A 4.5x17 mm implant (Fig.7) is not stable. It is removed. Osteotomy is deepened. The implant is placed deeper (Fig.8) with higher insertion torque (50 Ncm). A 3.5x9 mm abutment is used, as compared to 3.5x5 mm in Fig.7. The reason to place the 4.5x17 mm implant deeper instead of placing a 4.5x20 mm one is to reduce the chance of implant thread exposure mesially in spite of the fact that bone graft is placed (*).
Xin Wei, DDS, PhD, MS 1st edition 11/17/2015, last revision 01/19/2018