It is always my pleasure to hear back from you.
I have reviewed the
planning of Ms.
Pan's case again and I think this picture would help you understand the
reason why (Fig.2).
When you look at the bottom part divided by the red line. It is very dense
bone. However when I looked at the upper part from the red line even it
showed high HU around 1000, but still as it is grafted bone, it may have not
had the actual fixing stability at the top. That's why you might have felt
that tapping which goes down 3mm at the top for the cortical bone has low
resistance.
However, those white dense part at the apex helped to hold the implant
firmly to achieve the torque.
So to answer your questions,
why I had resistance using the last drill 4.5x10mm. I had to remove the
drill and remove the bone from the drill and reentered the osteotomy. That
part you felt high resistance was the dense bone you got the fixation from.
And for those dense part, those bone comes out inside the blade of osteotomy
drill and like you did, scrape it out and if necessary, you may redo the
drilling. Dr. Heo, the founder of the Neobiotech does that too. Jennifer
No Tap at Grafted Site
Last
Next Xin Wei, DDS, PhD, MS 1st edition 05/01/2018, last revision
10/22/2018
