Sequential osteotomy stops one size smaller than the expected size of the implants (Fig.2): the last drills for the sites of 18 and 19 are 4.5x10 and 4.5x12 mm, respectively.  Because of underprep, insertion torque for these two implants are around 55 Ncm.  When she returns 2.5 months postop, the implants at #18,19 appear to have osteointegrated (Fig.5).  A cemented abutment is placed at #18 (6.8x4(1) mm) and a splinted provisional is fabricated at #18 and 19.  Bone starts to be resorbed at #19 (arrowheads).  The patient returns 8 months postop.  The bone loss at #19 appears to be stabilized (Fig.6).  It would be better to place a shorter implant in a deeper position.

Abutments Last Next Xin Wei, DDS, PhD, MS 1st edition 11/06/2015, last revision 12/26/2018