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Due to low bone density associated with no bone graft after extraction and possible accessory nerve, osteotomy at #19 is underprep in diameter (3.5 vs. 4.0x8.5 mm), but overprep finally in length 3.5x10 mm) with 1 ampule of Lidocaine. Insertion torque associated with 4.0 and 4.5 mm cortical taps and 4.5x10 mm implant (Fig.1) is between 30-55 Ncm. Since the implant is covered by buccal and lingual bone associated with deep placement, no bone graft is conducted. red and yellow dashed line: Inferior Alveolar Canal and a branch, respectively. There is no pain associated with the osteotomy.
Xin Wei, DDS, PhD, MS 1st edition 10/08/2019, last revision 10/08/2019