To facilitate wound healing, flapless approach is adopted using 1.6 mm pilot drill (Fig.4), followed by 1.4/2.6 mm bone expander.  In fact there is resistance to expansion in the zone 1.  Magic expander (3.0 mm) is also tried with difficulty.  It appears that bone density is higher than expected.  The second portion of Magic Surgical Kit is then used: 3.3 mm Magic Drill for 15 mm (gingival level, followed by Final Drill).  A 4x13 mm IBS implant is seated incompletely.  The osteotomy is further enlarged by 3.8 mm Magic Drill for 11 mm and deepened with 3 mm drill until 18 mm.  Finally the implant is placed at a satisfactory level with insertion torque > 50 Ncm (Fig.5).  A 4.5x4(3) mm abutment is placed and periodontal dressing is applied.  The patient chooses to return for impression 6 months postop (Fig.6).  The abutment changes to a 4x4(4) mm one.

Flapless Last Next

Xin Wei, DDS, PhD, MS 1st edition 09/20/2017, last revision 09/05/2019