In addition to infiltration in the buccal vestibule (Fig.2 white *), intra-ligamental injection is administered in the affected tooth with the anesthetic mentioned above (black *, for added hemostatic effect).  It appears that these two measures have some measurable effect when initial osteotomy is being done with a 2 mm pilot drill (Fig.3).  Hemorrhage from the extraction socket is less than usual.  The trajectory of the initial osteotomy seem to be ideal.

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Xin Wei, DDS, PhD, MS 1st edition 07/21/2015, last revision 10/14/2018