By the time a 4.5x20 mm tap is inserted (Fig.7 T), the mesial gap is visible (*).  When a 6x20 mm implant is placed (Fig.8 I), bone graft is placed buccally (Fig.2, as planned) and mesially (Fig.8 red circles, as compared to Fig.1 (distally)).  The implant has to be as large and long as 6x20 mm to get primary stability (insertion torque 50/60 Ncm).  The apex of the implant is close to the sinus floor (Fig.8 ^) or in fact the nasal floor (Fig.9 N).

There appears bone growth in the mesial gap 3 months postop (Fig.10 *).

Graft around Immediate Implant Last Next

Xin Wei, DDS, PhD, MS 1st edition 01/07/2015, last revision 12/17/2018