No Fixation of Fixture Anchor Pin with Offset

There is offset (10.5 mm) associated with #3 and 4 guided placement.  When #4 implant placement is done first with >20 Ncm, a fixture anchor pin cannot be engaged.  For anchorage purpose, can the implant be placed 1.5 mm shallower initially and then deeper later on (when #3 placement is done)?  In fact the insertion torque of #3 is less than 15 Ncm (Fig.1).  Narrow healing abutments are placed to reduce lateral micromovement.  Pain control is good with 1 carpule of Xylocaine with 1:100,000 Epinephrine.  The patient is pleased with much less postop discomfort than the 2 previous implant surgeries (#20 and 19).

The reason is that offset 10.5mm was used for this case.
Fixture anchor pin you have is only available in 9 mm regular offset. Jennifer
There is history of mild postop hemorrhage for a few days postop, as related to healing laceration palatal to #4 (7 days postop, Fig.2).  There is mild discomfort when temporary splinted crowns are fabricated 2.5 months postop (Fig.3).

Return to Upper Molar Premolar Immediate Implant, Trajectory Xin Wei, DDS, PhD, MS 1st edition 09/18/2018, last revision 12/03/2018