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图四：术后一周，伤口开始愈合。黑线代表图五CT切面。
图四'和图四''分别是拔牙后一周，一个月镜影相。一个月后伤口愈合很好，拍照后我们就开始植牙了。由于伤口刚刚愈合，单纯用尖的骨凿插入开始 bone expansion，完全可以不使用刀片做切口。但是这个病例复杂，还是用#15刀片开始bone expansion，然后使用bone scalpels (a series of thin osteotomes to expand bone buccopalatally, pushing the septum bone into the healing buccal and palatal sockets) 4, 5, and 6 (left and right) mm, bone blades 4, 5.5, 7.5, and 10 mm, round tapered osteotomes 2, 3, 4, and 5 mm, 4.5, 5.0, and 6.0 mm taps (a type of instruments to make threads of implant bed. All of instruments used above at depth of approximately 11 mm). Using taps helps the user feel the torque (whether the prospective implant will have primary stability or not). Last, use an adjustable torque racket (wrench) to place 6x11 mm tapered implant (tatumsurgical.com). Prior to surgery, as large as 8x11 mm implant is planned. During the surgery, it was found that the mesiodistal dimension limits the diameter of the implant to be placed at the site of the tooth #3. It is planned in my mind that an implant will be placed at the site of #2 at later stage.
Xin Wei, DDS, PhD, MS 1st edition 02/24/2013, last revision 04/28/2018