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Prepare scalpel and bury the implant, because grafted area has low bone density. Primary stability may be low. Due to delay in surgery in association with coronavirus, the bone may be shrunken in the width. Finish osteotomy using 4.0x7.3 to 4.0x10 mm drills. Remove the guide to compare the ridge width with the osteotomy. Place a 4.5x10 mm implant if deemed proper. In fact the ridge and keratinized gingivaval band are wide immediately prior to implant placement so that tissue punch is used.
Xin Wei, DDS, PhD, MS 1st edition 02/28/2020, last revision 06/01/2020