A 74-year-old man finally agrees to have the tooth #24 to be extracted for immediate implant with 3-year mobility and buccal shift (occlusal trauma or root fracture, Fig.0,1).  Because of curved root tips of the neighboring teeth (Fig.1 red dashed line), the initial osteotomy will be created mesially (Fig.2 red arrow), followed by change in trajectory (Fig.3). 

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Xin Wei, DDS, PhD, MS 1st edition 09/30/2019, last revision 09/30/2019