Finally 4.5x17 mm implants are placed with insertion torque > 60 Ncm (Fig.15).  Following insertion of abutments (3.5x5 mm), immediate provisionals are fabricated. The crestal bone is preserved (^).  The implant threads are subcrestal.  Fig.21 (2 months postop): There is no bone loss around the implants.  The patient returns with porcelain chip at #9 mesiopalatally 2 years 10 months post cementation (Fig.25 *).  The chip is probably due to distal placement of the implant and failure to extend zirconia coping mesially.  The bone loss at #10 can be dated as early as the time of placement.  A smaller implant (such as 3 mm) could solve the issue.  Preop CT is a prerequisite of implant success.  Lack of periodontal maintenance and of posterior occlusion are other culprits.  Treat Early Implants as Immediate Ones Last Next Xin Wei, DDS, PhD, MS 1st edition 06/01/2015, last revision 12/08/2018