Following 3-4 more turns, the torque reaches 45 Ncm (Fig.2) with the distal thread covered (<) and autogenous bone graft placed in the distal defect (*).  Clinically the implant is placed within bone boundary buccolingually.  The new implant seems necessary considering short (Fig.2 S) and probably resorbed (Fig.1 R) roots of the premolars.  A 4x3 mm unipost is placed to keep periodontal dressing in place.There is no obvious bone loss 5.5 months postop (Fig.4).

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Xin Wei, DDS, PhD, MS 1st edition 07/17/2020, last revision 07/17/2020