Extraction of the upper left 2nd premolar turns out to be difficult.  The root is stable and easy to break.  Periotomes, forceps, elevators and surgical bur have been used.  The roof and the distal wall of the socket are as thin as egg shell and perforated (Fig.3).  It appears that there is no residual root in the socket or the sinus (Fig.1,2). 

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Xin Wei, DDS, PhD, MS 1st edition 12/28/2015, last revision 01/05/2019