It is quite challenging to get precise implant placements with absolute parallelism and implants placed in axial lines for better load distribution. It is also important for predictable prosthetic outcomes. In this particular case, the wisdom teeth on both the sides were medially tilted, encroaching the future prosthetic space messy-distally. 38 was extracted before guided implant placement, but 48 was retained for better guide retention and was extracted after the guided surgery. The procedure time was drastically reduced and the implant placements were keyhole and atraumatic. The only areas which needed surgical intervention were wisdom teeth removals.