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Considering severe bone resorption, a 6.9x10 mm bone-level (Fig.4) or 7x14 mm gingiva-level (Fig.5) implant does not seem to be long enough to achieve primary stability. Probably a 7x17 mm gingiva-level implant is more appropriate, but it carries more risk of nerve injury. Be careful. Take several intraop PAs for depth confirmation. Try shorter osteotomy and implant first and use longer one if necessary.
The pattern of the bone resorption may be related to loss of the buccal plate. It may be necessary to pack bone graft against the remaining buccal plate prior to implant placement. The amount of the graft should be small so that it will not block the osteotomy.
Xin Wei, DDS, PhD, MS 1st edition 01/18/2015, last revision 01/18/2015