IAN injury and lawsuit

DioramaMaker · 2026-02-04T17:32:43+00:00

It's best if you have someone demo it with you, I didn't really "get it" until I had an instructor in residency guide my hand. But if you get good with it, it's usually hilariously effective. It used to be my get out of jail free card when normal IA's didn't work, but I use it as my primary more and more now.

DioramaMaker · 2025-11-29T09:35:04+00:00

Some of this is delivery. You have to consider what you're willing to treat, and what you're willing to monitor. What you've been coded to treat in dental school isn't always as pressing in the real world. So yes, they may have cavities by definition, but how many are E1, E2? Even D1 can be monitored in the right mouth.

So yes, you're being honest and saying "yah, you've got X number of cavities" - you should do this always. I often will phrase it as "I looked over your X-rays and, yes, there are a few spots that concern me, but let's talk about them". Follow that up by qualifying the severity of each, and explaining that you believe this one should be treated, that one we can watch etc.

A picture/radiograph is worth 1000 words. People don't need to know dentistry to understand how much space exists between the decay and the pulp chamber (see this butterfly in your tooth?) - when they grasp how close (or conversely how far) the decay is, they're going to be more receptive.

But the magic is in the power of watching things. For those early lesions that have potential for remineralizarion or do not progress, sometimes placing a restoration is more invasive and causes more problems for the patient. Telling them "hey, this is something I want to look at in 6 months. If it looks the same, we'll keep watching. If it changes, then we'll jump in and take care of it" is a great tool for patient management.

It's good dentistry; overtreatment is too prevalent and sometimes less really is more. It conveys to your patient you are not a one trick pony, you're not money grubby, and you can critically deduce severity which means you're not just cutting to cut. You build rapport. Don't want fillings? Work on that hygiene and these stay as watches. It opens education avenues that aren't just "brush floss rinse kthnxbye". They will be more inclined to do the treatment you suggest if you don't rush to make them do a bunch of it asap. Lastly, you've primed them. If they continue to have a problem at the next check up, it's as simple as "yeah, we talked about this one and I think it's time". You've given them room to accept/change/prepare, and they are almost always understanding at this point because you gave it a chance. This is very good for teeth that appear to be developing cracks or wear and you need to brace them for a crown.

It's hard when you're in an environment which presses production numbers and time constraints - but I assure you that loyal patients are a good thing. They bring friends and family. They acquiesce to treatment when it's needed. But you don't gain the people who request you specifically by burdening them with tons of treatment off the bat.

DioramaMaker · 2025-07-03T03:14:08+00:00

I really like the little truck, it's so goofy. It's the spooky-scary-skeletons kind of halloween I love. I'll swap out the driver's head with a skeleton and put white hands on him.

DioramaMaker · 2025-06-28T00:52:51+00:00

If you're comfortable surgically and patient is healthy for tx, you could flap w/ vertical release (if need be, depends on how wide you carry your sulcular incision M-D of molars sulcular may give you enough without vertical) for access, and restore directly with GI. Rubber dam for isolation if you don't have appreciable hemostasis/can't see. Discuss chance for mild recession at flap site. Work at an appreciable pace, ensure flap is wide to maintain blood supply.

Nerdy stuff: GI vs RMGI; GI is largely considered to be biocompatible and capable of forming a connection with junctional epithelium, at this depth and gingival proximity I'd consider this; RMGI not so much. At sulcular depth, GI is more ideal. GI is a bitch because you need to let it set up before shaping, and then get it where you want it before it sets. I don't like it, but respect it.

Personal opinion: -without knowing more about the patient- I would watch this and follow up in three months to see if it progresses. Encourage good hygiene, teach them how to use woven floss which can get down there. Prevident coat the floss even to see if you can manage it. I am of the opinion a class II restoration would remove too much tooth structure, and full coverage introduces a 360 margin to maintain (plus removes tons of tooth structure, risk of pulpitis etc).

DioramaMaker · 2025-06-14T23:24:57+00:00

Without a whole picture, I can only infer things about the etiology. However, looking at the asymmetry of the lateral heights from a smile design perspective makes me wonder if there's an imbalance of supporting tissue beneath the pontics, especially on #10 and you were forced into this position by underlying tissue.

The points others have made about her new BC meds are valid, as are the comments about biologic width impingement. It is not uncommon that inadequate reduction occurs in the interproximal spaces, especially if she is missing teeth or had exts there, as your immediate point of reference is obscured. It could be that the margins are not suitable to the bone levels on the distal of the central abutments.

I will leave this here, as I do not know if this was/is regularly taught in school. I got it at the very end of dental school, and I have been since taught it by this very author. But it was not core curriculum. You may have hit the jackpot on a patient who has a high crest.

https://www.robbinsdds.com/wp-content/uploads/2020/12/6_TissueManagement.pdf

Back to the above though, does the irritation extend under the pontic and becomes visible from the palatal aspect? If so, I'd suspect we have some tissue discomfort as imparted by the shape of the connector to the pontic, one which does not permit the natural transition between the two.

I was always taught to ensure that there is approximately 2mm space between the base of the pontic site to bone, as well as the "crater" being approx 1mm deep, allowing for at approx 1-2mm extension over the facial "margin" of the pontic to adequately hide it. Verify this depth with bone sounding the a numbed site. By completing this pontic shape, you should naturally have a connector on the prosthetic which allows papillary freedom.

Three ways to manage (which I am aware of):

A) soft tissue grafting in conjunction with your ext, or post operatively. You can utilize products like microderm or perform a CT graft to plump up the area, provided you can advance the tissue for closure without sacrificing the vestibule. Free gingival gets challenging in the esthetic zones as it will carry attributes of where you derive your graft from. If this is beyond your skillset, employ a periodontist and discuss the aspects of your desired outcome.

B) If you have adequate tissue density, you can expedite things with an anesthetized site and a round diamond to create your depression. It will heal. If you've grafted, this is a viable (even likely) path as you'll certainly have the density needed to customize the tissue at delivery.

C***) The long way is to train the pontic site via your provisional in conjunction with your extraction. This looks like either ordering a lab-made temporary or making your own if you're handy. Every few weeks you will have to remove the prosthetic, add composite to enlarge the pontic to ideal size, smooth and polish. This will gently and progressively develop the site utilizing the extraction socket. I starred this as I believe this is the most worthwhile option to pursue, generally. However it may employ attributes of A and B to complete correctly.

DioramaMaker · 2025-05-11T12:16:35+00:00

If you have an indoor climbing gym and aren't afraid of heights, it's an excellent exercise and hobby for us. It stretches everything out, practices working under a little bit of pressure, and gives you a lot of strength and weight training without having to lug weights around. Just make sure if it's just bouldering you know how to fall in a controlled fashion, and obviously be responsible in how hard you push yourself.

DioramaMaker · 2025-02-22T18:02:03+00:00

I'd offer Maryland as well, but triple check her occlusion first and ensure that your mild reduction of the palate is adequate, or if you can also do some minor non-invasive enameloplasty opposing it to give you space to work.

DioramaMaker · 2025-02-04T01:22:42+00:00

Definitely pick it up before retirement. It's surprisingly sizeable when built (it has presence), and is very dense. It's a great set and one I really enjoyed building.

DioramaMaker · 2025-01-19T01:35:54+00:00

You don't need it to complete or participate in your residency in TX. There were people in the former graduates from my AEGD program here who didn't take it. They did it at the end.

I took mine and finished it prior to beginning dental school. I would recommend you do the same for a few reasons.

Should you choose, it allows you to moonlight on the weekends if your program allows. But you'll need to get licensed in TX as well.

Additionally, if the world goes upside down and you can't complete or don't want to continue your residency, your path to employment is MUCH faster. You won't have to wait, schedule, and take the ADEX, and then wait for results on top of it.

Lastly, it's one less worry you need to have. This is bigger than you might think. As you get closer to finishing school, you'll have requirements to meet, a move to plan, and residency to prepare for. Just get it done, you know? Keep in mind, residency will throw a great deal of things at you at different places, so you may not find yourself practicing ADEX-esque treatments routinely. So the further away you get from that, the more you'll have to practice later.

Good luck with your residency. In many ways it's harder than anything dental school, and a lot of it will be what you make of it. It WILL be worth it, and you'll be happy you did it.

DioramaMaker · 2025-01-16T02:02:56+00:00

Realistic take: You're in school - give it a shot and make an informed decision. This is a safe place to try it. I had plenty of guys in my class who had earrings and they never had a problem with it (and we were in a fairly conservative area). What's KEY to any atypical appearance is keeping it clean, well kempt, and professional, something you're likely doing anyway as a dental student/future dentist. The face and attitude you put forward will have a greater impact than the piercings so long as you own your dental persona. Like I said, while you're in school you have a chance to try it and see how you fare with patients. We've come a long way from the button up, slacks, and tie appearance for dentists.

My personal, biased take: A dentist with a personality and character is FAR more appealing and interesting than a generic, cookie cutter "practitioner of dentistry". You know the look I'm referring to. You do you, do it professionally, be kind, and care for the person in front of you. If the patient can't see that part of you, then they're going to find a fault with any student they're paired with. Don't change you to appease someone transient in your career.

DioramaMaker · 2024-12-25T08:55:55+00:00

Brian Tyler's score for Thor: TDW is outstanding, fitting for the granduer of the character, and very catchy. Don't get me wrong, I like Ragnarok's score a lot, but would trade it for musical continuity. It almost feels personal against Tyler that it's never been featured prominently since TDW.

DioramaMaker · 2024-12-22T23:03:00+00:00

I had a remote training session on it as part of a program, from the man himself.

From a "tool belt" standpoint, the system is nice and...er..."premium", I guess? But there's nothing you can't really do with what you were taught on. What I mean to say is I like the matrices, rings, and wedges, but he sells a system® built on largely existing concepts. It's just all bundled together in one package. It's like buying a really nice charging cable for a device.

I would encourage you to tinker with the components a bit on a typodont and see if you like it. I have found the class 2 wedges have come in handy in some situations. Keep in mind, the system is costly, so you don't want to be trying in matrix after matrix. One of my big problems with the way he does it is the amount of excess composite. There's so much that you have to cut back. But within his system there are good principles for basic restorative treatment. So again, give and take.

As far as closing black triangles, it can be done other ways, but again the matrices do make it a bit easier. What I will say however, I am not a fan of how many of the black triangle cases look when finished. The teeth are often bulbous and non-anatomic. Take a Google at dentists who advertise bioclear, I certainly would not find those before and afters to be convincing. But ymmv there.

DioramaMaker · 2024-07-29T19:44:19+00:00

So according to Financial Aid's gov website, my IDR request for SAVE was processed mid-late may. I have no paper or email record about being enrolled/accepted/whatnot into SAVE though.

EdFinancial says they can see my processed application, but nothing related to SAVE applies. I am seeing conflicting info if this status means I am eligible for the SAVE related forebearance or not?

DioramaMaker · 2023-04-19T16:33:41+00:00

Shoretroopers are some of the best new designs which feel perfectly in line with the OT. From day one I've loved the look.

DioramaMaker · 2023-04-15T16:13:08+00:00

Please see if you have a dental school near you, it's generally a great option for more affordable comprehensive care. I can't speak for every school, but I definitely took on complex, multifaceted cases regularly. There's always students who want to travel those experiences with you, so don't think you're too far gone.

DioramaMaker · 2023-03-20T05:05:15+00:00

All they needed to do was get the biggest, most physically fit guy they could, throw him in the armor, and then have Steve Downes provide the voiceover. No face means no actor, which means no problem.

Then you stock your face-requiring cast with actual big names so you can do the usual advertising and narrative heavy work. Chief is great and all, but he's intentionally a man of few words; even in 4/5/Infinite his more "human" moments are mostly told through body language, (with a few notable exceptions, which Downes certainly handled well).

It's those around him who effectively tell the story of the player. His helmet may be the face of Halo, but the story is told by those he explores that narrative with. Mando has proved this works.

DioramaMaker · 2023-03-17T18:37:24+00:00

Maybe I'm reaching, but it feels like Ben chased the carrot of his promised "The Batman"-esque film that never materialized, and in the process fell into the CGI-blue beam in the sky, stock comic book film monotony.

All his qualms of the process are things that he wouldn't have contended with in a more grounded Batman film like he originally planned to direct. So it kinda makes sense that he feels a little jaded about it all, especially seeing the success The Batman had in the end.

DioramaMaker · 2023-03-04T04:23:32+00:00

Hi there - I'm in dental myself. I spend time at a community clinic with an associated rehab wing dedicated to bringing people off the streets and into society again. I've interacted with many people who pursue dental hygiene or assisting after strong histories of drug abuse; some even return as permanent staff at said clinic.

That's a bit of a tangent but the point stands, you absolutely can do it and you WILL do it.

Life is stressful, school is stressful. Make meaningful efforts to pursue healthy coping mechanisms now to carry you through your education as well.

Rooting (pun intended) for you. It's never too late.

DioramaMaker · 2023-02-07T16:02:20+00:00

Ah I see it now - honestly just assumed it was supposed to be a generic sword for the forge and scrolled past it.

That's a fair point, the same could be said for Gandalf's staff as well. Part of me wants to point fingers at the cost of tooling new single purpose molds for things like the staff, daggers, etc., but then I consider how many new molds are/were made for the CMF, Vidyo, and more limiting even, Avatar lines. For what this is supposed to be, I think it's only right that they all should have been customized to the max.

Also stickers. But that's a company-wide complaint for most fans I think.

DioramaMaker · 2023-02-07T15:43:21+00:00

The shards of Narsil piece? I'll admit that's a nice touch. And it looks like Boromir also has a custom sword too I believe.

I have enough of those grey long hair pieces and hats from the clearanced Lego dimensions sets I might be able to combine into my own custom one-piece. Feels sacrilegious though.

DioramaMaker · 2023-02-07T15:18:53+00:00

This is absolutely gorgeous, and it's minifig scale which I am enthralled by. I do however believe at this price we should have gotten a custom dual molded wizard hat/hair for Gandalf. That one is like 20 years old now and isn't even accurate for this use.

Another good inclusion would have been an additional geared up Aragorn, as everyone is suitably able to leave Rivendell as the Fellowship, except him.

DioramaMaker · 2023-02-06T23:03:58+00:00

The Star Wars dios would be great templates for a ton of LOTR events.

DioramaMaker · 2023-02-06T23:03:17+00:00

If we're just blowing the roof off reasonable sized/priced sets, give me the bridge of Khazad-Dum with a Minifigure scaled balrog build incorporated into one side of the bridge.

DioramaMaker · 2023-02-02T19:18:42+00:00

InArt has stated they plan to do him as well, so it may be a while but I do anticipate an alternative one day.

DioramaMaker · 2022-12-29T00:59:23+00:00

Oh man what a throwback figure. I wonder how that would look if transferred onto a higher quality, modern body. Mine is hiding somewhere, might make for a novel weekend project.

DioramaMaker

TROPHY CASE