Following placing allograft with 3-4 amalgam carriers, a 5x11 mm IBS implant is placed with 20 Ncm (Fig.5,6).  In fact the implant turns when an abutment is placed.  When the implant is re-inserted, torque decreases to 10 Ncm.  Instead a healing screw is placed.

The low torque value is due to soft bone and failure to underprep.  #4 Expander (Fig.3) seems larger than 4.5 mm implant (Fig.4).  #3 Expander (1.7/3.1 mm) should have been used prior to definitive implant placement.  

Soft Bone Last Next

Xin Wei, DDS, PhD, MS 1st edition 06/26/2017, last revision 05/13/2019