Fig.6: The second osteotomy is made in the septum by using series of tapered osteotomes (2,3,4x17 mm), followed by 4.5x20 mm tap at depth of 17 mm with satisfactory binding. The integrity of the sinus floor (red line) is violated.  The next larger taps should not be extended so deep.  The first osteotomy (palatal socket) should have been obliterated partially by the expansion of the second osteotomy.

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Xin Wei, DDS, PhD, MS 1st edition 12/29/2013, last revision 04/22/2018