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  • Question, what does implant planning and presentation look like in your office? Do you charge for the CBCT? How do you present the implant as the best option for patients?

    Nolan, Jedediah and 2 others
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    • We don’t charge at our office for the CBCT. I see it as a tool I need and it costs me nothing more to take a scan. But then again we do a 3D scan on all our new patients.

      We always give 3 options:

      Good: removable partial.

      Better: Fixed Bridge

      Best: Implant

      We have models of all three and put them in front of the patient.

      We tell them advantages…

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      • I love the idea of not charging for CBCT. Its a great lead generator for your implant cases.

        However, not being a practice owner, we usually end up charging for it (because that’s how the practice does it) Some people argue that due to the liability of the CBCT, some fee should be charged. Others say that a serious patient will be willing to…

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      • When I started my implant journey, I primarily placed implants at the bone level. It was straightforward, and at the time, I thought it was the best approach for most cases. As I’ve grown in my understanding and experience, I’ve transitioned to placing implants subcrestally in many cases—and the benefits have been significant.

        Placing…

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        Nolan, Jedediah and Ivan
        1 Comment
        • Thank you for the thoughtful tip Apolinar! Have you encountered any challenges or any negative effects of placing subcrestally? Has it been any more difficult restoratively? Beautiful crowns by the way!

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        • Tough tough overall case. Patient is a 15yo female with aggressive perio. Cases like this take careful planning and consideration because youre trying to plan for the next 60+ years.

          I’m partnering with a prosthodontist for this case and we have a tentative tx plan but I’d love to hear outside opinions!

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          Nolan, 87madrigal and 4 others
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          • I simply refuse to believe they are 15 🙁 that’s so sad!

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          • That is so tough! Definitely not your run-of-the-mill case! I would love for you to share some of the options we should be considering here.

            Specifically your thoughts on implants in a person so young!

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          • Reply to #10 implant site

            You’re on the right track with your planning. Prioritizing at least 1.5mm of buccal bone is crucial, and having over 2mm in the incisal 4mm is definitely a positive. As for the thinner palatal bone, you’re right that the thicker palatal tissue and improved blood supply can compensate to some extent.

            However, when palatal bone starts getting…

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            Jedediah and Ivan
          • Reply to #10 implant site

            You are totally right that palatal bone is less likely to get resorption or peri-implantitis and that most problems occur on the buccal. However, as a periodontist I often get cases sent to me where they went too palatal and now there’s no palatal support for the implant. 1.5-2mm buccal and palatal is a recipe for success in my book.

            drcajee and Jedediah
          • #10 implant site

            #10 is planned for a 3.2x10mm implant. The socket was grafted about 4 months prior to the CBCT. I skewed it more towards the palate to ensure the 1.5mm buccal bone (which I believe is more important to have that thickness on buccal rather than the palate). I do have 2+mm buccal bone in the incisal 4mm of the implant. My concern still is…

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            Jedediah and Ivan
          • Hey Guys. I have an immediate implant for site #7 with a signif PARL, prob cystic. pt has no significant reported med hx. As this case approaches im asking myself weather physical debridments and pre/post op abx are enough to prevent infection/early failure. Thankfully in general after 8 years of placing implants ive only had a few of…

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            Jedediah, jostanger and Ivan
            5 Comments
            • Because CHX can inhibit fibroblasts and osteoblasts I’m always wary of using it in these cases. I go the systemic abx route.

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            • I find peridex to be highly effective in infected extraction sites and use it regularly with great success of many immediate implants. I don’t find the negative effects to be clinically significant b/c the site to continually bleeding. I don’t use it for healing post op and many other situations but after extracting infected teeth and those…

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            • 🚀 Motivation Monday 🚀

              ⭐️ What is a routine, ritual, or habit that has helped you to be your best self lately?

              Jedediah and 87madrigal
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              • I’ll go first. Switching away from coffee to matcha has been a game changer for me. Also running at least 1 mile every day has helped me stay on track in terms of mindset.

                For some reason after turning 35, I had to develop some new routines and rituals to be my best self. Maybe it’s due to parenthood, or maybe I’m gettin old haha 😅 (I’m 37 now)

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              • I have found yoga helps my back to stay loose. I do not do anything else. I feel they have me running around the office so much I get a good cardio workout most days. 😂

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            • Profile photo of Ivan

              Ivan posted an update 6 months ago

              6 months ago (edited)

              Whats up yall. Lets get to know eachother!

              Share what your plans are for this weekend! Big plans, small plans, or even no plans! 👇🏼

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              • I’ll go first, first stopping by the vet to get these guys their shots. They’re only 3 months but soon they’ll be absolutely massive. Got them so they can protect our property from coyotes and mountain lions!🐶

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                • Working on giving my website a facelift. 😬

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