The lower right 2nd and 3rd molars are nonsalvageable for a 51-year-old lady (Fig.1).  An immediate implant is to be placed at the site of #31.  There is no acute infection.  Anesthesia should be easily obtained with infiltration.  If pain is associated with osteotomy, the drill must be close to the inferior alveolar nerve (yellow dashed line: upper border of the inferior alveolar canal).  If the pain is not controlled, the procedure will be changed to socket preservation without any hesitation. 

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Xin Wei, DDS, PhD, MS 1st edition 09/25/2014, last revision 09/26/2014