When the roots are extracted (Fig.3 (illustration)black), the septum is narrow (white).  A 1.2 mm pilot drill penetrates the septum to start osteotomy (red), followed by a 1.5 mm drill and a 2.6 mm bone expander. 

By the time the expander is used, the septum starts to break off (Fig.4 green).  The osteotomy site has to be changed: first to the palatal slope of the palatal socket (red) with the coronal end of the drill leaning buccally.  Suddenly a better idea occurs: new osteotomy remains in the palatal socket, but as buccally as possible (blue) and finishes with rounded tapered osteotomes 2-4 mm at ~17 mm deep.  The coronal end of the osteotomes is controlled to be positioned in the center of the socket (Fig.5 blue).

Immediate Provisional for Upper 1st Molar Last Next

Xin Wei, DDS, PhD, MS 1st edition 12/15/2014, last revision 08/15/2021