Emergency Care: Extractions

Name: Emergency Care: Extractions
Uploaded: 2020-04-07T14:19:05.000Z
Duration: 3 h 36 min 35 s

Extractions Made Easy

In this webinar, the speaker will cover how to simplify the process of extractions using three basic instruments. The presentation will include videos and live demonstrations of tools.

Introduction

Due to limited services during the pandemic, extractions and root canals are becoming more common for general practitioners.

This presentation aims to consolidate an entire course of material into one hour.

A PDF with all the information covered in this presentation will be available on Huey's website.

Speaker and Acknowledgments

The speaker is a "smile engineer" with degrees in engineering and dentistry.

The companies and organizations that helped spread the word about this presentation are acknowledged.

Principles of Extraction

Using a steady force allows creep to build up, releasing hyaluronic acid which results in the breakdown of periodontal ligaments.

Applying a steady load for 3-4 minutes can cause a tooth to give way.

Proper positioning is important for effective extraction.

Use gravity to your advantage by positioning yourself above or below the patient's head depending on which tooth you're extracting.

Armamentarium

Three basic instruments can be used for most extractions:

Elevators

Forceps

Luxators

Different types of elevators are used depending on whether you're doing a simple or surgical extraction.

Forceps come in different shapes and sizes depending on which tooth you're extracting.

Luxators are used for teeth that have been previously treated with endodontics.

Techniques

Simple Extraction Technique

Anesthetize the area around the tooth being extracted.

Loosen the tooth using an elevator until it becomes mobile.

Use forceps to grasp and remove the tooth.

Surgical Extraction Technique

Make an incision in the gingiva to expose the tooth.

Use a bur to remove bone around the tooth.

Loosen the tooth using an elevator until it becomes mobile.

Use forceps to grasp and remove the tooth.

Luxator Technique

Insert a luxator into the periodontal ligament space.

Move the luxator back and forth to loosen the tooth.

Use forceps to grasp and remove the tooth.

Conclusion

The process of extractions can be simplified by using three basic instruments: elevators, forceps, and luxators.

Proper positioning, steady force, and correct technique are important for effective extraction.

Simple, surgical, and luxator techniques were demonstrated for different types of extractions.

Principles of Tooth Extraction

In this section, the speaker discusses three principles of tooth extraction that are important to understand before performing the procedure.

Tooth Loosening and Creep

After initial load is applied to a tooth, it will loosen itself after waiting for 3-4 minutes.

Creep occurs in bone when an increasing deformation is expressed as a function of time when subjected to a constant load.

When a load is applied to the tooth-bone interface, there is an immediate change in conformation. Over time, the bone will start to change shape until it changes shape very steeply at the end.

Bone Movement and Strength

Bone moves when force is applied. It should be thought of as soft dirt that can move with time and climate.

Bone is extremely strong in compression but about 30% weaker in tension and about 65% weaker in shear.

To extract teeth, torsion should be used to create shear loads through rotation motion.

Leverage and Conical Roots

Leverage can be used to create space for teeth extraction.

Almost every one of these teeth has a conical root.

Weed Extraction Techniques

In this section, the speaker explains how to extract weeds and relates it to tooth extraction techniques.

Extracting Weeds

To remove a weed completely, grip it tightly around the neck and pull it out.

The same technique is used for tooth extractions.

Rotate the teeth gently to remove them from the root.

High-Level Extraction Guidelines

This section covers high-level guidelines for tooth extractions.

Managing the Patient

Ensure that there is no pain during the procedure.

Tell patients that they may feel pressure but not pain.

If patients experience pain, ask them to raise their left hand so you can stop and address their concerns.

Calmness is Contagious

Stay calm during extractions as this will help keep patients calm too.

Losing your cool will make patients uncomfortable and lead to a bad experience.

Know Your Anatomy

Use a cone beam CT scan if possible to view teeth in 3D.

Always use a throat screen when extracting teeth with restorations or broken down teeth.

Keep a hemostat nearby in case something falls onto the throat screen or bib.

Using Throat Screens During Extractions

This section covers using throat screens during extractions.

Wetting Gauze for Patients with Gag Reflexes

Wetting gauze with water can help reduce gag reflexes in some patients.

Keeping Hemostats Nearby

Keep hemostats within reach at all times during extractions.

Importance of Tooth Movement

In this section, the speaker emphasizes the importance of creating visible movement in multiple directions before applying pressure to a tooth. This helps prevent complications during extraction.

Key Points:

Visible movement in multiple directions is important before applying pressure to a tooth.

If a tooth breaks without visible movement, it can become fused to the bone and require surgical removal.

Retrieving loose root tips becomes much simpler if the entire tooth was moving before breaking.

Techniques for Tooth Extraction

In this section, the speaker discusses techniques for tooth extraction, including using bite blocks and surgical burs. The speaker also emphasizes the importance of listening to the tooth and taking advantage of the path of least resistance.

Key Points:

Bite blocks are useful for supporting the jaw when removing lower teeth but may not work well for upper teeth.

A 702 bur is a surgical burr that should be used when sectioning a tooth. It's important to go deep enough and start at the neck of the tooth.

Listening to the tooth and taking advantage of its natural movement can make extraction easier.

Finding the path of least resistance and being patient can help prevent complications during extraction.

Final Tips for Tooth Extraction

In this section, the speaker provides final tips for successful tooth extraction, including being careful between restorations, visualizing the tooth when possible, using leverage, and improvising as needed.

Key Points:

Be careful when extracting teeth near restorations to avoid damaging them.

Visualize the entire tooth whenever possible before beginning extraction.

Use leverage to create space around difficult-to-remove teeth.

Improvise as needed during extractions by adapting to the situation and overcoming challenges.

Introduction to Surgical Instruments

In this section, the speaker introduces the idea of improvising and adapting surgical instruments to get the job done. They then break down the surgical kit into three main categories: essentials, elevators, and forceps.

Essentials

Mouth props are essential but adult ones are too big. Use smaller ones with a loop and tie floss around them to prevent aspiration.

Optra gates are great for illuminating the mouth and protecting lips during surgery.

Insert Optra gates by holding it in a figure 8 shape and inserting it under each cheek before walking it around on the upper and lower lip.

Elevators

Elevators use leverage to create space in the mouth.

No further information provided.

Forceps

Hemostats can be used for cutting off small arterioles or as pliers for opening packages or loosening implant components.

Mark one hemostat with red tape to indicate that it is ruined and should only be used for picking up pieces of amalgam or loose particles.

The other hemostat should be straight so that it can clamp down on tissues effectively.

Hue Freidy's New Black Line of Instruments

In this section, the speaker introduces Hue Freidy's new black line of instruments which reduces eyestrain during surgery.

The black mirror reduces eyestrain by reducing reflections from headlights during surgery.

Essential Surgical Instruments

In this section, the speaker discusses the essential surgical instruments that dentists should have in their kit.

Components to Look For

A mirror is a necessary component for any dental surgery.

An explorer is not used often but should be kept in the kit as it may come in handy.

Minnesota Lip Retractor

The Minnesota lip retractor is a must-have instrument created by the University of Minnesota. It can hold back tissue and provide access to the surgical site.

Molt 9 and Molt 9 Black Line

The Molt 9 periosteal elevator is an important tool for elevating soft tissue and separating gingival complex around the neck of the tooth.

The Molt 9 Black Line is an improved version of the original instrument, which has become a favorite among dentists.

Scalpel Handle

There are two types of scalpel handles: round and number five barb Parker handle.

The round scalpel handle looks like a pencil and allows for easy rotation with just a finger motion.

Essential Tools and Elevators

In this section, the speaker discusses essential tools and elevators used in tooth extraction.

15 Blade

The 15 blade is a workhorse tool for simple extractions.

It's important to avoid using technical terms like "blade" around patients as it can increase their blood pressure.

Elevators

301 Straight Elevator

The 301 straight elevator is used to luxate or create movement of the tooth.

The concave side of the instrument should be placed against the tooth that needs to be loosened.

Rotate the elevator towards the tooth you want to loosen.

34 Straight Elevator

The 34 straight elevator is similar to the 301 but slightly bigger.

Both are standard straight elevators that everyone should have in their kit.

Cryers or Flags

Cryers or flags are also called East West's North's house.

They're used for bifurcated roots where one root has been extracted, and another remains intact.

Place it into the extraction socket and rotate it so that its sharp point grabs onto the distal aspect of the root remnant in the mesial hole.

Removing Bone Fragments

In this section, the speaker demonstrates how to remove bone fragments using forceps.

Using Forceps to Remove Bone Fragments

The speaker shows how to remove bone fragments by getting the forceps right below the broken bone and taking a little bit of that bone away.

This technique allows for better access to the tooth and makes it easier to remove it.

Different Types of Forceps

In this section, the speaker explains why there are different types of forceps and their uses.

Ash Forcep vs. Straight Forcep

The speaker shows two types of forceps - ash forcep and straight forcep.

The ash forcep has a larger moment arm than the straight forcep, which gives it a mechanical advantage over the latter.

The ash forcep is designed for lower interiors but can be used for every tooth with a conical shape.

With its long moment arm, the ash forcep allows for more control with less pressure applied on the tooth.

Criers East West's and Flags

In this section, the speaker briefly mentions other dental instruments that are not commonly used.

Criers East West's and Flags

Criers East West's and Flags are other dental instruments that are similar in function to each other.

They are not commonly used but can be helpful when needed.

How Ash Forceps Work

In this section, the speaker demonstrates how to use ash forceps properly.

Using Ash Forceps Properly

To use ash forceps properly, grab them and come into the arch to get a hold of the tooth.

Make sure that the beaks are down as low as possible, close to or even touching the bone.

Apply a little bit of force and rotate in one direction using the mechanical advantage provided by the long moment arm.

With this technique, less pressure is applied on the tooth while still maintaining control.

Types of Forceps

In this section, the speaker discusses two types of forceps used for tooth extraction and their differences.

Ash Forceps

These forceps have a hinge that converts leverage into force to hold onto the tooth.

They provide rotational force and squeezing handles together to keep the tooth in place.

They are effective on single-rooted teeth from premolar to premolar uppers and lowers.

The size of the parrot's jaw determines which type of ash forcep is best suited for use.

Straights

These are designed for maxillary anterior teeth and get on the tooth in the same way as ash forceps.

They only provide rotational force, making them less effective than ash forceps.

They cannot be used effectively on lower teeth because they run into maxillary teeth.

Tooth Extraction Technique

In this section, the speaker explains how to extract a tooth using shear forces and demonstrates it with videos.

Shear Forces

Shear forces create a mechanical advantage between the tooth and bone interface by rotating it along its long axis.

Rotating a tooth keeps buccal bone safe by putting it in compression along its moment of inertia axis.

Tooth Extraction Videos

Two videos demonstrate how to remove a tooth using straights or ash forceps.

The first video shows how to remove a tooth using shear forces with straights.

The second video demonstrates the use of ash forceps, which provide both rotational and squeezing forces to keep the tooth in place while rotating it out.

Fully Guided Implant Case

In this section, the speaker briefly mentions the importance of removing teeth before starting a fully guided implant case.

Tooth Removal for Fully Guided Implant Cases

Removing teeth is important before starting a fully guided implant case.

No further information is provided on this topic.

Tooth Extraction Techniques

In this section, the speaker discusses his tooth extraction techniques and tools. He explains why he doesn't use elevators as a starting point and instead uses ash forceps to rotate teeth out.

Using Ash Forceps for Extraction

The speaker's protocol involves coming in around the tooth with a Moulton, getting on it with ash forceps, grabbing it, and rotating.

The speaker demonstrates a typical ash forcep extraction of a premolar that is broken off at the gum line. He applies apical pressure and rotates the instrument back and forth until the root remnant comes out.

This technique can be used from premolar to premolar straight through the front anterior teeth.

Cow Horns for Bifurcated Teeth

The speaker introduces cow horns (23 cat ones), which are great for bifurcated teeth.

To use cow horns, elevate soft tissue with a Moulton on both sides pushing down to the bone. Then insert cow horns into the furcation and pump up and down until it starts to see.

Calla Curved Apical Pick Elevator

The calla curved apical pick elevator is used for molars that have three roots or when there is an extra curve in one of the roots.

The elevator is inserted into one of the canals, then rotated so that it engages all three roots before being elevated.

Periotomes

Periotomes are used to cut the periodontal ligament and loosen the tooth from the socket.

The speaker demonstrates how to use periotomes by inserting them into the space between the tooth and bone, then rocking them back and forth until the tooth is loose.

Piezo Surgery

Piezo surgery is a technique that uses ultrasonic vibrations to cut bone without damaging soft tissue.

The speaker demonstrates how piezo surgery can be used to remove a broken root tip.

Final Thoughts

The speaker emphasizes that it's important to have a variety of tools and techniques for different situations.

Using the 23S Cow Horns

In this section, the speaker explains how to use the 23S cow horns for tooth extraction. The speaker emphasizes the importance of using a throat screen and being cautious as the tooth can shoot out of the mouth.

Technique for Using 23S Cow Horns

Use a throat screen to prevent the tooth from shooting out of the mouth.

Manipulate the cow horns until you feel like you have a good point.

Squeeze the cow horns together underneath the location of the tooth while giving a little buckle pressure.

Reset and let chips slide in a little bit more before rotating slightly to fit tips between mesial and distal root tips.

Using 88 Millimeter Cannons for Tooth Extraction

In this section, the speaker explains how to use 88 millimeter cannons for upper molar teeth extraction. The speaker compares these cannons to big guns used in World War II.

How to Use 88 Millimeter Cannons

Use 88 millimeter cannons for extracting upper molar teeth.

Seat three prongs around teeth into four ocation space on buccal side and grab palatal root with two prongs on palatal side.

Overview of Tooth Extraction Techniques

In this video, the speaker demonstrates tooth extraction techniques using different forceps. The speaker explains how to use the 88 forceps for upper maxillary posterior teeth and Michael Jordan cow horns for lower first molars. They also discuss the importance of preserving buccal bone during extractions.

Using the 88 Forceps

The single beak goes into the vacuation between mesial and distal buccal roots.

The two prongs are always on the palate.

Predominantly used with a buccal leverage motion.

Extracting Teeth with 88 Forceps

Apply pressure to hold tooth to buckle.

Let hydraulic pressure build up from bleeding.

Potential for removal of radicular bone.

Using Universal Forceps

Use 150 upper universal forcep for upper teeth and 150 lower universal forcep for lower teeth.

Hold both forceps in hand like they're shedding water to differentiate between them.

Note that there were some interruptions due to computer issues, but they did not significantly impact the content of the video.

Tooth Extraction Techniques

In this section, the speaker discusses tooth extraction techniques and tools used in the process.

Universal Forceps

Universal forceps are used for extracting teeth.

There are three types of universal forceps - Ashe forceps, 23 and 88.

The speaker almost never elevates anymore.

Full Mouth Extraction

Elevating is only done during a full mouth extraction for immediate solutions like all on four kind of solution.

Luxate with the elevator starting with a 301 then go to the 34 if necessary just to put a little bit of trauma on the root.

Almost always go straight to the forceps in almost all cases.

Serial Extraction

Serial extraction involves taking out all teeth by popping papilla, using a 301 elevator to create a little bit of motion before using an 88 forcep to extract it.

For premolars, use ash forceps and get hold of the tooth as close to the ground as possible as close to the root as possible to create rotational forces.

Rotate anterior teeth for removal instead of luxating them.

Note that timestamps have been associated with bullet points where available.

Buccal Repositioning and Tooth Extraction

In this section, the speaker demonstrates how to extract a tooth using the buccal repositioning technique. They also provide tips on how to deal with resistant teeth and minimize trauma during extraction.

Extracting Resistant Teeth

Use buccal repositioning to get a better grip on the tooth.

Canines have long roots, so if they are resistant, skip them and come back later.

If a tooth is being very resistant, put some rotational force on it to create a little trauma. Leave it alone for a few minutes before trying again.

After extracting the tooth, use a curette to ensure there is no infection left in the hole.

Using Ash Forceps and Root Tip Pick

Use ash forceps for single-rooted teeth.

The double-ended root tip pick can be used to remove any remnants of tooth left behind after extraction. One end is flat while the other is concave.

Double-Ended Root Tip Pick

In this section, the speaker provides more details about using the double-ended root tip pick instrument.

Using the Double-Ended Root Tip Pick

The double-ended root tip pick has two ends that are curved in opposite directions.

To use it, go down between the bone and root tip where there might be remnants of tooth left behind. Get down beside it and flick or rock it back and forth until it comes out.

Root Tip Pick and Mechanical Advantage of Ash Forceps

In this section, the speaker discusses the use of a root tip pick and the mechanical advantage of ash forceps over run yours.

Root Tip Pick

A hand instrument is used to create a purchase point for the root tip pick to go in and flick out.

The root tip pick is designed to place bone behind the root tip into compression, making it easier to flick out.

When roots are curved, imagine an extension of the curvature of that tooth and flick it towards that curvature.

Mechanical Advantage of Ash Forceps

Ash forceps are designed for removing teeth while run yours are designed for pinching bone.

Run yours can damage their edges when grabbing tooth remnants, making them less effective as a Roger.

Double-action run jurors have a force magnifier but still do not provide the same mechanical advantage as ash forceps.

Advantages of Using Double Action Run Jours

In this section, the speaker explains why double action run jours are better than single action ones.

Advantages of Double Action Run Jours

Double action run jurors have a force magnifier which makes them more effective than single action ones.

Single action run jurors operate like scissors which does not give you the same mechanical advantage as ash forceps.

How to Use Root Tip Pick Effectively

In this section, the speaker explains how to use a root tip pick effectively.

Using Root Tip Pick Effectively

Place bone behind the root tip into compression by rotating on distal before flicking forward.

Flick towards curvature when roots are curved.

Socket Scraping and Bleeding

In this section, the speaker explains the importance of making the socket bleed after tooth extraction. They introduce new curettes with serrations that can scrape the walls of the socket to make it bleed. The speaker also discusses using a bone file to remove sharp edges around the socket.

Serrated Curettes

New curettes have serrations on them that are super helpful in scraping the walls of the socket to make it bleed.

Regular curettes may not be sharp enough to make it weep, so something sharper is needed.

The serrated curette has teeth on it and little serrations similar to a bone file on its flat face, which works really well in scraping that laminator and getting it to bleed.

Bone File

A bone file can be used to take off bone spurs around the edge of a crater created by tooth extraction, which can be irritating to patients.

The new bone files have crosshatch designs on both ends, allowing them to work in both directions (push and pull).

Surgical Extractions

In this section, the speaker defines surgical extractions as situations where other tools are needed to remove root tips or remnants because they require cutting through soft tissue more aggressively.

Tissue Pliers

There are two types of tissue pliers; one is roughly six inches long but smooth while another has teeth for better grip.

Surgical Blades

Surgical blades are used for cutting through soft tissue more aggressively.

The speaker recommends using a #15 blade for most surgical extractions.

Sutures

After a surgical extraction, sutures are needed to close the wound and promote healing.

The speaker recommends using 4-0 chromic gut suture material because it is absorbable and does not need to be removed later.

Dental Handpieces and Burs

In this section, the speaker discusses different types of dental handpieces and burs that can be used in various situations.

Types of Handpieces

There are two types of handpieces: one with sharp points for grabbing soft tissue and one with flat points for not pinching soft tissue.

The smooth handpiece works well when working with cross-linked collagen membranes for grafting because it doesn't perforate the collagen.

The NSK handpiece is a cost-effective solution that can be taken into any electric motor opportunity. It has an angulation that allows it to get into tight spots in the posterior really well.

Types of Burs

The 702 crosscut tapered fissure bur is the workhorse bur. It's perfect for almost everything that needs to be done.

If a wider trough is needed, a couple passes with a 702 bur will make it wider.

After making a cut, use a 301 straight elevator to elevate out the separated mesial buccal cusp mesial-buccal root, distal buccal Road, and powder separately.

Air Embolisms

Standard handpieces like the ones on illustrations shoot water and air out the tip which may create an air embolism.

The NSK handpiece has an air off option at a 45-degree head instead of more like 105-degree head like other standard attachments.

Nose Cone Attachment

For just a few hundred dollars, you can buy this attachment which snaps down right on top of your can be motor and turns it into a surgical solution.

The nose cone attachment has external irrigation, doesn't have any air coming out the tip, and works well with longer drills or shanks.

Importance of Cutting Deep Enough

In this section, the speaker emphasizes the importance of cutting deep enough when performing dental procedures.

Cutting Through the Crown

When cutting through the crown, it is important to cut deep enough to see what is underneath.

Under-preparing a tooth can result in breaking off cusps and leaving the root in the hole.

Using a straight elevator in one of those grooves can cause subsequent lengthening of the groove that has been cut.

Tip for Cutting Upper First Molars

Use fissures on bur as ruler when making peace sign cut.

From free gingival margin to furcation, it's three to four millimeters.

When fissures are at top of fringes coincidental with Phrygian margin, tip is now four millimeters down and should be cutting through furcation.

Tips for Lower First Molars

Use free edge of margin on lowers as well to do exact same thing except you're not gonna cut a peace sign on your lower first molars you're just gonna cut it from buckle lingual right in center of tooth cutting mesial roots away from distal roots.

Always stop short of lingual on lower.

Using Bur 859 by Brassler

Bur 859 by Brassler is used for fine-tuning.

English Piezo Technique for Surgical Extractions

In this section, the speaker discusses the use of a medium needle diamond and a piezo device in surgical extractions.

Using a Medium Needle Diamond

A medium needle diamond is useful for removing remaining root tips.

The tip should be removed from the facial to the lingual while being conscious of the buccal bone.

The cat eye technique can be used to remove two pieces together without applying any forces to the buccal bone.

Piezo Device

A piezo device changes electrical energy into mechanical energy.

The cube is a simple and powerful piezo device that has two settings: water and power.

Different tips can be used for different procedures such as sinuses or ridge augmentations.

When using the vibrating piezo tome, it's important not to go down on the buckle because that bone is typically one millimeter or thinner.

Video Demonstration

In a video demonstration, the speaker uses a piezo device to extract a broken tooth with a root remnant.

After elevating soft tissue with Multan I, he uses his cube on the distal and lingual sides before using his straight elevator and forceps to remove it completely.

English Castro Viejo's Needle Drivers

In this section, the speaker discusses his favorite needle drivers for suturing.

Traditional vs. Castro Viejo's Needle Drivers

Traditional needle drivers are what most people are trained on but can be difficult to use in odd spots.

Castro Viejo's needle drivers have a locking device that allows you to hold them like a pencil and rotate your finger for better purchase when suturing.

Oral Surgery Kit

In this section, the speaker discusses the contents of an oral surgery kit and demonstrates the use of various instruments.

Scissors

The Dean scissors are used for cutting sutures.

Eisah scissors are small and delicate, ideal for cutting collagen or trimming cross-line membranes during grafting.

Oral Surgery Cassette

An oral surgery cassette is used to store all necessary instruments for a specific procedure.

Cassettes are color-coded and labeled according to the procedure they are intended for.

Survey and Contact Information

To receive CE credit, fill out a survey that will be emailed after watching the video.

Contact information is available on their website if further assistance is needed.

English Protocol for Tooth Extraction

In this section, the speaker discusses the protocol for tooth extraction and shares insights on using different instruments.

Using Asch Forceps for Maxillary Teeth

Lay patient at a 30-degree angle from horizontal

Use Asch forceps to extract maxillary teeth

Physics forceps work well under the principles of applying constant force and allowing the tooth to go through creep before it falls out.

Double Action vs Single Action Orange

A single action orange has one pivot point while a double action orange has two connected with a hinge action.

Double action orange provides mechanical advantage over single action orange.

The speaker prefers using Asch forcep, 88, and 23 s instead of physics or double-action oranges.

Cow Horns for Curved Roots

Cow horns are used as separating devices to snap teeth in half when roots are curved towards each other.

The speaker uses cow horns to separate teeth but only after loosening them first.

The protocol is not recommended as an initial strategy.

Laying Flap for Difficult Extractions

Elevate tissue gently to get forcep down initially.

If remaining tooth structure above bone is too soft, surgical protocol is necessary with vision required.

Elevating Teeth with Straight Elevators

Dr. Stanley explains when to use straight elevators to elevate teeth prior to using forceps.

When to Use Straight Elevators

Never use straight elevators on anterior teeth because they are all straight.

For posterior teeth, straight elevators work well in a cereal extraction where you're taking out the whole arch and just want to loosen them.

Straight elevators create motion on both the tooth you're taking out and the tooth beside it, which can become a problem.

Live Surgical Video Streaming

Dr. Stanley talks about live surgical video streaming and how doctors can benefit from it.

Implant Compare Channel

Implant Compare is a live streaming service that streams live surgeries from beginning to end and uncut.

The platform is free for doctors who want to learn more about implant surgery.

Check out Implant Compare for more information.

Q&A and Contact Information

Dr. Stanley answers questions from viewers and provides his contact information for further inquiries.

Questions and Answers

Fill out the survey after watching the video to get a link to the PDF that lists all of the instruments used in the video.

If you have any questions, feel free to reach out via email or through their website.

Contact Information

Email: dr.robert@stanleyinstitute.com

Website: stanleyinstitute.com