The smallest 2 piece bone-level implant available is 3.8 mm.  It may be too wide for the ridge (Fig.3).  The advantage of it is that there are two types of angled abutments: 15 and 25°.

One piece angled implant (3x14 or x17, 15°) appears to be the best option (Fig.4).  For the better vision, an incision will be made, preferably palatally.  Osteotomy is also initiated palatally (2:1 ratio).  The starting pilot drill will be 1.2 or 1.5 the whole length 17 mm.  If perforation of the labial apical plate occurs or is anticipated, a shorter length is used (14 mm).  The 2nd pilot drill is 2 mm, half of the length.  A 3 mm drill is used to open up the crest so that when a 1 piece implant is placed, it will not cause crestal bone crack and reduce the chance of postop bone resorption.

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Xin Wei, DDS, PhD, MS 1st edition 02/22/2015, last revision 02/22/2015