The mesial surface of the tooth #31 is reduced prior to osteotomy (Fig.1 >) so that the mesiodistal width of the edentulous area is 4.5 mm.  An incision is made instead of tissue punch because of the narrow keratinized gingiva.  The potential osteotomy site happens to have nonkeratinized tissue.  Because of apparently sufficient clearance from the Inferior Alveolar Canal (Fig.2 red dashed line), the implant is placed ~ 1 mm deeper later.  After suturing, periodontal dressing is applied.  At patient's request, a provisional is fabricated with occlusal clerance 26 days postop.  The occlusal surface of the provisional perforates 3.5 months postop with the provisional having pressed the gingiva, which is consistent with crestal bone loss (Fig.3).  Trajectory PA Last Next Xin Wei, DDS, PhD, MS 1st edition 06/01/2018, last revision 01/16/2019