The bone is felt soft during initial osteotomy (Fig.3).  Attention is being paid to correcting the trajectory.  Under prep is ignored.  When a 5.9x10 mm implant is placed, the insertion torque is between 25 and 30 Ncm (Fig.4). 

Since the implant is placed subcrestal mesially (>), the mesial margin of the abutment is subgingival (Fig.5).  

The patient returns for restoration 13 months postop with implant osteointegration (Fig.8).  The lamina dura-like structure forms between the cortex and the coronal first thread.

Soft Bone of A Smoker

Xin Wei, DDS, PhD, MS 1st edition 07/13/2015, last revision 08/28/2016