The 1st intraop PA taken after initial osteotomy at the depth of 12 mm shows that the mental loop (Fig.4 red dashed line) appears to be more superior than what is expected from CBCT study; while the apical end of the osteotomy at #28 is going to be moved mesially (>), that at #29 distally (<) to reduce the chance of injury to the loop in the subsequent osteotomy.

At 50 RPM, drills collect bone granules while osteotomy.

Both implants (3x14 and 4.5x12 mm) are placed with insertion torque 56 Ncm (Fig.5).  The coronal threads of the implants are exposed lingually.  The autogenous bone, collected during osteotomy, is placed over the exposed threads.

From Removable to Fixed Prosthesis

Xin Wei, DDS, PhD, MS 1st edition 07/20/2015, last revision 07/20/2015