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In contrast to the upper arch, the bone density in the lower arch is high. The challenge is bone height. Short implants will be used (6 mm for #31 (Fig.2) and 8 mm for the majority of the others (at premolar and canine sites). If needed, extra implants will be placed at incisor sites (Fig.6,7 (implant can be longer)) and at #29 (Fig.3) . If a site is too small for a 3.8 mm 2-piece implant, a 1-piece one may be placed.
Use a 1.2 mm drill (from 1 piece implant kit) to start osteotomy through a surgical stent, followed by incision. To seat the surgical stent, the 4 ball abutments may have to be removed.
When #31 site is re-studied, the ridge is narrower: a narrow 2-piece (Fig.2') or 1 piece (Fig.2'') implant may be required, pending finding upon incision. Osteotomy is being made along the lingual plate (cortical and cancellous junction). The same is applied to the site of #30.
Xin Wei, DDS, PhD, MS 1st edition 07/03/2016, last revision 07/03/2016