice growth. For CE, case discussions, and a community of GPs who love clinical dentistry, join Elevated GP at theelevatedgp.com.

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The best marketing a dental practice can get is patients talking about you. In part two, Stephen Taylor, Director of Marketing at Delmain, and Dr. Melissa Seibert dig into social media, reviews, community presence, and patient experience, and why fixing the leaks in your practice often beats spending more on ads.

In this episode, you'll learn:

• Using social media for branding and validation rather than as a primary patient acquisition channel
• Aligning your content with your ideal patient and your brand
• Why platforms penalize inconsistent posting
• Facebook groups and becoming a pillar of your community
• How to ask for reviews and referrals without being slimy, and why your team is your biggest asset
• Low-key community marketing ideas that build goodwill
• Recommended reading: Influence by Robert Cialdini and The 1-Page Marketing Plan
• Marketing as a force multiplier: how front desk training turned more phone calls into new patients without more ad spend
• Why understanding patient behavior, like how many still prefer to call, shapes where you invest
• AI answering services at the front desk: the patient experience and HIPAA considerations

Questions answered in this episode:

Is organic social media worth it for a dental practice? It helps with branding and validation, but consistency and alignment with your ideal patient matter. Patient word of mouth usually drives more new patients than your own posts.

How do I get more Google reviews? Train your team to ask, especially the people who spend the most time with patients, and make the ask simple and sincere.

Should I spend more on ads if marketing isn't working? Not first. Fix leaks like unanswered calls and poor phone conversion, then scale what's working.

About the guest: Stephen Taylor is Director of Marketing at Delmain, a dental marketing company that supports practices with websites, SEO, paid ads, and patient acquisition. Learn more at delmain.co.

Hosted by Dr. Melissa Seibert, DMD, MS, FAGD, ABGD. The Dental Digest Podcast is a top 1% podcast for general dentists focused on clinical dentistry: restorative dentistry, occlusion, endodontics, implants, imaging, and practice growth. For CE, case discussions, and a community of GPs who love clinical dentistry, join Elevated GP at theelevatedgp.com.

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You can be the best clinician in town, but if new patients can't find you, your schedule stays empty. Stephen Taylor, Director of Marketing at Delmain, explains what actually brings new patients into a dental practice in 2026, from the fundamentals that still work to AI search, SEO, Google and Meta ads, and the measurement that separates real ROI from wasted ad spend.

In this episode, you'll learn:

• The marketing fundamentals that still work in 2026: a website and a phone that gets answered
• How one practice dramatically increased new patients from Meta ads by running them only during business hours
• How patients are using AI tools like ChatGPT, Gemini, and Claude to choose a healthcare provider, and how to show up
• Whether Google Ads are still worth it when so many people search with AI
• Why SEO still matters and overlaps heavily with AI visibility
• How a practice in a competitive New Jersey market grew patient opportunities with SEO alone
• The biggest way dentists waste marketing dollars, and why you must connect marketing data to your practice management system
• Realistic new patient benchmarks and how to build a plan around your goals
• A startup marketing plan: website, Google Business Profile, Apple Maps, reviews, ad timing, and ongoing content
• Organic social media, micro-influence, and why your patients are better influencers than you

Questions answered in this episode:

Do dental practices still need a website in the age of AI search? Yes. The website is essential for visibility, AI citations, and meeting patient expectations.

Is SEO still worth paying for? Yes. The work that helps you rank in traditional search also helps you appear in AI overviews and AI assistants.

How do I know if my marketing is working? Track beyond clicks to booked appointments, kept appointments, and collections by connecting marketing data to your practice management software.

About the guest: Stephen Taylor is Director of Marketing at Delmain, a dental marketing company that partners with more than 200 practices on websites, SEO, paid ads, and patient acquisition.

Hosted by Dr. Melissa Seibert, DMD, MS, FAGD, ABGD. The Dental Digest Podcast is a top 1% podcast for general dentists focused on clinical dentistry: restorative dentistry, occlusion, endodontics, implants, imaging, and practice growth. For CE, case discussions, and a community of GPs who love clinical dentistry, join Elevated GP at theelevatedgp.com.

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Should you perform a pulpotomy, a direct pulp cap, or a full root canal on a mature tooth with deep caries? Endodontist Dr. Judy McIntyre gives general dentists a candid, practical guide to vital pulp therapy, when a preoperative CBCT is essential, what separates a well-done root canal from a compromised one, and how to know your limits and build a real partnership with your endodontist.

In this episode, you'll learn:

• What vital pulp therapy is and isn't, from open-apex teeth to mature adult teeth
• Why preoperative symptoms matter when choosing between vital pulp therapy and root canal therapy
• Her pulpotomy technique: diamond bur, hemostasis, sodium hypochlorite, and a bioceramic or MTA cap
• Why you lose cold testing after vital pulp therapy, and the follow-up system to catch failures early
• Annual radiographs on endo-treated teeth and pulp testing before crowns
• When a preoperative CBCT is a must: molars, retreatments, apicoectomies, premolars with fast breaks, and two-canal canines
• Endo-resolution CBCT versus large field of view scans, and why she dislikes image filters
• Minimally invasive and ninja access cavities: when conservation stops serving the patient
• Avoiding the cowboy mentality and building a reciprocal relationship with your endodontist
• The elements of a well-done root canal: anesthesia, rubber dam, full armamentarium, irrigation, obturation, and a sealed restoration
• Single-cone technique versus lateral and hybrid obturation, and why bioceramic sealer should not replace gutta-percha

Questions answered in this episode:

Pulpotomy, pulp cap, or root canal on a mature tooth with deep caries? It depends on symptoms, your true abilities, and whether the patient will return for follow-up. Frank expectations and a recall system are essential.

Which endo cases need a preoperative CBCT? Dr. McIntyre recommends it for all molars, retreatments, and apicoectomies, and for premolars or anteriors when 2D imaging shows fast breaks, curvature, or resorption.

Is the single-cone technique acceptable? Yes, when the cone intimately fits the prepared canal. Sealer is a vehicle, not the filling, and gutta-percha keeps the canal retreatable.

About the guest: Dr. Judy McIntyre is an endodontist and educator who teaches general dentists about CBCT, vital pulp therapy, and endodontic setup, and is known for encouraging GPs to love their endodontists.

Hosted by Dr. Melissa Seibert, DMD, MS, FAGD, ABGD. The Dental Digest Podcast is a top 1% podcast for general dentists focused on clinical dentistry: restorative dentistry, occlusion, endodontics, implants, imaging, and practice growth. For CE, case discussions, and a community of GPs who love clinical dentistry, join Elevated GP at theelevatedgp.com.

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Jim McKee is in private practice in Downers Grove, Illinois. Jim has a restoratively based practice with an emphasis on occlusion and temporomandibular joint disorders. In addition to private practice, Jim is a published author who has lectured national and internationally for over 25 years. Jim provides a new perspective on occlusion and TM joints that helps increase the predictability of occlusal, orthodontic, restorative, orthognathic and airway treatment options for both the patient and the dentist. He is the founder of the Chicago Study Club program and has extensive experience in directing study clubs in the United States and Canada. He is a ResidentFaculty member at Spear Education in Scottsdale, Arizona. Jim is a past president of the American Academy of Restorative Dentistry and the American Equilibration Society.

Episode Overview In part two of this two-part series on Dental Digest, host Dr. Melissa Seibert and dual-boarded periodontist/prosthodontist Dr. Ashley Hoders challenge the conventional assumption that implants are always the gold standard in the anterior aesthetic zone . They explore why maxillary laterals and mandibular incisors are biologically hazardous sites for implants, how to choose mechanical over biologic failure, and how root submergence preserves vital bundle bone and papilla architecture .

Guest Information

• Guest: Dr. Ashley Hoders, DDS, MS

• Credentials & Affiliations: Dual board-certified diplomate and fellow of the American Board of Periodontology and the American Board of Prosthodontics; MS from the University of Texas Health Science Center at San Antonio . Clinical researcher with the McGuire Institute, co-creator of Spear Hygiene, visiting faculty at the University of Washington Graduate Periodontics Department, and active member of the American Academy of Restorative Dentistry .

Key Clinical Takeaways

1. The Fallacy of the Anterior Implant "Gold Standard"

• Maxillary lateral incisors and mandibular incisors represent non-strategic implant locations due to narrow space, thin facial bone, and continuous lifetime craniofacial changes .

• Natural adjacent teeth and jaws continue to move, erupt, and remodel across a patient's lifespan, whereas ankylosed/osseointegrated implants remain static, causing mismatched incisal edges and uneven gingival zeniths over time .

2. Mechanical Complications vs. Biologic Disasters

• Conservative cantilevered or single-retainer resin-bonded bridges achieve a $\approx 98\%$ success rate over 10+ years in properly managed occlusal schemes .

• Fixed tooth-supported alternatives fail through mechanical inconvenience (e.g., wing debonding or connector fracture), which is easily repaired .

• Implants carry biologic risk: at least 50% of implants exhibit inflammation or peri-implant disease, introducing chronic inflammatory challenges into an avascular environment where treatment is unpredictable .

3. Two-Layer Diagnostic & Treatment Planning

• Dual perio-prosthodontic diagnostics require planning not just for the immediate edentulous site, but predicting what happens when adjacent teeth compromise (e.g., adjacent traumatized central incisors) .

• 3D planning dictates restorative pathways before surgery, verifying whether crestal morphology necessitates cement-retained versus screw-retained solutions .

• Placing an anterior implant too shallow or too facial is the ultimate "kiss of death" for long-term peri-implant tissue stability .

4. Biologic Tension and Muscular Equilibrium

• Bone stability relies on eliminating tension from the surrounding musculature (lips, cheeks, and tongue) and establishing a robust collar of keratinized mucosa .

• Genetic cell turnover rates and masticatory function continuously challenge crestal bone margins .

5. Root Submergence & Partial Extraction Therapy

• Anterior facial bone is frequently $ thick; removing the tooth and its periodontal ligament (PDL) causes rapid resorption of the bundle bone, resulting in horizontal and vertical ridge collapse .

• Root submergence retains the submerged root structure inside the alveolus, tricking the body into maintaining the PDL, preserving bundle bone volume, and sustaining interproximal papilla height for adjacent restorations .

• "Pro-tooth" dentistry prioritizes buying time with natural root structures (via posts, ferrule optimization, or partial extraction therapies) over premature implant placement .

Notable Mentions & Literature

• Bill Robbins, DDS: Commentary in the International Journal of Periodontics & Restorative Dentistry (IJPRD) on avoiding lateral incisor implants; single-retainer RBFDP designs utilizing the mesial of the canine .

• Matthias Kern, Dr. med. dent.: Long-term evidence supporting single-wing cantilever resin-bonded bridges (using the distal of the central incisor) .

• Frank Spear, DDS, MSD: Clinical philosophy on valuing natural tooth retention: "I'm not anti-implant, I'm pro-tooth."

• Mike Gunson, DDS, MD: Research surrounding facial aging, craniofacial growth, and implant positioning discrepancies .

Detailed Show Notes

Episode Overview In part one of this two-part series on Dental Digest, host Dr. Melissa Seibert sits down with dual-boarded periodontist and prosthodontist Dr. Ashley Hoders to examine the latest consensus literature on peri-implant soft tissue deficiencies, biologic bone preservation, and the biomechanics of skeletal expansion . They unpack why soft tissue recession is fundamentally a bone problem, how thin tissue starved of blood supply triggers crestal loss, and why treating skeletal arch deficiencies with dental compensation compromises cortical bone .

Guest Information

• Guest: Dr. Ashley Hoders, DDS, MS

• Credentials & Affiliations: Dual board-certified diplomat and fellow of the American Board of Periodontology and the American Board of Prosthodontics; MS from UT Health Science Center at San Antonio . Clinical researcher with the McGuire Institute, co-creator of Spear Hygiene, visiting faculty at the University of Washington Graduate Periodontics Department, and active member of the American Academy of Restorative Dentistry (AARD) .

Key Clinical Takeaways

1. The Reality of Peri-Implant Soft Tissue Deficiencies

• Recent joint consensus papers (AO/AAP) reveal that non-diseased peri-implant soft tissue deficiencies have an overall prevalence of 46.2% .

• These deficiencies worsen over time: 33% at 1 year and 64.5% at 5 years .

• Clinicians should exercise caution when planning implants in the aesthetic zone and consider alternative modalities (such as resin-bonded bridges) when appropriate .

2. Mid-Facial Margins vs. Interproximal Papilla

• Interproximal papilla height is dictated primarily by the bone levels on adjacent natural teeth .

• Mid-facial mucosal margin stability is driven by facial bone thickness (which is frequently $), 3D implant positioning, and placement timing (immediate vs. delayed protocols) .

3. Soft Tissue Recession is an Underlying Bone Problem

• Soft tissue recession or peri-implant deficiency cannot occur without an underlying bone dehiscence or bone loss .

• Bone requires two primary conditions to remain stable :

  • Vascular Nutrition: Thin tissue has inadequate blood supply, starving the underlying crestal bone and causing progressive remodeling .

  • Absence of Tension: Muscle attachments, vestibular pull, and lack of keratinized tissue exert tensile forces that destabilize bone .

4. Proactive Grafting as a Bone Stabilizer

• Because bone cannot be predictably regenerated over an avascular implant surface or root dehiscence, soft tissue grafting serves as a proactive biologic shield .

• Converting thin phenotypes to thick biotypes and widening keratinized mucosa delivers blood supply and buffers muscle tension, safeguarding crestal bone before recession occurs .

• 5. Skeletal Solutions for Skeletal Discrepancies

  • Post-industrial human development (diet changes, decreased breastfeeding) has led to smaller maxillas and contracted arches .

  • Treating skeletal constriction with purely dental expansion tips teeth outside the cortical plate, causing bone dehiscences, severe recession, and mobility .

  • Skeletal discrepancies require orthopedic/skeletal solutions (e.g., MARPE) rather than dental camouflage to preserve the periodontal foundation .

  6. Patient Communication & Treatment Planning

  • Utilize 2D/3D radiographs alongside high-quality clinical photographs at baseline .

  • Drawing directly on printed photos helps patients visualize bone anatomy, soft tissue margins, and long-term aesthetic trade-offs before consenting to anterior implant therapy .

  Notable Mentions & Literature

  • Consensus Literature: Academy of Osseointegration (AO) and American Academy of Periodontology (AAP) consensus papers on peri-implant disease and soft tissue deficiencies .

  • Influences & Citations: Kevin Murphy (AARD literature review), Joseph Kan (interproximal bone dynamics), Mariana Evans (airway, cranial growth, and post-industrial skeletal changes), Jeff Rouse, and Bill Robbins (interdisciplinary diagnosis)

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Dr. Vince Kokich Jr. is a highly esteemed orthodontist, educator, and thought leader in the field of orthodontics and interdisciplinary dentistry. Following in the footsteps of his father, Dr. Vince Kokich Sr., a globally recognized pioneer in orthodontics, Dr. Kokich Jr. has built his own legacy by advancing innovative approaches to patient care, education, and the integration of specialties within dentistry.

Dr. Kokich Jr. earned his Doctor of Dental Surgery (DDS) degree with high honors from the University of Washington School of Dentistry, a program known for its rigorous clinical training and commitment to evidence-based care. He went on to complete his orthodontic residency at the same institution, where he honed his skills in diagnosing and treating complex malocclusions, facial growth discrepancies, and interdisciplinary cases.

Throughout his education, Dr. Kokich was recognized for his academic excellence and dedication to improving patient outcomes. His passion for teaching began early in his career and has remained a cornerstone of his professional life.

Dr. Kokich Jr. has practiced orthodontics for over two decades, specializing in comprehensive treatment plans that address both functional and esthetic concerns. He is particularly renowned for his expertise in:

• Interdisciplinary Treatment: Collaborating with restorative dentists, periodontists, and oral surgeons to achieve optimal outcomes for complex cases.
• Aesthetic Orthodontics: Enhancing smiles through precision orthodontic treatment tailored to each patient's unique facial structure and goals.
• Education and Mentorship: Sharing his knowledge and clinical experience with the next generation of orthodontists.

As an orthodontist, Dr. Kokich is committed to providing patient-centered care. His approach focuses on creating harmonious outcomes that not only align teeth but also improve facial aesthetics and long-term dental health.

Dr. Kokich Jr. is a sought-after speaker at national and international dental conferences, where he shares his expertise on topics such as:

• Advanced interdisciplinary treatment planning.
• Managing complex dental esthetic cases.
• Incorporating emerging technologies into orthodontic practice.

He has been invited to lecture for prestigious organizations and institutions, including the American Association of Orthodontists, the American Academy of Esthetic Dentistry, and various study clubs and universities worldwide. His dynamic and engaging teaching style makes him a favorite among both clinicians and students.

Dr. Kokich Jr. is the creator of Kokich Education, an educational platform dedicated to elevating the knowledge and skills of dental professionals. Kokich Education offers a range of resources, from webinars and case studies to in-depth courses, empowering clinicians to tackle even the most challenging cases with confidence. The platform reflects Dr. Kokich's philosophy of interdisciplinary collaboration and lifelong learning.

To learn more about Kokich Education, visit kokicheducation.com.

Dr. Kokich Jr. has contributed to several peer-reviewed articles and textbook chapters that focus on the integration of orthodontics with other dental specialties. His work has been instrumental in advancing the understanding of how orthodontics can complement restorative and prosthetic dentistry to achieve superior outcomes.

Dr. Kokich Jr. is an active member of several professional organizations, including:

• The American Association of Orthodontists (AAO).
• The American Dental Association (ADA).
• The Pacific Coast Society of Orthodontists (PCSO).

Dr. Vince Kokich Jr. continues to honor the legacy of his father while forging his own path in orthodontics. His dedication to innovation, education, and patient care has made him a leader in the field. Through his practice, lectures, and Kokich Education, Dr. Kokich inspires clinicians worldwide to achieve excellence in their work and deliver transformative care to their patients.