When a new osteotomy is formed in the palatal wall of the palatal socket (Fig.3 A, B), it is possible to control the coronal end of the osteotomes in the middle of the extraction socket.  Although a 6 mm tap has achieved enough stability, a 7 mm tap is inserted, since the socket seems to be extremely large.  Nose blowing test is performed after each step of osteotomy.  Bone graft is placed in the osteotomy (Fig.3C: pink circles) before placing a 7x14 mm implant (Fig.3D: brown; Fig.4 I).  The slot in the septum (red dashed line) appears to help change the trajectory of the implant placement (arrow in Fig.3D).

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Xin Wei, DDS, PhD, MS 1st edition 10/29/2015, last revision 12/25/2018