Dr. Wei, for our patient Sergio IACs (Integrated Abutment Crowns - which means interrelated whole) case I wanted to know that :
    Why bone expansion was unable to be done? and 
    What is the Stent for this kind implant, when is the situation to have it for implant in this case?
Thank you !
Regards,
Suniti.......

Bone expansion in narrow ridge is tricky.  In fact it was done at the site of #8 with width of ~ 6 mm (see Fig.5-8), where 4.5 mm implant was placed.  There is not much bone on the either side (buccal or lingual).  It appears that it was placed too buccal.  That is why the buccal plate was perforated.  Ideally there should be at least 1 mm bone on the either side of the implant placed.  In the future, incision will be made before bone expansion.  Osteotomes will be placed right in the middle or slightly toward lingual.  The lingual plate is thicker and tougher.

Stent is made for CT scan and sometimes is used as a surgical guide for any implant systems.  It is not made too often in my office now.  If the ridge is narrow or there are multiple implants in a row, stent will be made.

IACs (Integrated Abutment Crowns - which means that they are interconnected, joined together)

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Xin Wei, DDS, PhD, MS 1st edition 09/10/2013, last revision 09/10/2013