Dentistry by Dr Bez Shokouhi

03/12/2025

Vertical Prep: Still a Game Changer? 🦷✨

I admit, I don't do a ton of conventional bridges these days. But when I do? I make sure the prep design counts. In the age of implants, conventional bridges sometimes take a backseat—but they absolutely still have a seat at the table in contemporary dentistry.

This case is a perfect example. Implants weren't an option here due to a mix of medical history, bone availability, and the patient's personal preference. So, we went with a bridge, utilizing the vertical preparation style.

Why vertical?

✅ Preserves more tooth structure where it counts.
✅ Long-term tissue stability.
✅ Forgiving on margin placement.

This technique is a lifesaver when you need predictable outcomes in complex cases. Stay tuned—final result photos are dropping soon! 📸

Who else loves the tissue response with vertical preps? 🙋‍♂️🙋‍♀️

17/11/2025

A classic case of cracked cusp syndrome hidden beneath old amalgam.
Here’s a quick breakdown of the workflow using by .

Initial: Failing amalgams, caries, thin cusps, and confirmed cracked cusp syndrome.

Prep: After amalgam removal, caries was evident. Occlusal reduction with one of my favourite burs, followed by meticulous caries excavation respecting removal end points.

Verification: Caries detector die is mandatory in my opinion!

Sealing: Sandblasted, bonded, and placed IDS/flowable composite.

Refining: Careful final refining of the preparation—I probably spend the most time on this step to ensure perfect margins and path of insertion.

Final: Two Emax A3 MT onlays, stained and glazed. Bonded under glycerine and all margins polished.

Fellow dentists, what's your go-to material for posterior onlays? Let's discuss below. 👇

06/05/2025

Dental social media is full of posts showcasing beautiful upper anterior work. Let's not forget the humble lower incisors also, which not only have an essential role in function, but also can contribute a great deal to smile aesthetics!

This lovely lady really wanted to make her lower incisors look nicer, and who could blame her? The treatment here is nothing fancy - just carefully executed composite restorations using Estelite Asteria.

Happy patient, happy dentist!

Do you have love for lower incisors too?

14/04/2025

I often get asked by my mentees whether or not a tooth that has thin cusps and/or cracklines requires some sort of indirect cuspal coverage restoration such as a crown or an onlay/overlay, even if it is completely asymptomatic.

The answer is not ALWAYS yes, and it depends on various factors, but it is OFTEN yes.

And I believe that I speak for most experienced dentists when I say that the longer you have been working, the lower your threshold for doing indirect crowns/onlays becomes. This is quite simply because you have seen again and again the danger of non-intervention, or inadequate intervention. Teeth crack, teeth break. Sometimes in a salvageable way, sometimes in a catastrophic way.

So yes, I will happily recommend crowns/onlays to patients without hesitation.

The case presented here is, admittedly, very clear-cut. Do not ignore marginal ridge fractures, even if they are not as dramatic as the one shown here. Many a lower molar has been lost to time because of these! 💀

If you enjoyed this post, please share and comment!

03/04/2025

In a recent post I explained how you achieve a sharp knife-edge margin for a vertical preparation zirconia crown.

Quite a lot of people wanted to know which tools I used to achieve this, so here are the wheels that I like to use with photos to show each step!

These lovely wheels are made by Edenta. It goes without saying that the margins will not have any glaze on them after these steps.

Ultra-polished clean zirconia is very soft tissue-friendly with the ability to create hemidesmosomal attachments, so it's well worth achieving that extra shine! ✨

17/03/2025

Got questions about crafting a crisp knife-edge margin for your vertical prep crowns? 🤔

You're not alone! A lot of you have been asking, so I've put together some diagrams to break down the process.

The key is understanding that milling alone won't give you that sharp edge. Instead, we create a 'pseudo-margin' by designing the crown slightly beyond the prep, onto packed PTFE.

Then, we refine it into the perfect knife-edge, as you'll see in the diagrams.

Hope this makes it clearer! 💡

If you like what you see, give it a like 👍, drop a comment 💬, and share it with your colleagues!

06/03/2025

CEREC in Action: A Cracked Cusp Case! 🦷✨

I’ve been using CEREC for most of my indirect restorations for a while now, and while it takes a bit more effort on my part, the process is actually quite fun!

Here’s a case of a 46 with classic cracked cusp syndrome—sharp, short-lasting pain on biting into hard food, but no irreversible pulpitis. The best long-term solution? A strong, indirect full-coverage restoration. With plenty of quality enamel remaining, a bonded lithium disilicate restoration was the natural choice.

Swipe through for the step-by-step process! ➡️

Drop any questions in the comments—I’ll be happy to answer! 👇😊

26/02/2025

Vertipreps, vertical preparation crowns, long bevel margins… whatever you actually call them, these days you see more and more of featheredge margin crowns being shown on social media.

I won’t deny that I’m a fan and have been presenting cases on them on Facebook and Instagram for the past 6 years or so. I personally jumped on the bandwagon years ago and after a fairly steep learning curve, became a believer. These days, for indirect cuspal coverage restorations, my treatment modalities basically fall into either bonded lithium disilicate onlays, or vertical preparation zirconia crowns.

I’d like to present a case here of some fairly extreme vertical preparation crowns being done for a lady in her mid-80s. Please excuse that there is a mix of high quality and intraoral photography.

Please watch to the end – you might be surprised!

If you enjoyed this post please like, comment and share.

29/04/2024

I'm going to call this a "simple" restoration on tooth 12, but the truth, as we all know, is that none of these are simple to do if you want to respect the biology, material science, adhesive principles and last but not least, get them to look half decent.

A combined class 3 and composite veneer restoration.

Estelite Asteria A2B and NE.

Polishing using crosscut tungsten carbide in speed increasing handpiece, yellow Identoflex by and Diacomp spiral polishers.

25/03/2024

🌟 Step-by-Step - Alignment + Injectable Composites 🌟

➡️ SWIPE to see the full case! ➡️

➡️ VISIT my page for even more detail (Link in Bio) ➡️

👉 Invisalign

👉 Tooth Whitening

👉 Injectable Composites

Here's a nice case of alignment, whitening, and bonding done in a super conservative way. I love this modality of treatment and so do patients! 😁

This gentleman was seeking treatment for his obvious dental problems. We went through a course of clear aligners to align the teeth which primarily involved expansion and alignment of the upper arch, followed by some whitening and finally restorations. 💫

He had the option of ceramic restorations but we chose composites due to financial reasons. The treatment was done using the injectable technique. 💉

Myself and the patient are overall very pleased with the result! (With the potential exception of the hair... 😄)

Photos taken using the awesome Intra Diffusers by .hant

If you have any questions please ask away, and if you enjoy the case thank you for liking, commenting and sharing! 🙌

13/03/2024

Step-by-step case of alignment and injectable composites. Hope you enjoy the case!

Here's a nice case of alignment, whitening and bonding done in a super conservative way. I love this modality of treatment and so do patients!

This gentleman was seeking treatment for his obvious dental problems. We went through a course of clear aligners to align the teeth which primarily involved expansion and alignment of the upper arch, followed by some whitening and finally restorations.

He had the option of ceramic restorations but we chose composites due to financial reasons. The treatment was done using the injectable technique.

Myself and the patient are overall very pleased with the result! (With the potential exception of the hair...)

If you have any questions please ask away, and if you enjoy the case thank you for liking, commenting and sharing!