This case series evaluated bone dimensional changes following the application of an occlusive titanium barrier on severely resorbed fresh extraction sockets to achieve bone regeneration. Six extraction sites with buccal bone loss were filled with a xenograft and covered with a titanium plate fixed by two miniscrews and left intentionally exposed. No infection occurred. After 4 months of healing, sufficient hard tissue had formed to allow implant insertion. Mean vertical bone gain was 7.3 ± 2.2 mm at the buccal side and 4.2 ± 1.2 mm at the lingual side. The average bone width augmentation was 23 ± 1.0 mm. At 24 months, all implants were clinically successful. Based on these preliminary findings, occlusive titanium barriers without primary closure may be successfully used in immediate alveolar reconstruction procedures.