After extraction without drilling, a 4x11 mm dummy implant is placed as a tap drill with satisfactory stability (Fig.5).  To get subcrestal placement, a shorter (4x9 mm) implant is inserted with insertion torque of >35 Ncm (Fig.6).  In retrospect, a larger implant (4.5 mm) would be better in term of primary stability.  After allograft placement into the buccal and lingual gaps, a 4.5x4(4) mm abutment is placed for an immediate provisional.

The sinus floor is penetrated by the implants without bone graft for sinus lift.

No Drill Osteotomy

Xin Wei, DDS, PhD, MS 1st edition 11/26/2016, last revision 01/19/2018