After placing bone graft into the sinus and the osteotomy (Fig.2 black *), a 5x9 mm implant is placed with >30 Ncm.  Second round of bone graft is placed around the implant, including DB defect (white *).  Then a 5x4(2) mm pair abutment is placed, followed by the third round of bone graft (Fig.3 *).  If the abutment were placed prior to the 2nd round of the bone graft, the latter would be unable to reach the deepest implant threads or the defect.

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Xin Wei, DDS, PhD, MS 1st edition 02/07/2020, last revision 02/08/2020