A 3.8x10 mm dummy implant is placed tentatively with an apical space (Fig.4 (the distal root surface of the lateral incisor is denuded (<)).  When a same dimension definitive implant is placed with 40 Ncm, it is 2 mm below the lingual gingival margin, whereas 6-7 mm below the buccal one (Fig.5).  Vanilla graft is placed before placement of a 5.5x4(5) mm abutment (Fig.6).  The root surface of the lateral incisor is covered by the bone graft.  Later the abutment is changed to a longer and smaller one (Fig.8) with more of the allograft (*).  The short implant is chosen because it has to be placed deep to prevent periimplantitis, especially lingually, in spite of the fact of the unfavorable crown/implant ratio (Fig.4).   The diameter of the implant is small so that there is ample space to pack bone graft both buccally and lingually.

2-Piece Implant Last Fig.5 Fig.7 Fig.9

Xin Wei, DDS, PhD, MS 1st edition 03/20/2018, last revision 12/02/2018