The Perfect Sinus Lift - or at least my perception of it !! Praia do Cabeço, Algarve — August 14, 2026 Sometimes, after many years of surgery, there are procedures that remind us why we still enjoy operating. Yesterday, I performed what I would probably describe as the perfect lateral window sinus lift. Not because it was particularly complex. Not because I used a new instrument or a sophisticated technique. Quite the opposite. It was memorable because the anatomy, visibility

It has been a while since I last wrote something for the blog. The truth is that life at the clinic has been moving at an incredible pace. These past two months have been intense in every possible way — a lot of work, many challenges and, above all, an enormous learning process. But I finally feel that we are settling into a good rhythm. There is some light at the end of the tunnel. Yesterday, we treated one of those cases that reminds us exactly why Implant Dentistry remains

The First Day of Summer The Last Teeth Standing: Preserving Architecture in the Transition from Natural Teeth to Implants Today is the first day of summer. The sun is shining, the sky is clear, and somehow the day already feels different. I started the morning with 10 kilometers on the treadmill, trying to simulate what the mountain will demand from me in fifteen days. A treadmill is obviously not a mountain, but preparation always begins long before the climb itself. And the

Last Friday evening, driving home after another intense week, I found myself reflecting on something that surprised me. We had treated cases that, honestly, I believe are difficult to see anywhere else in the world. Challenging situations, complex reconstructions, unexpected problems. The kind of cases that demand not only knowledge, but courage. And somehow, together, we solved them like lions. Yet, as I drove home, I realized something strange. I wasn’t particularly proud o

There are days in implant dentistry when everything goes according to plan. And then there are days when biology reminds us who is really in charge. Today was one of those days. The case seemed straightforward. A patient presented for the placement of two implants in the mandibular first molar area. Because of the available mesio-distal space, the restorative plan was to replace the missing molar with two premolar-sized crowns rather than creating an oversized restoration. Pr

This chapter presents a practical, anatomy-driven approach to immediate implant placement according to tooth position. Implant selection is based not on the tooth itself, but on available bone, socket morphology, source of primary stability, prosthetic requirements, and long-term maintenance. The key principle is simple: preserve anatomy, maximize stability, and place the implant where the final restoration will function and be maintained predictably over time.

Quando Dois Primeiros Molares Não Têm Nada em Comum Hoje foi um daqueles dias que nos lembram porque a medicina nunca pode ser reduzida a protocolos. Curiosamente, tive dois casos praticamente iguais. Ou pelo menos pareciam iguais. Dois primeiros molares superiores. Dois dentes condenados. Duas extrações seguidas de colocação imediata de implantes. O mesmo conceito terapêutico. A mesma equipa. Os mesmos materiais. Mas, na realidade, eram casos completamente diferentes. O prim

29 de Maio de 2026 São quase duas da manhã e vou buscar a Sofia ao baile de finalistas do 9.º ano. Enquanto conduzo, dou por mim a pensar que este pode ter sido um dos melhores meses profissionais da minha vida. Não porque tenha faturado mais. Não porque tenha ganho mais dinheiro. Mas porque tive a oportunidade de viver experiências que me fizeram crescer, aprender e sentir que estou exatamente onde devo estar. Maio foi um mês de construção. Um mês de pessoas. Um mês de tecno

Basel is now behind me, but Lisbon welcomed me back with that almost cinematic May atmosphere: rain falling endlessly, traffic frozen on Avenida da República, dark skies, and the strange feeling that winter never really left. Somehow, that gloomy setting perfectly matched one of the most impressive clinical cases I have seen in recent years. About two months ago, Jenny, from Madeira, sent me a CBCT scan of a patient carrying six mandibular implants that had been placed more t

Yesterday we had one of those cases that reminds us why implant dentistry continues to be such a challenging and fascinating field. A patient referred from England arrived at the clinic with a complete prosthetic collapse in the first quadrant. She had an upper bridge supported by a canine and a first molar, but both abutments eventually failed, the bridge fractured at the pontic, and suddenly she was left with virtually no support between the canine and the molar. The initia

Last night I came back from Switzerland. We had a Key Opinion Leader Summit and, honestly, it was one of those moments that reminds me why these trips still matter. Beyond the lectures and the technology, it was another opportunity to reconnect with people — including Portuguese colleagues who, despite being geographically close, sometimes only truly connect when we meet abroad. I took the opportunity once again to go for an early run along the Rhine River. There is something

Full-arch rehabilitation with Falcon navigation showed impressive real-time control of angulation, depth, and implant positioning, especially in complex anatomy. However, limitations emerged: marker interference, tracking instability, calibration time, and loss of global parallelism. Falcon enhances local precision, but in full-arch cases, it may compromise overall control.

This week we pushed the limits of what is surgically possible. Using a new 4 mm implant, we treated a severely atrophic mandible without grafting, relying on precision, anatomy, and decision-making under pressure. This was not about short implants — it was about control, responsibility, and executing when there is no margin for error.

Success is not just about working hard — it’s about acting despite discomfort. The mind resists uncertainty, but growth happens when you move anyway. Like climbing, you don’t know if you’ll reach the top until you start. You may succeed or fail, but doing nothing guarantees the outcome. The only route that truly fails… is the one you never climb.

This case report describes a delayed prosthetic failure more than 10 years after mandibular full-arch rehabilitation with limited AP spread. Initially stable under low functional load, the system failed following maxillary fixed rehabilitation, increasing occlusal forces. Failure occurred at the prosthetic interface, highlighting the long-term impact of compromised biomechanics.

Two patients. Same symptom: a moving crown. Completely different biology. One ideal immediate implant case with high stability; the other a compromised indication that failed. At two weeks, true implant loss is unlikely. The issue? Mechanical, not biological. In implant dentistry, not everything that moves is lost — but clarity in diagnosis is everything.

“Most upper 1st premolar implant mistakes don’t come from lack of skill — they come from not reading the canine.” Good morning, ChatGPT. Good morning, world. Good morning, Lisbon. Today we’re finally hitting 25°C. Real spring. I just finished an amazing climbing session — one more step toward conquering my 6C+ . Today I fell on a move I had never reached before. It was a nice feeling because a lot of people was watching and i´m baby steps to close the 6 deal and move to the 7

Full-arch rehabilitation begins long before the implant. Ridge reduction, palatal positioning, and tissue control—turning a compromised anatomy into predictable outcomes.

Climbing and dentistry share the same foundation: focus, control, and the pursuit of inner strength. Both demand precision under pressure, where small decisions redefine outcomes. Success is not accidental—it is built through awareness, adaptability, and the ability to constantly shift the equation in your favour, even when conditions are far from ideal.

“We don’t notice the moment we make the wrong decision — only the moment it comes back to teach us.”