Immediate Implants: to Graft or Not to Graft, That is the Question.

Inclusion Criteria: * Need for tooth extraction in the anterior maxilla (13-23) due to cavities, internal resorption, fractures, restorative problems, endodontic complications and prosthetic reasons. * The failing tooth has adjacent and opposing natural teeth * Adequate oral hygiene (Bleeding on probing \<20%; Plaque index \<20%); * Absence of active and uncontrolled periodontal disease * Sufficient mesial-distal and interocclusal space for implant placement and definitive restoration * Sufficient interocclusal space to design a non-occluding provisional restoration Exclusion Criteria: * Systemic metabolic or osseous disease that could compromise peri-implant tissue healing. * Acute infection in the treatment area * Absence of one or both adjacent teeth * Non-integrity of the buccal bone wall (dehiscence or fenestration) observed during surgery, or when tooth extraction has altered the integrity of the osseous and gingival architecture