Планирование клинического случая 11

An anterior immediate in the aesthetic zone, plus a posterior case that runs right up against the sinus — this is a live single-implant planning session where attendees reason through each decision with faculty guiding every step. The #8 immediate covers the details that make or break an aesthetic-zone case: • When to flap vs. go flapless on an immediate — and why a narrow ridge tips it toward flapping (visualization, avoiding perforation, squeezing the alveolus to deliver the tooth in one piece) • Reading where the apex exits (facial vs. straight down) and staying intentionally palatal • Envelope flap vs. vertical release on a high smile line patient — keeping any vertical in keratinized tissue, or going with a giant envelope flap, to avoid a visible scar • The incisive nerve: when to reflect and visualize it, and the counterintuitive rule if you damage it — you fully transect and clean it out rather than closing up and risking paresthesia or dysesthesia • Socket shielding — leaving a thin shield of tooth to preserve the buccal plate, and when it's worth the extra finesse • Why the 50/50 protocol guides your drill between the buccal and palatal walls on a narrow ridge • The honest patient conversation: "85% of the time I can place same-day, but I'll never compromise 20–30 years of success to save you four months" Then #12 and #13 get into the posterior essentials: • Sizing to a tight buccolingual dimension and countersinking as palatal as possible • The whiteboard breakdown of why you sometimes reach for a wider drill coronally — countersinking the palatal bone so the implant seats in the middle instead of getting pushed buccal (critical on immediates) • Controlled sinus perforation at 50/50 vs. the less-controlled full-speed approach • And the mindset shift: perforating the sinus for cortical stabilization isn't overdoing it — in soft bone it's often your only real stability, and it's a genuine service to your patient The through line: even a case that looks routine on the pano is a stack of small, deliberate decisions. That's what you build by planning real cases with faculty in the room. Bring yours and run them by Dr. Briskie or the CSI faculty anytime. Want to plan cases like this alongside faculty who do them every week? 👉 www.coloradosurgicalinstitute.com 📞 Chris — (970) 410-6148 #DentalImplants #SingleImplant #ImmediateImplant #ImplantDentistry #CasePlanning #SinusLift #SocketShield #Neodent #ImplantSurgery #DentalCE #ColoradoSurgicalInstitute #CBCT