After the tooth loss, there is a progressive involution of the alveolar bone both in the horizontal and the vertical dimensions [1, 2]. Moreover, the most rapid reduction in the alveolar bone after tooth extraction occurs during the first 3 months [3, 4]. Implants immediately positioned in alveolus after the surgical extraction of the tooth exhibit a success ranging from 92.7 to 98.0% [5]. Some authors suggested that immediate implant placement may counteract the bone remodeling process and preserve the dimension of the alveolar ridge [6,7,8]. However, multiple animal investigations have failed to support this hypothesis [3, 9]. In this sense, studies by Araújo et al. [3, 10] found a pronounced resorption of the buccal and lingual bony walls after immediate placement in fresh extraction sockets. In long-term observations, no significant differences in the success and esthetic outcomes have been reported between immediate and delayed implants [11,12,13].

The surgical requirements for ideal immediate implants in fresh alveolus include atraumatic tooth extraction, preservation of the extraction socket walls, and thorough alveolar curettage to eliminate any possible pathological material [14, 15]. Also, primary implant stability is also an essential requirement and is achieved through the use of implants that exceed the alveolar apex by 3–5 mm or by placing a dental implant with a greater diameter than the alveolar socket [16, 17]. Gehrke et al. [18] demonstrate that the stabilities of the implants placed into fresh extraction sockets or at healed alveolar sites exhibited similar ISQ value evolutions across the three investigated time points (0, 90, and 150 days).

Non-submerged implants showed comparable clinical results to submerged implants and resulted in higher patient satisfaction due to decreased surgical intervention [19]. In this regard, Abrahamsson et al. [20] compared the mucosa and the bone tissue surrounding implants non-submerged or submerged and observed that parameters such as the length of the barrier epithelium of the peri-implant mucosa, the height of the zone of connective tissue integration, the level of the marginal bone, and the density of bone between threads were almost identical in the two experimental groups at the end of the healing period.