There is a need for the evaluation of the long-term response to xenogeneic extraction socket grafting. In this case report, two maxillary incisors were extracted, and the sockets were filled with a xenogeneic bone substitute to counteract postextraction volume loss. Three years after tooth extraction and ridge preservation, there was ample bone volume to insert two implants. Histologic and histomorphometric analysis of trephine drill biopsy specimens provided evidence of new bone formation and biologic integration of the bone substitute. The results confirm the benefit of ridge preservation techniques and give insight into the histologic long-term results after socket filling.