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Fig.5: Osteotomy is formed in the septum mainly by using osteotomes, followed by tap drill (T: 4.5x20mm). A fragment of bone (*) breaks into the mesiobuccal socket (MB) from the expanding septum (as shown in Fig.6).
Fig.7: A 5x20 implant may also push more bony fragment (G, graft) into the mesiobuccal socket from the septum. Part of graft is from harvested bone when reamers are used. No allograft or synthetic bone is used.
Fig.10: No matter where the bone comes from (Fig.7), the mesiobuccal socket is almost completely obliterated by bone growth (B) in 3.5 months postop.
Bone density increases mesially (Fig.13 arrowheads) and distally (*) 1 year 2 months post cementation, 1 year 7 months postop, probably due to the response to the cantilever effect.
Xin Wei, DDS, PhD, MS 1st edition 12/10/2013, last revision 07/05/2015