This prospective case series enrolled consecutively qualifying patients that required immediate dental implant placement in large, uncontained, fresh molar extraction sites using recombinant human bone morphogentic protein-2/ absorbable collagen sponge (rhBMP-2/ACS) combined with mineralized bone allograft. A total of 11 patients with 15 extraction sites missing bony walls were enrolled for treatment in this prospective case series. The clinical and radiographic effectiveness of rhBMP-2/ACS combined with mineralized bone allograft supported healing of immediately placed implants. Implants were uncovered at 4 to 6 months and were clinically and radiographically evaluated for ridge preservation and implant integration. All extraction sites exhibited ridge preservation and implant integration 1 year following restoration.