Abstract
Immediate implant placement is a predictable clinical practice that offers some advantages over standard delayed implant placement and similar survival rate both in the anterior and posterior areas. However, immediate implant placement in multirooted teeth presents a clinical challenge for the constant drill deflection during osteotomy preparation, which makes difficult implant placement in the center of the interradicular bone. In an effort to solve this problem, a modification to the conventional immediate implant was proposed in the literature, by using the multirooted tooth as an anatomical guide prior to extraction, to ensure a correct three dimensional placement of the implant in the septal bone. The aim of this article is to present this technique with one-year follow-up of pre-extraction immediate implant bed preparation in the area of the left maxillary first molar.