Visualization of the inferior alveolar canal was compromised due to incorrect horizontal positioning of the radiographic film.
However, after calibration of the radiograph, it was possible to safely advance an additional 3 mm in the mesial osteotomy.
A second periapical radiograph (PAR) was then obtained, this time with the plate correctly positioned, allowing clear visualization of the inferior alveolar canal. A 15 × 4 mm implant was placed in the mesial position, and a 13 × 4 mm implant in the distal position.
By obtaining two sequential PARs —within a total procedure time of less than 10 minutes—, longer implants were safely placed, optimizing the use of the available bone while ensuring nerve safety.