Since the bone density at #18 is low, under drilling is required (with guide).  A 5x11 mm tissue-level implant will be inserted initially through the metal sleeve (Fig.3).  Double check the trajectory in the second part of placement without the sleeve.  Ask the lab to design slightly lingual placement to avoid the buccal dense bone.

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Xin Wei, DDS, PhD, MS 1st edition 02/27/2020, last revision 03/12/2020