Different Bone Density in Socket after Preservation

A 55-year-old woman is going to have implant placement at #18 using surgical guide 5 months post socket preservation (Fig.1).  The bone density of initial osteotomy until 3.5x7.3 mm drill seems to be soft (Fig.1,2).  Underprep is decided for the remaining osteotomy (Fig.3).  The last drill is 3.5x10 for 4.5x10 mm implant (Fig.4).  In fact initial insertion torque is >55 Ncm.  The implant has to be backed up several times to get final torque ~ 35 Ncm.  Retrospectively the bone density of the lower portion of the osteotomy is higher than that of the upper one (compare Fig.2,3).  There is crestal bone (grafted one *) resorption 4 months postop (Fig.5).

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Xin Wei, DDS, PhD, MS 1st edition 04/09/2019, last revision 05/23/2020