Wide Ridge

The ridge post bone graft (#28) and socket preservation (#30) is wide.  Using a surgical guide (Fig.2), tissue punch is used to initiate osteotomy without compromising the keratinized gingiva (Fig.3).  With no stop fixture mount for a 4.5x11.5 mm implant being placed at #28, the osteotomy at #30 is much easier.  A 5x17 mm Tatum tapered tap is inserted with the guide and then without the guide.  Finally the 5x14 mm tissue level implant is placed free hand (Fig.4).  With underdrilling at #30 (4x10 and 4x11.5 instead of 4.5x10 and 4.5x11.5), primary stability is high.  So is #28.  Abutments are placed for periodontal dressing (Fig.5).

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Xin Wei, DDS, PhD, MS 1st edition 04/30/2021, last revision 05/01/2021