Immediate implant will be avoided at #19 due to severe bone loss.  Instead a short implant (5.5x5 or 6 mm) will be placed at #18, while a 4x11.5 mm one at #20 for FPD (Fig.5,6).  All of the implant will use guides.  There is a special point at #18.  After use of 4.5 mm drill, the guide will be removed for free hand osteotomy using 5.0 mm drill, 5.5 mm tap and implant placement.  PRF will be prepared for membrane and sticky bone at #19 and 20.

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Xin Wei, DDS, PhD, MS 1st edition 02/17/2019, last revision 01/11/2020