The tooth #15 has 3 residual roots.  There is no septum left between the buccal roots when the tooth is extracted.  A septum exists between the palatal (P) and buccal (B) sockets (Fig.2).  Bone expansion technique is utilized to create an osteotomy in the septum.  However, the smallest rounded tapered osteotome cannot be driven into the narrow septum; it slides.  To get an initial engagement, a slot is created by a high-speed surgical handpiece and fissure bur on the top of the septum.  A series of blade-like osteotomes are inserted into the septum for sectioning (>).  The smallest rounded osteotome is now easy to be inserted into the middle of the septum.

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Xin Wei, DDS, PhD, MS 1st edition 05/31/2013, last revision 05/01/2014