After Magic Drills (3.3 and 4.3 mm at #19 and 18, respectively), 4x11 and 5x9 mm IBS implants are placed with insertion torque >35 Ncm with immediate placement of pair abutments (4.5x5.7(2) and 6.5x4(2) mm, Fig.2).  In fact these sites are converted to a premolar and a 1st molar (because narrow ridge at #19).  Following GBR and suturing, periodontal dressing is applied around the abutments for increased retention.  The regional ridge reduction makes Marking Bur unnecessary (because of flat ridge top and the soft bone in this case) and more importantly there is no thread exposure upon implant placement.  The trimmed site (concavity) is favorable for bone graft and membrane placement. 

One month postop, loose perio dressing is removed and replaced by a splinted nonfunctional provisional.  The implant sites look normal nearly 3 months posotp; there is no bone loss (Fig.3).  Impression is taken, although the abutment at #18 is incompletely seated.

Ridge Reduction Last Next CT Post Cementation Coronal Section

Xin Wei, DDS, PhD, MS 1st edition 01/26/2017, last revision 09/17/2020