In this prospective pilot study on ridge preservation (RP), a collagen sponge was placed to fill the bottom half of the socket, followed by a sequence of bone graft, collagen membrane, and a sponge placed on top. Twelve patients with 13 hopeless posterior teeth were included. Changes in bone dimension (including variations of horizontal ridge width [HRW] and bone height [BH]) between the time immediately postextraction (T₀) and 6 months later (T_6M) were evaluated through CBCT. The soft tissue was assessed using a wound healing index (WHI) at 2 weeks (T_2W), 2 months (T_2M), and 6 months (T_6M) postsurgery. Measured at three parallel levels (1, 3, and 5 mm apical to the crest of the palatal plate), the mean HRW changes (T₀ to T_6M) ranged from 0.47 to 1.05 mm. Statistically significant negative correlations were observed between WHI (T_6M) and midcrestal BH change. This proposed RP technique showed favorable outcomes regarding HRW and BH, even in periodontally compromised dehiscence sockets.