In this chapter, the 2 biggest issues will be tackled.
In spite of use of surgical guide, implant tends to shift buccal probably related to the dense lingual plate. Osteotomy will be initiated slightly more buccal and overprep coronally before going for depth. For non-guided cases, Lindamann bur will be used to remove the thick coronal portion of the lingual cortex. The last drill for depth could be undersized in diameter for stability.
For bone-level implants (screw loosening issue), use sensor 1 as much as possible for parallelism even during surgery, particularly when abutments are placed. Use small size of the latter if indicated to reduce soft and hard tissue interference or use profile drill immediately post implant placement. When the patient returns for impression, examine the implant and abutment for stability and tenderness. If indicated, take BW with sensor 2 or PA with sensor 1 after abutment screw cleaning and retightening (not before).
Xin Wei, DDS, PhD, MS 1st edition 12/29/2019, last revision 12/29/2019