Because of the long  crowns of the neighboring teeth, it is difficult to remove the apical portion of the root, including gutta percha with surgical handpiece (Fig.3 * (1.2 mm drill for 12 mm)) for socket shield.  To avoid the perspective implant touching socket shield, initial osteotomy is palatal.  When a 2 mm drill is being used, the coronal end of the palatal plate starts to perforate.  A 2.5x14 mm 1-piece implant is placed with 30 Ncm (Fig.4).  The teeth #8 and 9 fracture (an implant is placed at #8 and bone graft at #9), while the implant at #7 is osteointegrating (Fig.7).  In fact the shield is exposed without symptom.

Narrow Space Last Next Xin Wei, DDS, PhD, MS 1st edition 10/18/2018, last revision 10/15/2019