How to Prevent Deep Implant Placement?

A 4.5x10 mm implant is well placed at #19 in term of trajectory with guide (Fig.1).  Because of crestal bone resorption, the implant is placed deep with increased potential of abutment screw loosening.  The key to prevention of bone loss is socket shield.  A 6x5 mm healing abutment is placed with 10 Ncm (Fig.3 (PA taken 21 days postop)). 

Since a 5.2x5.5(4) mm cemented abutment seems to be incompletely seated (Fig.4), a smaller one is placed with 30 Ncm without much improvement in seating (Fig.5).  PAs are taken before and after cementation (Fig.6.7).

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Xin Wei, DDS, PhD, MS 1st edition 10/10/2019, last revision 03/30/2020