Finally a longer IBS implant is placed (4.5x15 mm, Fig.9,10) to achieve primary stability (50 Ncm).  Yellow dashed line: sinus floor; *: bone graft.  When the provisional is removed for impression 3 months 10 days postop, the implant is found to have been placed distopalatally (Fig.13), which should have been avoided.  It is agonizing to re-encounter the off-axial implant 1 year post cementation (Fig.14).  It is also amazing that the abutment screw has not loosened.

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Xin Wei, DDS, PhD, MS 1st edition 11/12/2018, last revision 11/12/2018