After placement of bone graft around the 4.5x11 mm final implant (with low torque) to enhance stability, a 5.5x4(3) mm definitive abutment is placed in a restorable position (Fig.8).  The implant turns while the abutment screw is hand tightened.  Since there is an apical space (Fig.8 <), the implant is then placed ~ 1mm deeper with ~ 30 Ncm (Fig.9). 

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Xin Wei, DDS, PhD, MS 1st edition 07/09/2020, last revision 07/09/2020