No Drill Osteotomy

A 69-year-old lady has pain at #31.  Because of curved and obliterated root canals (Fig.1,2), it is the better to extract the tooth and have an immediate implant.  The roots are also long and narrow and close to the Inferior Alveolar Canal (Fig.1 yellow dashed line), whereas the canal is hardly recognizable in a 2nd PA (Fig.2 ?).  For safety, taps are to be used for osteotomy (Fig.3).

She is taking a blood thinner.  Make sure that she has stopped taking it for 2-3 days prior to surgery.  Postop, suture and perio dressing may be needed for hemostasis.  Gauze (3-4 pieces) is provided to the patient.  Is a drill not used at all?

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Xin Wei, DDS, PhD, MS 1st edition 05/21/2015, last revision 05/22/2015