Narrower Longer Fixture

After use of 4x7.3 mm drill with guide, the buccal osteotomy height  is 4 mm at #19, unsuitable for 4x5 mm Bicon implant, which requires 3 mm subcrestal placement.   PA shows 4.3 mm bone from the Inferior Alveolar Canal (IAC, red dashed line (the superior border)).  Following 4x8.5 mm drill, a 4x7 mm IBS implant is placed with distobuccal thread exposure and 3.2 mm clearance from IAC.  With 3.5x10 mm drill less full length, the implant is placed a little deeper (10 Ncm).  Bleeding spots created (Fig.3), sticky bone (cortical, fine granule) is placed (Fig.4 *), which is covered with PRF membrane and Colla tape.  4-0 PGA is used.  There is no postop paresthesia.  The length discrepancy is probably due to distal free end guide, which produces mesial placement of the implant.  Try to make a premolar-sized crown.  Use profile drill in uncover.

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Xin Wei, DDS, PhD, MS 1st edition 07/22/2021, last revision 07/22/2021