Restoration-Oriented Placement

It is smooth and quick to finish osteotomy with guide at #6,7,10-12, but when 3 mm 1-piece implants are placed free hand at #7 and 10 (Fig.1,2), the gingival parts of the abutments contact the incisal edges of the lower incisors (anterior deep bite) in spite of effort to change the trajectory by repeated back and forth placement after use of Lindamann bur buccally.  Following an immediate provisional (Fig.3,4), the occlusal surface of the posterior teeth are raised to eliminate anterior restoration interference.  Immediate postop CBCT shows that the implants at #7 and 10 could be placed more buccally (Fig.6,7, as compared to the normal position at #6,11,12 (Fig.5,8,9)).  Fig.10 was taken 2 days preop, while Fig.11-13 postop.  Can we change 1-piece implants (3mm) at #7 and 10 to 2-piece one (3.5) and use angled or cementation abutments for easy restoration (Fig.14-16)?

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Xin Wei, DDS, PhD, MS 1st edition 11/16/2018, last revision 12/11/2018