The placement of dental implants into fresh extraction sites has been performed for more than 20 years. There are numerous advantages in this treatment modality for both patient and surgeon. Utilisation of molar sites has only more recently been gaining in popularity.

The quest is to provide patients with a replacement tooth in the shortest time possible without compromising the biological rules governing the healing process. The fresh extraction socket is a biologically active area promoting osseous healing. The surgical site is patent and the area available for the insertion of a root-form titanium dental implant. Success is dependant on the ability to obtain adequate initial primary stability of the implant.

The multirooted molar teeth provide a reduced volume of bone in which adequate insertion torque can be achieved. The proximity of anatomical structures such as the inferior alveolar nerve and the maxillary sinus add to the challenge. Techniques describing utilisation of tissue beyond the apices of these teeth is therefore also limited.

Judicious use of the inter-radicular bone can often overcome the anatomical limitations of immediate implant placement into fresh molar extraction sites. Tips and traps assisting the surgeon in implant placement to improve the predictability of this technique will be presented.

Conflict of interest: None declared.