When the tooth is extracted, the septum (Fig.2 S) is deviated distally (Fig.3 arrowheads).  Osteotomy for immediate implant is initiated in the center of the septum with the coronal end of drills (Fig.3) and implant (Fig.4 I (5x12 mm)/abutment (Fig.4,5 A (7.8x5.5(2) mm) in the center of the edentulous space as much as possible.  Prior to implant placement, mixture of allograft and Osteogen is used for sinus lift (Fig.4 *).  In fact, the patient returns 4 months postop.  The provisional perforates at the occlusal surface, but there appears to be new bone formation in the mesial socket (Fig.10 *).  Remember no bone graft being placed in the mesial socket (instead Osteogen plug being used).  Retrospectively, the implant should be placed in the center of the socket using surgical guide.  Graft Materials   Last   Next   Xin Wei, DDS, PhD, MS 1st edition 05/11/2016, last revision 12/26/2019