hello everyone in welcome into episode 165 of chairside live I'm your host Megan strong
in today's episode dr. moreau jean is comparing obsidian press to metal and Brooks ear interior
then we're introducing you to a new segment with our friend in chair side magazine contributor
Gary the lawyer he'll be talking about managing your Yelp account but first let's catch up with
dr. Murray shot hello and thank you for taking the time to watch one of my cases that started
over a decade ago way back in the beginning of my dental technician career I fabricated these P FM's
on 8 and 9 for one of my dental technician colleague but not long ago he stopped by to
show me that he is noticing a crack on one of the crowns and also that the dark root of the
endodontic retreated tooth started to show another complaint he had was the uneven gingival margin
and the length asymmetry of the central incisors a closer look at ground number 9 reveals a cohesive
fracture propagated at the margin we know that most incidents of porcelain fracture with pfm is
increased with long-term survival due to cyclic fatigue the receding margin along with the thin
gingival biotype covering the dark root and the gingival pigmentation observed on the patella
between 9 and 10 are making the tissue around number 9 appear very low in value you see me
here assessing the gingival biotype and sounding down to the bone my measurements confirm there
was no risk of violation of periodontium if I will remove no more than 0.5 to 1 millimeter of tissue
Here I am approximating the gingival height with a piece of floss and from the measurements I knew
I will not end up exactly at the same gingival level with number 9 but patient was aware that
the amount of gingiva camión number rate will be dictated by the biological weight and the amount
of existing circular depth this is a taper narrow tip zere cut bird that I usually use to cut the
zoo cornea restorations with but for this case I decided to reuse one and try it on these P
FM's there is a big color difference between these preps for these types of cases there are several
material options and different approaches to mask the metal post and the discoloured dentin slide
gingival contra was also done on the left central in a one point two millimeter syringe preloaded
with three percent hydrogen peroxide and a brush tip was used to remove the tissue tags because
the old pfm had metal lingual further lingual reduction was necessary and clearance was checked
to ensure sufficient material thickness Here I am finalizing the prep in a dried field placing the
margin at the gingival level using a fine diamond bur before temporizing and allowing the tissue to
heal prior to injecting Glocks attempt into the tray to fabricate the temporaries my assistant
modified the pre-op impression to compensate for the tissue loss from the gingiva to me and the
marginal changes note how great the prep on number nine looks under the temporary I knew it will be a
challenge to mask the dark dentin and the metal post if I will choose to go with a full ceramic
or Broxson interior crown but because the post was very large into the canal I opted not to mask
the discoloured dentin or the post with opaque composite further removal of dark dentin from the
ferrule and subsequently application of the opaque composite would have weakened the tooth even more
this is at the final impression appointment after the tissue was allowed to heal for two
weeks note the tin gingiva on number nine and how it picks up on the dark route underneath it makes
the tissue appear very low in value when compared to the tissue over the right central after I read
measured the sulcus minor laser touch-up was done prior to the final impression getting ready to
take the impression I use double core technique with ultra PAC double zero and two cord my
assistant recommended me the Fischer ultra packs serrated core packer and I decided to give it a
try I like it because it grabs on the cord and is perfect for anterior preps anatomical Comper caps
were placed and medium and heavy body capture material was used to take the final impression
there are different methods to mask the discolored prep of this tooth like I said one would be to
effectively make a normal color prep by using opaque composite this allows the use of more
translucent final restorations such as bronzer interior or monolithic obsidian the other option
is to leave the prep as is and use p FM or Brock's of solid zirconia crown since I left the prep as
it was I thought obsidian press tomorrow will be a great choice because will completely cover the
post however for destroying I decided to also look at Brock's interior this is an outstanding
beautiful high translucent zirconia and I wanted to see just how much an unmasked metal post would
show through here are the brass or interior crowns at the Tryon this was not a surprise
I knew the left central will display a low value since I decided not to mask the darkness of the
prep obsidian press two Merrill turned out to be best for this situation where I will still get
some of the optical properties of the translucent material at the incisal edges and will blend nice
with their surrounding dentition but because of the low value of number nine there was an extra
step I did perform in my attempt to brighten the root below the tissue I had my assistant use boost
and bleached the ferrule in the attempt to get the gingiva to look more pink in the end the Obsidian
press - maro did mask the post but there wasn't a drastic change after bleaching tissue still look
slightly low in value after final cementation of obsidian pressed metal crowns the gingiva on
number eight didn't quite match number nine but without violating the biological width it was an
improvement from where we started patient did not notice the minor differences in gingival asymmetry
and he was very happy with the result thank you again for watching back to you Megan thank you for
that doctor murder Shawn alright now it's time for a brand new segment featuring our in-house legal
counsel in chair side magazine contributor Gary Pritchard or as we affectionately call him Gary
the lawyer take it away Gary hi I'm Gary Pritchard in-house counsel for Glidewell laboratories and
the author of the Gary the lawyer feature new to chair side magazine in this scintillating
series of articles and videos my goal is to give you information you can actually use
after consulting with your own lawyer of course rather than just vague discussions and confusing
treatises that are heavy on syllables but light on utility as always please remember that the
information that I'm providing does not constitute an attorney-client relationship is not intended as
legal advice and is not a substitute for obtaining legal advice from a qualified attorney I'm going
to tell you how I have been able to get Yelp to remove some negative reviews you can find
the actual letters I wrote on the online or print version of chairside magazine but here's the idea
behind the letters first go to the Yelp website and look at its general guidelines the area on
the website where it gives the user the standards for posting on its site the idea is to show Yelp
that the offensive post is in violation of one or more of these guidelines for example
one of its guideline states no threats harassment lewdness hate speech or other displays of bigotry
now put your politically correct pants on and pay attention because this is the key if you can tie
the harassment or discrimination into one of the legally protected categories that is age
race sex disability religion national origin etc you can substantially strengthen your complaint
let's say that the complaint states that your dental equipment is old and outdated you feel
harassed or discriminated against because of your age someone makes a complaint that your fat
hygienist was mean she felt harassed because of her disability yes obesity is now a disability in
and of itself and a notarized statement from her attesting to the harassment can only strengthen
your yelp complaint letter are you understanding the program can you smell what I'm cooking other
Yelp guidelines can be equally helpful here are just a few ideas Yelp states that reviews
should not be written by competitors in your industry if you suspect a competitor is behind
a complaint you should certainly point that out to Yelp along with any evidence to substantiate
your position Yelp says no commercial promotional content therefore if the review has any reference
to businesses or other products other than yours you have grounds for an objection for example if
the review complains that you don't use the state-of-the-art TS 150 mil from Glidewell
Laboratories you could object or you could just treat yourself to one through any of our fine
dealers Yelp states that the reviews on the place for rants about it business's employment practices
political ideologies extraordinary circumstances or other matters that don't address the core of
the consumer experience accordingly you should complain about reviews by disgruntled former
employees you can be sure if it's a complaint about your practice it's an extraordinary
circumstance use that Yelp states that the reviews should not publicize other people's
private information including full names so if they use the personal name of either you or any
of your employees in the negative review make a complaint yup states that the review should
discuss firsthand consumer experiences only so be sure to object to any review that says
my wife or my mother or my husband to receive horrible treatment one last point to note in
my successful attempts to have reviews pulled from Yelp I addressed the letters - yelps agent
for service of process which can be found through the website of the California Secretary of State I
think that gives the letter some extra attention yep also informed me that emailing and objection
to the website is another way to complain about a violation of their company standards I think it's
a good idea to use both use the shotgun complaint approach get two looks at your complaint and point
out multiple violations of the guidelines in each complaint throw it all out there make
something stick and keep those Yelp reviews of your business fair accurate and representative
of the great work that you do good luck out there thank you for that Gary put some good
practical advice and you can look forward to more great information from Gary the lawyer in future
episodes but until then that's it for this episode of chairside live so on behalf of everyone here at
Glidewell laboratories we thank you for watching and we'll meet you right back here next week
you