After extraction of the tooth #25, there seems to be more bone vertically at the site of #24 than that of #25.  Therefore the osteotomy is initiated at #24.  The edentulous space is 9 mm mesiodistally, whereas the incisor width is 6 mm.  The first pilot drill is fractured (1.2 mm).  The latter is retrieved with incision.  With better visibility, the initial osteotomy is found buccal.  When a 3x14(2) mm dummy 1-piece implant is being placed partially, the buccal plate seems to be thin.  A 2.5x14(4) mm 1-piece implant is placed instead with stability (Fig.2). 

The depth of the osteotomy at #22 is 2-3 mm more than the expected implant length (Fig.2 with 2.7 mm drill in place).

The 3.8x18 mm implant is placed at #22 (with insertion torque more than 50 Ncm, Fig.4).  Allograft with Osteogen is placed around the implants (*) in addition to Osteogen plug (cut in a thin layer) placed against the buccal wall of the socket at #22 (potential leakage).  The abutment at #22 is 5.5x5(3) mm.

The implants seem to be ready for impression 4 months postop (Fig.8).

Depth Control

Xin Wei, DDS, PhD, MS 1st edition 05/09/2017, last revision 09/20/2017