After extraction, a 2 mm pilot drill is used to start osteotomy in the mid palatal wall more than 13 mm (Fig.1).  Bone density is low (smoker).  The longest (at that time, now 15,16,18 mm available) bone-level implant (4.5x13 mm, Fig.2) is placed with insertion torque of 35 Ncm after using 3.2 mm drill (1 drill underprep). 

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Xin Wei, DDS, PhD, MS 1st edition 09/29/2015, last revision 11/25/2020