This case study and technique video demonstrates the case planning, extraction, osteotomy preparation, and immediate placement of a 4.0 x 8.0mm implant with a 2.5mm well for a maxillary lateral incisor. Additionally, the technique of changing the Pilot Drill trajectory while drilling on a slope is demonstrated. This technique facilitates ideal implant placement. For the preparation of the osteotomy, Hand Reamers were used with a Threaded Instrument Adapter, which offers better control — especially in thin bone.