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Following placement of a 4.5x11 mm implant at #19 (14 months post guide fabrication), a fixture anchor pin is placed. With stable guide, it is much easier to finish osteotomy and implant placement at #18 (Fig.1). Since the patient is nervous and sensitive to drilling, a shorter implant is placed (7 mm instead of 9 mm vs. 8.5 mm drill). The stability is unaffected because of the dense bone. After use of 5.5 mm profile drill, healing abutments (5.5x3 and 5.5x4 mm) are placed without interference.
Xin Wei, DDS, PhD, MS 1st edition 01/30/2020, last revision 01/31/2020