The size of the implants at the sites of #18-20 is shown in Fig.3 in millimeters.  The insertion torque is around 50 Ncm.  Red dashed line: the Inferior Alveolar Canal and Mental Foramen (loop).

It appears that there is mild bone loss, particularly mesial to the implant at #18, 4 months postop (Fig.5,6 *).   The patient is a smoker.  In fact, the implants should have been placed deeper.  Underprep should have been avoided, particularly at #18.  Oral hygiene should be emphasized.

Five months post cementation, the patient returns because of loose abutment screw at #18.  Bone resorption is noted (Fig.7 arrowheads).  His oral hygiene is fair.  He refuses implant at #2, saying that he dares not to chew on the left. When the screw became loose again 3 months later, he accepted the treatment.

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Xin Wei, DDS, PhD, MS 1st edition 02/09/2016, last revision 10/03/2018