This paper demonstrates that an intact extraction socket is not necessary for the successful integration of a titanium implant fixture. Several case reports are used to describe the immediate placement of fixtures into compromised sockets, some in conjunction with bone grafting and/or guided tissue regeneration techniques to enhance the surgical result. Advantages of immediate implant placement are threefold: (1) treatment time is significantly reduced; (2) ridge contour can be preserved; and (3) it is possible to place the fixture in a more ideal axial position, thus enhancing fabrication, esthetics, and biomechanics of the subsequent restoration.