The mesiobuccal plate is completely destroyed.  There is almost no bone distal to the tooth #20 clinically when the tooth #19 is removed.  Pain control is poor with infiltration anesthesia (multiple injections) and incomplete insertion of a 4.5 mm tap (Fig.4). 

Bone Loss Involving Neighboring Tooth Last Next Xin Wei, DDS, PhD, MS 1st edition 07/18/2016, last revision 08/25/2018