Fig.4 (intraop PA) is taken with a radiopaque material in the mesial socket (M). The former appears to increase contrast. The bottom of the mesial socket is separated from the the inferior alveolar nerve (I) by a thin layer of bone.
The remaining granulation tissue is removed with confidence. When it is finished, bleeding is noted to come from the connection (arrowheads) between the mesial lesion and the neurovascular bundle. Therefore the connection is a branch of the inferior alveolar vessels.
The mesial socket is too big for the largest tap (8 mm in diameter). So it is not an appropriate site for implantation.
Since the height of the distal socket (D) is larger than the septum (S), the former is to be chosen for implant placement. To ensure safety, osteotomy is done confined to the socket and without drilling.
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Xin Wei, DDS, PhD, MS 1st edition 06/15/2013, last revision 09/30/2014