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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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SPONSOR: Garrison Dental Solutions. Use code 26PODCAST for 10% off your order at https://www.garrisondental.com/ (valid for one purchase made directly through Garrison, through December 31, 2026).

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.