To avoid distal end guide, do not remove the 3rd molar.  While a 5x7.3 mm implant is long for the site (Fig.2), a 5.5x5.5 mm one seems to be a better option (Fig.3).  The latter could be 1 mm more coronal.  The last drill (5.0 mm) and cortical tap will be used free hand.  #17 will be extracted after implantation.  Since the patient is reluctant to have #16 to be extracted, place #18 implant ~ 1-2 mm more distal so that the implant crown will have some occlusal contact with #16.

3rd Molar Last Next Guide

Xin Wei, DDS, PhD, MS 1st edition 08/30/2019, last revision 09/09/2019