This article describes the combined use of the immediate dentoalveolar restoration (IDR) technique and the osseodensification implant site preparation method to improve immediate implant primary stability in periodontally compromised extraction sites. Positioning of soft and hard tissues was evaluated in two clinical cases in which the IDR technique and the osseodensification implant site preparation method were used to replace teeth at sites with severe alveolar bone loss. The results were analyzed by clinical assessment, photography, radiography, and computed tomography scans. Based on this preliminary study, the use of osseodensification can enhance the results achieved using the IDR technique due to improved primary implant stability, as measured by higher insertion torque.