By breaking the proximal contacts, the crown, abutment and implant at #14 are shaken loose using forceps.  Finally the crown breaks off.  Make a slot on the top of the abutment and use a screw bit to turn the abutment/implant counterclockwise.  There is abundant granulation tissue with arterial hemorrhage associated with granulation tissue removal.  The defect involves the distal surface of the implant at #13 and the mesial surface of the tooth #15.  Therefore bone graft is deposited in these surfaces (Fig.4 arrowheads, as compared to preop BW, Fig.4').

Lingual Defect Last Next Xin Wei, DDS, PhD, MS 1st edition 02/21/2019, last revision 02/28/2019