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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.
Xin Wei, DDS, PhD, MS 1st edition 08/30/2019, last revision 02/02/2020