After change in trajectory (Fig.3), single drill technique is adopted (3.3 mm Magic Drill for 13 mm) and a 4x11 mm dummy implant is placed with 40 Ncm and 1 mm subgingival palatal (Fig.4 (*: perimplant space).  The definitive implant is placed deeper with >50 Ncm (Fig.5); with placement of a 4x5.7(2) mm abutment and mixture of autogenous bone and Vera Graft (*), the existing crown (9) is relined and inserted as an immediate provisional.  The periimplant space appears to be filled with denser bone 3.5 months postop (Fig.7 *).  Impression is not taken because of gingival bleeding, which is in turn probably due to the low margin.  A new provisional is fabricated.  The abutment may have to change to 4 or 4.5x4(3) mm.  There is no access hole of the crown.  No residual cement is noted immediate post cementation (Fig.9).

Metal Shade Abutment Last Next

Xin Wei, DDS, PhD, MS 1st edition 10/10/2017, last revision 08/15/2018