Immediate implant placement may represent a possible treatment plan for single tooth restoration. This study evaluated the insertion of osseointegrated implants in intact fresh extraction sockets in the anterior maxilla. The bone-toimplant gap was accurately grafted with a bovine bone mineral prior to implant engagement, and an immediate screw-retained restoration was delivered. After 3 months, the provisional crown was replaced with the definitive ceramic crown. Marginal bone levels remained stable after 1 year. The horizontal ridge dimension was also evaluated at three levels using CBCT scans after 1 year. The horizontal width of the postextraction crest was well preserved independently from the thickness of the buccal bone plate at baseline.