Bothering tooth #30 with big apical lesion. Bone destruction is shown on panoramic, PA, and CTCB. The most predictable outcome is reached when the procedure is performed in several steps: First, I did an a traumatic extraction, complete removal of chronic lesion and ridge preservation w/ bone grafting and no resolvable membrane. Suture and membrane were removed in 3 weeks. After 3 months another CTCB was taken, and I placed a bone level tapered 5.2x11.5 implant. Now I have to wait about 4 months to start the final rehabilitation. It is not wasting time. It’s getting the highest implant treatment survivor rate. If having healthy bone is needed, as important or even more is getting enough keratinize tissue. Furthermore, it’s crucial placing a no restorable membrane which preserves grafted bone and allows keratinize tissue growth.