Primary socket closure in immediate implantation may be difficult, due
to the opening left by the extracted tooth. The absolute need for bon
e augmentation and primary flap closure for implants placed into fresh
extraction sites has never been proven. The hypothesis of the present
study was that immediate implants can succeed without primary flap cl
osure. A technique that does not require any incisions during immediat
e implant placement is described. No barrier membranes were used and t
he sole grafting material used were autogenous bone chips. Full soft t
issue coverage was achieved 1 week to 2 months postimplantation, Clini
cal osseointegration was achieved with minimal gingival recession and
papillae preservation. Immediate implant placement in the anterior max
illa can be successful for replacing a single tooth even without prima
ry closure.