Following insertion of 4 mm tap drill with low stability, a 4.5x16 mm implant is placed with >45 Ncm (Fig.4).  After placement of a 4.5x7(4) mm abutment and of a piece of PRF membrane against the buccal wall of the socket, Vanilla allograft is packed buccodistally (Fig.5 black *).  Post incision, the ridge at #6 and 7 is found to be narrow for implant placement; after bone graft (white *) and PRF membranes buccopalatally, the wound is closed.  If the mesial crest does not resorb, the abutment cuff should be changed to 5 mm or a mill abutment (4.5x2 mm) is to be used.  Some of the bone graft remains distal to the coronal portion of the implant 5 months postop (Fig.13).

Larger Implant for Primary Stability

Xin Wei, DDS, PhD, MS 1st edition 08/24/2017, last revision 05/28/2018