When the same sized implant is placed (Fig.8; 7x14 mm), the insertion torque is between 50 and 60 Ncm.  It appears that the implant obliterates the mesial (*) and distal (>) space.  It is the engagement of this large implant into the mesial, distal and buccal walls of the original extraction socket and the palatal wall of the septum that the implant gets primary stability.  Penetration of the sinus floor (cortex) may also contribute to the stability.

Allograft mixed with Osteogen is inserted in the osteotomy (for sinus lift) and remaining sockets before and after implantation.

Sinus lift happens to be shown 2 months postop (Fig.19  *).  Compare to Fig.8, both the mesial and distal gaps have disappeared in 2 months.

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Xin Wei, DDS, PhD, MS 1st edition 08/21/2014, last revision 03/15/2020