For successful aesthetic and functional outcomes, implants need to be placed in the proper three-dimensional position in relation to the desired final prosthetic tooth position. The hard and soft tissue changes that take place following tooth extraction often poses challenges to the clinician in achieving the goal of ideal implant position. Frequently, bone augmentation procedures are required to optimise the site. In this lecture, the biological and dimensional changes that take place following tooth extraction will be presented. In addition, the two approaches for bone augmentation will be discussed - the simultaneous approach and the staged approach. The discussion will also focus on the advantages and risks of immediate implant placement.