Retrospectively, it is the best to use a sharp pilot drill to start osteotomy, since it is less likely to slide than an osteotome.  Furthermore, the initial osteotomy should be as lingual as possible (Fig.12 long arrow, as compared to short one).

B-L Position

Xin Wei, DDS, PhD, MS 1st edition 01/17/2015, last revision 01/17/2015