Osteotomy is enlarged by 2.5 and 3 mm reamers at 12 mm, followed by 4.5 and 5 mm taps at ~ 11 mm.  At this time, the mesial wall of the osteotomy has started breaking down (Fig.3 M).   Retrospectively, the osteotomy should be started distolingually or the implant should be smaller or placed deeper to prevent periimplantitis.

Moderate Diameter Implant Last Next Xin Wei, DDS, PhD, MS 1st edition 08/23/2015, last revision 08/25/2019