How would you remove this impacted tooth and place implants?

A 60 yr old pt coming for the implant consultation. An impacted canine was noted after taking CBCT.
How are you going to remove this impacted tooth? Any advice/precautions?

Andy comments:

Don’t remove the canine..,

Dr.Herman Comlekci BScDDS comments:

Extract the canine, Buccal approach, use a Piezo bone/surgery unit and surgical burs ie 702 . Place your Implant and graft the defect with allograft mineralized bone chips and cover with collagen membrane. I've treated many of these cases with great success. Good luck.

Tim comments:

Great question and IMHO there is no right or best approach. I think doing it in 2 stages would be safe and yield a satisfactory result and it could also be done in a single stage. As is frequently the case on this forum someone is quick to suggest their preferred bone grafting protocol and no comment regarding the quality/quantity of surrounding soft tissue. My experience has been that buccal impacted canines usual lack gingiva. Another suggestion, and certainly the safest, is to refer.

Dr spec. Ivona Bjenjas comments:

In my career I have put at least dozen of implants through impacted teeth and I have never had any problem. So you can do it through impacted tooth but you need very sharp burs cause you will be drilling through enamel and dentin, also lot of cooling on 100%. Here is one of mine case report... https://www.beogradskiosmeh.com/unconventional-implant-placement-through-impacted-maxillary-canine-a-case-report/

Greg Kammeyer, DDS, MS comments:

I agree with Dr Herman. I am concerned that if you have to ask about it, then you may want to stage the case. A piezo isn't essential.