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15 CASE STUDY a taper of 7.5° and an internal hexagon to prevent rotation. The restoration with the iSy Implant System uses Platform-Swit- ching abutments [5]. Implantation More sparing incision lines and smaller incisions are superior to a flapless implant insertion because the bone is well exposed and controlled working is assured. At the time of the surgery, there was a class III defect as defined by Cawood and Howell [6]. The height and width of the bony ridge was adequate, the alveoli were reossified, and the alveolar ridge was slightly round- ed (Fig. 1 and 2) . Using a crestal incision, the attached gingiva at the surgical site was slit in the middle so that there was at least one millimeter of fixed mucosa pre- sent lingual and vestibular. This is necessary both for subsequent close wound closure and for a long-term stable reconstruction and ease of maintaining hygiene. After a mesial releasing incision around tooth 45, we prepared a mucoperiosteal flap in vestibular and lingual directions to expose the jaw bone (Fig. 3) . The guide template was stably fixed over the remaining den- tition in the lower jaw and the pilot drill hole was made with the 2.8-millimeter iSy Pilot drill to the desired implant depth, eleven millimeters in regio 46 and nine millimeters in regio 47. We removed the template and checked the prosthetically oriented position of the implant bed with the depth and direction indicators (Fig. 4) . Implant insertion The iSy Implant set includes the implant and the single-use form drill. The drilling protocol for the iSy System has deliberately been reduced. Thanks to the special drill con- figuration, the form drill for the particular implant diameter is used immediately after drilling the 2.8 millimeter pilot drill hole. The sterile packed drills were taken out of the holder using the angled hand piece without touching them and the implant bed in regio 46 was then expanded to 3.8 millimeters and in regio 47 to 4.4 millimeters (Fig. 5) . Because the cortical bone in this case had a bone density of 2, we used a tap to reduce the insertion resistance and thus to counteract any necrosis (Fig. 6) . The iSy Implant is supplied pre-mounted on the implant base. The implant was transferred to the surgical site and inserted using the driver, which snaps into the implant base using light pressure and removes it from the sterile packaging (Fig. 7) . Due to the pre-tapped thread it is important to ensure that the positions of the thread ends in the cortical bone and on the implant match. The implant shoulder was positioned epicrestally and one face of the hexagon was aligned in the buccal direction. For visual inspection of the correct alignment, one face on the implant base should correspond to that of the face of the hexagon (Fig. 8) . The cylindrical healing cap made of PEEK that is included in the implant set was snapped onto the implant base using the handpiece for healing caps (Fig. 9) . The implant was then inserted in the same manner in regio 47 and the healing cap was attached (Fig. 10 and 11) . We used the bone chips harvested in the spirals of the form drill (Fig. 12) for late- ral bone augmentation (Fig. 13) . Using non-resorbable simple interrupted sutures (Resorba 5.0), we closed the surgical site and allowed the implants, in accordance with the iSy Concept, to heal open (Fig. 14) . Fig. 4: The implant positions and angulation were checked after drilling the pilot drill hole using the direction indicators. Fig. 7: The iSy Implant, pre-mounted on the implant base, was inserted with the help of the driver. Fig. 6: The tap was used to reduce the insertion resistance in dense bone. Fig. 9: The healing cap was taken out of the pa- ckaging and snapped onto the implant base. Fig. 5: After the pilot drill hole was made, the implant bed was processed to the desired depth of 11 millimeters with the single-use form drill. Fig. 8: The implant was positioned equicrestally on the vestibu- lar side and aligned to one face of the implant base buccally.