I have a 14 year old male patient who had peripaical lesions develop around #11,12 [maxillary left canine and first premolar;23,24]. I then extracted both teeth 2 years aro. #13 [maxillary left second premolar; 25] had been in horizontal version and was uprighted by the orthodontist. The patient has now presented for implants and crowns to replace #11, 12. My first question is why is there a large radiolucent lesion in the #11,12 area? Is this an apical scar or cyst? Viewing the radiographs it appears as though there is a continuity with the nasal cavity and maxillary sinus. What would be the best way to treat this lesion so that I can install implants later on. Should I first do a biopsy of the radiolucent lesion? Should I do a bone graft? What material would you recommend? Can I place implants in this site in a 14 year old male? If not, what age would be appropriate? Is there a test I can do to determine when I can install the implants?