The architecture of molars is intricate; the orientation and positioning of the implant is influenced by the root's location and the socket's structure during immediate implantation surgical techniques. The large socket size facilitates the positioning of wide-diameter implants within the inter-radicular bone at the centre of the multi-rooted socket, while the implant reduces the size of adjacent voids, thereby decreasing the requirement for grafting materials. Application of ultra-wide diameter implants in immediate molar replacement is widely accepted and exhibit minimal bone loss and maintain stable soft tissue conditions over a period of 7 years[1-2].

Conventional healing abutment placement is not appropriate for these broad extraction sockets, which are difficult to seal without mucoperiosteal flap reflection and the crestal socket shape. The use of surgeon-fabricated screw-retained temporary restorations is advantageous for improving gingival contours and achieving desirable aesthetics [3a].

Custom immediate posterior healing abutments provide support for local anatomy during osseointegration and allow direct access to the implant during the restorative phase.
Post-osseointegration, the result is an anatomical representation that mimics the growing profile of real teeth, allowing precise laboratory replication of the final abutment.
This method provides all the advantages of implant provisionalization [3a].

This clinical case illustrates the treatment of a molar by immediate extraction and implantation followed by placement of a sealing socket abutment (SSA).

The patient was diagnosed by 3D CT scan and radiograph during a routine control of a classic first molar.  The clinical signs necessitated tooth extraction followed by immediate implantation, socket gap filling and placement of a sealing socket abutment to support anatomical structures.