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Immediate implant placement in fresh extraction sockets offers several advantages which include patient comfort, ridge preservation as well as decreased treatment time. Prior to undertaking this therapeutic path, however, clinicians must consider several critical factors that become apparent in a thorough diagnostic protocol. These include socket morphology, apical pathology, deficiencies in the labial plate of bone if applicable as well as biotype. This presentation will highlight the potential complications that can occur during immediate implant placement as well as their clinical management.