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In fact the implant turns when a 4.5x4(3) mm pair abutment is tightened. When the abutment is removed, the implant is backed up; with a healing screw, sticky bone is placed (Fig.6 *) and then covered with a piece of PRF and a part of GEM cap (a little too stiff, difficult to be adapted under flaps). The wound is sutured with 4-0 PGA; periodontal dressing is applied. The implant is somewhat over-seated without the bone graft covering the apical end of the implant (Fig.7, as compared to Fig.4). A 4.5 mm implant should be placed.
Xin Wei, DDS, PhD, MS 1st edition 05/11/2020, last revision 05/11/2020