Mastering complex anatomy in full-arch implant cases requires both technical skill and the wisdom to know your limitations. Dr. Clark Damon joins The Fixed Podcast to share rare but invaluable techniques for challenging anatomical situations that every implant dentist will eventually encounter.

The conversation centers around two advanced procedures: sinus crushing and pterygoid implant placement. Dr. Damon reveals that despite completing 3,000 arch cases, he's only performed sinus crushes on three patients—a testament to both the rarity of proper indications and the importance of understanding when this approach is truly necessary. He walks through his precise technique, from the diamond burr scoring to the use of collagen tape rather than particulate graft, explaining how this one-surgery approach can transform cases with pneumatized sinuses that would otherwise require multiple procedures.

Perhaps most valuable is Dr. Damon's candid discussion about knowing when to collaborate with specialists. "Too many clinicians are taking on cases they really shouldn't be doing," he observes, emphasizing that revenue pressure often leads to complications that "come home to roost fairly quickly." Instead, he advocates bringing specialists into your office for complex cases—creating learning opportunities while maintaining the patient relationship.

The episode showcases Dr. Damon's pterygoid expertise, having placed over 1,000 implants with a stunning 99.5% success rate. He details precise placement techniques, including his preferred 18mm length and entry point between the second and third molar positions. Using the analogy of aiming between the "field goal posts" of the lateral and medial pterygoid plates, he demystifies this advanced technique that dramatically reduces stress on anterior implants.

Whether you're looking to expand your implant capabilities or simply understand when to call for reinforcements, this episode delivers practical wisdom from one of implant dentistry's most experienced practitioners. The techniques discussed may be advanced, but the philosophy is universal: always prioritize predictable outcomes over pushing clinical boundaries beyond your comfort zone.