The bone is long enough to hold a 11.5 mm long implant.  There is no difficulty in inserting the corresponding drill (4.5x11.5 mm) into the metal sleeve, but the lower right posterior teeth prevent the implant handpiece from going downward completely when the handpiece accesses lingually.  Because of the extra manipulation, a 5x10 mm implant achieves insertion torque of ~ 20 Ncm (Fig.2).  <: apical space.  When the implant is placed initially according to the protocol/design, the implant is slightly supracrestal buccally.  The implant is then seated apically ~.5 mm, which is unnecessary retrospectively.  The bone density mesial to the implant (Fig2 *) increases 5 months postop (Fig.4), whereas that distal to the implant remains low 9 months postop (Fig.5).

Limiting Factor Last Next Xin Wei, DDS, PhD, MS 1st edition 03/11/2019, last revision 06/22/2019