Fig.4,5: Illustration. Extraction of the horizontally impacted #17 should be traumatic and should be avoided.  After extraction of the tooth #18, place a implant at the mesial socket (green) with a cemented abutment (blue).  If the septum is intact after implant placement, place collagen plug (pink, or Osteogen plug otherwise) in the distal socket.  Bone graft is placed in the remaining socket (red circles).  Piece of the collagen plug is placed for final seal.  An immediate provisional (white) is fabricated to close the socket and should be splinted to that at #19 (grey).

Fig.6: CBCT coronal section at the tooth #20.  There appears to be no periapical radiolucency.

Mesial Socket Implant Placement at Lower 2nd Molar

Xin Wei, DDS, PhD, MS 1st edition 07/10/2016, last revision 07/10/2016