It should be safe and necessary to place a 3x20 mm 1-piece implant with 15° angulation.   Insertion torque is between 40 and 45 Ncm.

Intraop PA shows that the nasal floor is apparently perforated (Fig.3).   In fact the transverse cortical plate is the horizontal plate of the palatine bone.

There is no gingival recesssion (data not shown) or bone loss around the implant 1 year post cementation (1 year 9 months postop; Fig.14). 

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Xin Wei, DDS, PhD, MS 1st edition 03/27/2015, last revision 02/03/2019