After withdrawing the pilot drill (Fig.2'), a Lindamann bur is used to remove bone (Fig.2'' *) between the initial osteotomy and the apical socket.  Ultimately the new osteotomy (Fig.2''' red line) is changed so that it is palatal to the apical socket and the incisal edge and past through the cingulum (C).  

Since the case is complicated and the operator is more familiar with tissue level implant than bone level one, the former is used.  The osteotomy is palatal so that there will be little or no metal showing in this case.

Buccal Gap Closure

Xin Wei, DDS, PhD, MS 1st edition 05/29/2015, last revision 05/30/2015