Question:

This ridge is too thin. The implant shown in the planning software is 3.2mm for a premolar. Should I do this case?

https://secureservercdn.net/198.71.233.181/52t.f24.myftpupload.com/wp-content/uploads/2021/03/4-2-268x300.png

https://secureservercdn.net/198.71.233.181/52t.f24.myftpupload.com/wp-content/uploads/2021/03/1-3-300x270.png

https://secureservercdn.net/198.71.233.181/52t.f24.myftpupload.com/wp-content/uploads/2021/03/3-2-250x300.png

https://secureservercdn.net/198.71.233.181/52t.f24.myftpupload.com/wp-content/uploads/2021/03/2-3-286x300.png

The implant shown on the CBCT slice seems to be labeled 3.5x10. I probably wouldn't go narrower than that for a premolar.

Guided Bone Regeneration would turn this into a really nice implant site. I would definitely either do the GBR or refer it out to someone who can do that. Otherwise you would be dealing with a fairly narrow ridge and an unnecessary amount of uncertainty.

There are a variety of ways to make this ridge "work" such as ridge split, or osseodensification (aka Versah Densah burs) but I would advise GBR is more predictable.

GBR is technique-sensitive. It involves covering the bone graft with a membrane and securing it with something (usually tacks or sutures).

I like to use allograft and also you can use some shavings from the patient’s own bone for this.

There are little bone harvesters like this one that work nicely. Here is a link:

shorturl.at/dgtyE

PS: Anecdotally some people say not to place Hiossen implants narrower than 4mm. I don't know if there is any truth to this. Just something that came up online.