After sequential osteotomy, a 4x16 mm implant is initially unable to be seated low enough for the buccal crest.  Following packing the osteotomy with Vanilla Graft (.5-1 mm) and additional 2-3 mm depth of osteotomy with 3 mm reamer, the implant is placed slightly apical to the buccal crest (Fig.4,5, ~35 Ncm); with placement of Vanilla Graft (*) and a 4.5x4(4) mm abutment, an immediate provisional is fabricated to close the socket.  In fact the long implant has not penetrated the sinus floor (Fig.8 (from panoramic X-ray)).

Why Placed Deep

Xin Wei, DDS, PhD, MS 1st edition 10/17/2017, last revision 02/16/2018