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With understanding tissue punch and engagement of drill as much as possible into guide sleeve before pressing pedal, guided surgery is accomplished with confidence (Fig.1,2). With undersized drilling, there is no thread exposure palatally, when a flap is raised. Vanilla graft is placed, since it has been prepared before incision. No membrane is used. It appears that the palatal bone expands while the implant is being placed. There is mild crestal bone loess 4.5 months postop (Fig.5).
Xin Wei, DDS, PhD, MS 1st edition 09/12/2018, last revision 04/17/2019