The implant at the site of #13 is intentionally placed palatally, since the buccal plate is found to be lost after extraction, whereas the implant at the site of #15 deviates buccally due to perforation of the buccal aspect of the septum.  Bone graft is placed in the gap of #15 after implantation, whereas the sequence is just the opposite for #13, since the buccal gap of #13 socket is small with buccal plate perforation.  It is easier to place bone graft in the most apical aspect of the socket pre-implantation than post-implantation.  If bone granule is unintentionally dropped into the osteotomy, the implantation may be difficult.  A: abutment placed for immediate provisional bridge.

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Xin Wei, DDS, PhD, MS 1st edition 09/03/2014, last revision 01/19/2018