Fig.3 is design of implant (7x17 mm, slightly apical to the apices of the tooth (pink)) placement based on the previous X-ray.  Retrospectively, a new PA or preferably CT should have been taken.  Gingiva may have recessed in 4-5 years, particularly with periodontal patients.  Soft tissue landmark may be not reliable.

Warning Sign for Paresthesia

Xin Wei, DDS, PhD, MS 1st edition 11/22/2014, last revision 03/28/2015