After use of 4.8 mm Magic Drill, a 5 mm tap drill does not achieve stability, whereas a 5.5x9 mm dummy implant does (Fig.4).  A 5.5x11 mm IBS implant is placed with 50 Ncm with a 6x4(4) mm abutment and bone graft (Fig.5 *).  The Inferior Alveolar Canal, unclear in the last 2 PAs (Fig.4,5), is shown in the postop panoramic X-ray (Fig.6 red dashed line).  The immediate provisional and abutment dislodge 1.5 months postop (probably due to tight vertical space); since the socket has been reduced and healed (Fig.7 ^), a healing abutment is placed.  The implant seems to osteointegrate 3 months postop (Fig.8,9). 

The crown is loose 23 months post cementation.  Although the buccal fistula disappears, the buccal plate collapses.  BW taken post retightening shows increased bone density around the implant (Fig.10).

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Xin Wei, DDS, PhD, MS 1st edition 10/28/2019, last revision 10/28/2019