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What is unclear preop is the large periapical radiolucency (Fig.1 red dashed line) of the palatal root (P) of the tooth #14. When the tooth is extracted, it is difficult to remove granulation tissue from the palatal apical socket, which is enlarged (Fig.2 (impression of sockets),3). The small dimension of the septum (~4x5 mm (Fig.1 pink) is also unrecognized preop, which leads to sinus perforation when 4.8 mm Magic Drill is used. Yellow dashed line: sinus floor.
Xin Wei, DDS, PhD, MS 1st edition 06/13/2017, last revision 04/18/2018