Severe buccal plate atrophy occurs after #19 extraction with socket preservation (Fig.1).  How to prevent it?  In fact the buccal crest at #18 (Fig.1,2 B) is inherently lower than the lingual one (L) by ~ 4 mm before extraction.  After extraction (Fig.3 black), an implant (green) is placed 2 mm subcrestal lingual, while supracrestal buccal 2 mm. 

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Xin Wei, DDS, PhD, MS 1st edition 10/13/2019, last revision 10/13/2019