I have a 30-year old patient who presented with #14  missing, having been extracted 2-years prior. The alveolar ridge at that site had resorbed significantly on the buccal and occlusal (no clinical image). CBCT scan showed 6-7mm of vertical bone remaining at that site. During surgery I raised full thickness flap without releasing incision from second molar to first premolar. In spite of CBCT findings, when performing the osteotomy I found that at 9 mm I could still feel full bone support with probe.
I considered using 8mm (without maximum utilizing the bone) or 10mm (having bicortical support and sinus penetration) Alpha-Bio SPI implant, since I did not have a 9mm implant. In the end I decided on the 4.2*10mm Alpha bio SPI implant. I installed the 10mm implant and achieved bicortical support and good primary stability, but with a minimal sinus penetration. I placed bovine bone graft, collagen plug, covered with membrane and sutured with Assucryl 4/O. This is my tenth implant case and first sinus penetration. Clinical case photos are below. What are your thoughts on this case?
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