The initial osteotomy is established with the 1.6 mm drill at 11 mm (Fig.2).  Later the depth increases to 13 mm.  The initial osteotomy is found to be too lingual, but experience shows that as osteotomy increases in diameter, the trajectory would shift buccally due to the thick lingual plate (slope).  When 3.3 mm Magic drill reaches 11 mm, the patient feels pain.  It is probably due to the dense bone.  A 4x11 mm IBS implant cannot be seated completely due to high torque; it is removed.  The osteotomy is increased with 3.8 mm drill.  The implant is re-seated with >55 Ncm; it is over-lingually placed.  Due to failure to seat the implant driver completely, the implant cannot be un-torqued.  A 4.5 mm 15° angled abutment (3 mm cuff) is placed for immediate provisional (Fig.3*).

Stable Osteotomy with IBS Drills Last Next

Xin Wei, DDS, PhD, MS 1st edition 09/14/2016, last revision 06/25/2017