The trajectory of initial osteotomy (2 mm) is acceptable (Fig.5), but the presence of the apex of the root is ignored (Fig.5 *) until a 4.5x15 mm implant is placed (Fig.6, 50 Ncm).

Primary stability is achieved because of under prep (3.2x15 mm and 3.8x13 mm drills).  The implant is later placed a little deeper.

Since there is no apparent periapical radiolucency, the radicular apex is not intended to be removed.

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Xin Wei, DDS, PhD, MS 1st edition 02/02/2016, last revision 09/22/2018