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As expected, bone density is low at #31 during osteotomy.  Underprep in depth (close to IAN) and diameter is done with satisfactory torque (~15 Ncm).  What was not expected intraop is having to use one carpule of Septocaine in addition to Lidocaine.  Postop PA shows why (closeness of the implant to IAN, Fig.1).  The guide helps slightly subcrestal placement of the implant except lingual (equicrestal).  Autogenous bone graft is placed, followed by sutures.  Incision is initiated because of the narrow keratinized band.  An IBS abutment seems to be completely seated in the IS implant (Fig.2).  The gingiva is healthy at the time of impression.

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Xin Wei, DDS, PhD, MS 1st edition 07/14/2020, last revision 10/14/2020