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Dental Digest Podcast with Dr. Melissa Seibert

Dental Digest Podcast with Dr. Melissa Seibert

Auteur(s): Dental Digest Institute & Dr. Melissa Seibert: Dentist
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 The Dental Digest podcast is a show dedicated to discussing the latest trends, topics, and innovations in the field of dentistry. The podcast was created and is hosted by Dr. Melissa Seibert, a practicing dentist, and features interviews with leading experts in the field of dentistry, including dentists, researchers, educators, and industry professionals. Topics covered on the show range from clinical techniques and technology to practice management and marketing strategies, with a focus on providing actionable insights and practical advice for dental professionals at all stages of their careers. The Dental Digest podcast is available on all major podcast platforms and is a valuable resource for dental professionals looking to stay up-to-date on the latest trends and best practices in the field of dentistry. Hygiène et mode de vie sain Nature et écologie Science Troubles et maladies
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  • The E-B-C Concept: Designing the Implant Emergence Profile with Biologic Precision with Dr. Jonathan Esquivel,

    The E-B-C Concept: Designing the Implant Emergence Profile with Biologic Precision with Dr. Jonathan Esquivel,
    Nov 12 2025
    Injection Molding PDF Email me: dr.melissaseibert@gmail.com Join Elevated GP: www.theelevatedgp.com Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram In this second installment of Dental Digest's conversation with Dr. Jonathan Esquivel, host Dr. Melissa Seibert and her guest push deeper into the artistry, biology, and discipline required to restore anterior implants that are as functional as they are beautiful. While Part 1 introduced Esquivel's framework of space, volume, and time, this episode focuses on the next frontier—provisionalization, emergence-profile design, and the E-B-C concept that defines the biologic foundations of aesthetic implant therapy. Dr. Esquivel begins by demystifying the provisionalization workflow for anterior implants—whether immediate or delayed. He walks listeners step by step through decision-making factors such as ridge healing, tissue phenotype, and the importance of minimizing the number of disconnections to protect the fragile mucosal seal. He stresses that efficiency in implant dentistry isn't about finishing fast—it's about achieving predictability in the fewest biologically respectful appointments. The discussion then turns to the team-based dynamics between the restorative dentist and the surgeon. Dr. Esquivel details how he coordinates cases digitally, sending STL files and mock-ups for joint planning before the first incision. His six-phase system—Acquisition, Blueprint, Confirmation, Design, Execution, and Follow-up—illustrates how restorative-driven implant dentistry must begin with facial and prosthetic design, not with a drill guide. From there, the episode dives into the chairside artistry of immediate provisionalization. Using a pre-milled shell and temporary cylinder, Dr. Esquivel describes how to "pick up" a provisional and sculpt the subgingival contours in real time. But as he emphasizes, the true challenge lies not in fabrication—but in understanding how material additions and reductions influence soft-tissue behavior. This insight leads to one of the most clinically valuable segments of the episode: Dr. Esquivel's E-B-C concept, an evolution of the classic critical- and subcritical-contour framework. The E-Zone (Esthetic Zone), roughly the first millimeter below the gingival zenith, governs margin stability and the visible pink–white transition. The B-Zone (Biologic or Boundary Zone) supports the mucosal seal and should remain concave to create space for healthy soft tissue. The C-Zone (Crestal Zone), the most apical 1–2 mm, must be slim and biologically quiet to preserve the crestal bone. Dr. Esquivel explains how even subtle over-contouring in these zones can trigger recession or bone loss, while proper shaping promotes long-term harmony between implant and tissue. Using tactile language, he describes his preference for pear-shaped acrylic burs to sculpt the concavity of the B-zone, and how digital workflows now allow clinicians to model these micro-contours virtually before any material is placed. The conversation culminates in a reflection on philosophy as much as technique. Dr. Esquivel urges clinicians to focus on mastering the basics—aesthetic symmetry, biologic respect, and patience—rather than chasing novelty. "An implant is not a tooth," he reminds us. "Our goal is to protect the bone, guide the tissue, and understand what we can't see." Listeners will leave this episode with a detailed understanding of: How to design, print, or fabricate custom provisionals that shape the soft tissue biologically The dimensional logic behind the E-B-C zones and how each governs tissue stability Why limiting abutment disconnections preserves the mucosal seal How digital and analog workflows can be integrated seamlessly And the mindset shift required to see implants not as prosthetic devices, but as biologic restorations Part 2 is both a masterclass in subgingival design and a meditation on restraint. Dr. Esquivel reminds us that excellence in implant aesthetics doesn't come from doing more—it comes from doing less, but with absolute intention.
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    35 min
  • Implant Aesthetics Unpacked: Biologic Design & Power of Provisionalization with Dr. Jonathan Esquivel

    Implant Aesthetics Unpacked: Biologic Design & Power of Provisionalization with Dr. Jonathan Esquivel
    Nov 5 2025
    Injection Molding PDF Email me dr.melissaseibert@gmail.com Join Elevated GP: www.theelevatedgp.com Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram In this episode of Dental Digest, Dr. Melissa Seibert sits down with prosthodontist and educator Dr. Jonathan Esquivel for part one of an enlightening two-part series that explores the biologic and aesthetic complexities of implant restoration. Known for his meticulous approach and his evidence-based framework of space, volume, and time, Dr. Esquivel brings clarity to one of dentistry's most challenging frontiers: the anterior aesthetic zone. They begin by examining why restoring a single anterior implant is often considered the ultimate test of restorative mastery. Dr. Esquivel explains that implants behave fundamentally differently from natural roots—they lack the periodontal ligament and its vascular support—making soft tissue far less forgiving. Even slight changes in tissue contour or bone volume can compromise long-term success. He introduces his four cornerstones for implant predictability: luck (biologic variability), three-dimensional positioning, emergence-profile design, and patient maintenance, emphasizing that precision and patient education are inseparable. The conversation then turns to three-dimensional implant positioning and the role of reverse-engineered planning. Dr. Esquivel insists that every implant must begin with the end in mind—by first visualizing where the tooth should be. He details how ideal placement, roughly 4 mm apical to the planned incisal edge and aligned toward the cingulum, forms the foundation for natural emergence and long-term stability. But true success, he notes, depends equally on interdisciplinary collaboration—sometimes requiring orthodontic repositioning or periodontal modification before an implant is ever placed. Dr. Esquivel and Dr. Seibert next tackle the aesthetic challenge of adjacent implants and the pursuit of symmetry. Perfect papillae between centrals are notoriously difficult to maintain, and Dr. Esquivel discusses techniques—from soft-tissue grafting to orthodontic extrusion—to preserve harmony between the pink and the white. He stresses that treatment planning is as much about patient selection and expectation management as it is about surgical technique: "The hardest part isn't the implant—it's finding a patient willing to go through the process." The discussion deepens into the critical role of soft tissue in achieving lasting aesthetics. Dr. Esquivel explains his distinction between margin-preservation therapies (maintaining existing tissue contours) and margin-re-establishment therapies (rebuilding lost dimensions). He makes a compelling case that most anterior implants benefit from connective-tissue grafting, since thicker tissue phenotypes promote margin stability, mask restorative materials, and protect against recession. From there, the episode explores ridge dimensional changes after extraction—why bone and soft-tissue collapse are inevitable without intervention, and how provisional restorations can slow this process. Dr. Esquivel cautions against relying on removable flippers, which may accelerate resorption, and instead advocates for properly designed Essix retainers or fixed provisionals that maintain space without transmitting occlusal pressure. His guiding principle: space, volume, and time—allowing tissue to heal in an environment that supports both biological integrity and aesthetic form. The conversation culminates with an in-depth reflection on the biological and prosthetic purpose of provisionalization. Drawing on insights from Dr. Todd Schoenbaum, Dr. Esquivel reframes the provisional phase not as optional, but as biologically mandatory. The provisional guides tissue healing, allows for gradual adaptation, and provides essential information for the ceramist—ensuring that the final crown replicates the ideal emergence contours established chairside. As Dr. Esquivel puts it, "Dentists should take credit not for the white, but for the pink—the transition zone we've designed and stabilized." By the end of this episode, listeners will gain a detailed understanding of: How to apply Dr. Esquivel's space–volume–time model to aesthetic implant planning The biologic reasoning behind connective-tissue grafting and margin-preservation therapies Why provisionalization is central to both soft-tissue stability and prosthetic accuracy How to communicate healing timelines and realistic expectations to patients Part one of this series is both technically rigorous and refreshingly human—an exploration of how aesthetic implant success lies not in speed or convenience, but in respecting biology, sequencing, and time.
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    30 min
  • Why Implants Aren't Always the Answer: Biologic Respect and Restorative Restraint with Dr. David Attia

    Why Implants Aren't Always the Answer: Biologic Respect and Restorative Restraint with Dr. David Attia
    Oct 29 2025

    Injection Molding PDF

    Email me: Dr.melissaseibert@gmail.com

    Join Elevated GP: www.theelevatedgp.com

    Follow @dental_digest_podcast Instagram

    Follow @dr.melissa_seibert on Instagram

    Episode Summary

    In this powerful continuation of their two-part conversation, Dr. Melissa Seibert and Dr. David Attia dive beyond digital workflows to confront the deeper philosophical questions shaping modern implant dentistry. Building on last week's discussion of data stacking, SmileCloud integration, and biologically driven design, this episode explores the nuanced realities of aesthetic-zone decision-making, ethical treatment planning, and the human side of high-level clinical care.

    Dr. Attia opens with an unflinching look at when—and why—implants may not be the ideal solution. Using examples from his collaboration with renowned prosthodontist Dr. Tony Rotondo, he explains why lateral incisors often perform better with resin-bonded fixed partial dentures (FDPs) rather than implants, especially in cases with limited mesiodistal space or compromised interproximal bone. He and Dr. Seibert examine the synergy between partial extraction therapy and resin-bonded FDPs, illustrating how biologic preservation can achieve long-term aesthetic stability with less surgical intervention.

    From there, the conversation transitions to Attia's mastery of provisionalization strategies in the aesthetic zone. He details how he designs custom healing abutments and Maryland-style bridges that provide patients with fixed provisionals—even when primary stability is limited. Listeners gain an inside look at his precision-driven process for contouring the subcritical zone, controlling soft-tissue architecture, and creating minimal yet functional clearance between the pontic and abutment. His philosophy is simple but profound: every anterior patient should leave the chair with something fixed—even if it isn't load-bearing.

    The discussion then widens to tackle the moral tension between commercial dentistry and biologic integrity. Dr. Seibert asks the hard question: How do clinicians reconcile high-quality, time-intensive dentistry with the economic pressures of high-volume practice? Dr. Attia's answer is unequivocal—ethical dentistry may take longer and require greater effort, but the money follows the mastery. He critiques the growing trend of overtreatment in both restorative and surgical spheres, warning of a coming wave of revision cases born from expedience and over-commercialization.

    Attia advocates for a "longevity-first" mindset—prioritizing preservation over replacement, patient education over production, and sustainable outcomes over speed. Drawing from his own follow-ups across fourteen practices, he reflects on the humility and evolution that come with long-term case review: what he did six months ago wasn't wrong—but it can always be better.

    The episode concludes with a candid meditation on values alignment in practice. Both clinicians emphasize the importance of knowing one's philosophy, communicating it transparently, and being comfortable acknowledging that "you're not everyone's dentist." Attia urges younger practitioners to resist the social-media allure of aggressive full-arch cases, reminding them that truly exceptional dentistry begins with sound biologic principles, refined communication, and disciplined restraint.

    Listeners will leave this episode with:

    • A framework for choosing between implants and resin-bonded FDPs in the aesthetic zone

    • Strategies for designing custom provisionals that maintain soft-tissue integrity

    • Guidance on educating patients about biologic and financial "costs" of treatment

    • Insight into navigating the ethical crossroads of modern dentistry

    This conversation is both technical and deeply human—a masterclass on how to balance innovation with integrity and how to practice dentistry that endures not just biologically, but ethically.
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    34 min
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