Eight months postop, the patient returns for #11 restoration.  She reports no problem at #11, while there is light tenderness with a 2-piece implant (4.5x20 mm) at #6 at night (Fig.10, a portion of panoramic X-ray).  Clinical exam reveals no abnormality at #6.  In fact the 20 mm 1-piece implant is placed in the bone (septum) between the nasal cavity (pink dashed line) and the maxillary sinus (yellow dashed line).  In fact the apparent nasal floor indicated as arrowheads is the horizontal plate of the palatine bone (hard palate)!  Therefore there is no nasal floor perforation in this case.  A long implant is indicated in the upper canine.

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Xin Wei, DDS, PhD, MS 1st edition 12/04/2015, last revision 02/03/2019