Implants on Autopilot

#2 Post graft with MFDBA, scanned for Optiguide no radiographic guide, uploaded to SICAT:

Simple proposal, I was a little buccal with my crown, so my screw access should be right in the central fissure:

Lido 2% with epi 1:50K lifts the periosteum and keeps the bleeding down:

Optiguides fit a bit loose due to the lack of undercuts so use a bite block:

Drill extender with a punch:

2.3mm Pilot, D2 set to 22mm which is 23.5 minus 1.5 for the Guide Handle.  We initially planned for an 8 which I thought I had, but did not!  Luckily we were right at the sinus floor, used the MIS bone compression with  the 3mm expander:

Since this was a beta case I went through the series short to the planned length which was about 2mm short of the raised sinus floor:

5.7 by 10mm Legacy 3.  No grafting ahead, I could feel the membrane, but could not feel the floor:

Implant placed, even with the central fissures and in line with the adjacent teeth.  Equi-distant from the adjacent teeth contacts:

Planned and placed, I know the DB root of #3 looks close, but we are more palatal and the shot is angled:

Healing cap, better x-ray of the DB root and the implant:

4 months later

Back from the Lab, easy stock freebie abutment:

Final.