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The osteotomy is enlarged with osteotomes (Fig.8 red arrow); at the same time the septum is being pushed distally (blue arrow) with leaning the osteotomes distally (white arrow).
When an implant (Fig.9 green area) is placed, the apex is mainly seated in the mesial socket, while the coronal end is more or less inclined distally for restoration. The apical half of the distal sockets is packed with collagen plug or dressing (light blue area), whereas the remaining sockets and coronal exposed threads are filled with bone graft (red circles). While the implant is being inserted, the septum is being distalized (blue arrow).
The most coronal socket is going to be obliterated by a cemented or healing abutment.
Xin Wei, DDS, PhD, MS 1st edition 03/21/2015, last revision 03/21/2015