Split or Drill Septum for Immediate Implant

A 44-year-old man has diabetes (under control) and poor dentition.  Six teeth (#1,16-18, 25 and 31) have lost between 2009 and 2013 (Fig.1,2)  The next tooth to be extracted will be #2 (Fig.2).  It has 3 roots (Fig.3 *) and a septum between the roots (S).  It appears that the septum is expected to be split or drilled to have an immediate implant be placed (Fig.4).  The length of the implant is between that of buccal roots and palatal one of the affected tooth so that the sinus membrane will be less likely perforated.  If the septum is thin, use Rongeur to remove it and grind it to smaller pieces for grafting later on.  Where does the implant end up?

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Xin Wei, DDS, PhD, MS 1st edition 11/30/2014, last revision 11/14/2019