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Placement of a cemented abutment appears to turn the implant as well. The abutment is removed and a healing screw is placed (Fig.3). The access is closed with Collagen plug. There seems to be sinus discharge into the pharynx postop with tenderness on the nasal bridge. The patient is scheduled to return 15 days postop to have the implant removed. The patient returns 23 days postop. After incision, a latch driver has to be used to remove the mobile implant due to limitation of the space and difficulty in holding a hand instrument. There is no sinus perforation. The granulation tissue is removed from the wall of the osteotomy. Metronidazole is used for disinfection. UF taps (6, 6.5 and 7 mm) turn out to be small. Stability is achieved with a 8x11 mm Tatum tapered tap (Fig.4), followed by a 8x11 mm implant with insertion torque of 60 Ncm (Fig.5).
Xin Wei, DDS, PhD, MS 1st edition 07/14/2016, last revision 05/24/2019