Low bone density is confirmed during osteotomy at #14.  Underprep is adopted: after use of 3.5x10 mm drill instead of 4.5x10 mm one, a 4x10 and 4.5x10 mm dummy implant are placed for bone condensation.  When a 5x10 mm definitive implant is placed, it is unable to be paced to the depth.  After use of 4.0x10 mm, the final implant reaches depth ~ 1 mm more than planned.  But there appears no bone palatal to the implant clinically.  Small-field CT is taken.  In fact there is crestal bone palatal to the implant, but in small amount and in low bone density (Fig.1,2). 

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Xin Wei, DDS, PhD, MS 1st edition 11/19/2019, last revision 11/19/2019