## 1 Introduction  
Immediate implantation is a popular topic in the current dental literature. One reason to place implants at the same time as extraction is to prevent remodeling of the bone in both the horizontal and vertical dimensions. Some authors consider this procedure unpredictable in terms of aesthetics because maintenance of the buccal plate height and width is not always guaranteed [1]; in other words, an immediate implant will not necessarily prevent natural bone remodeling. This is why they suggest letting the body heal first, with natural remodeling, and resuming work later, when the situation is stabilized, and known techniques can be used to restore volume in both hard and soft tissue. In many other studies, the authors promote immediate post-extraction implantation, because this technique seems to be able to preserve the soft and hard tissue after extraction [2; 3; 4; 5]. However, there are some specific clinical situations, such as the extraction of molars, in which it is very difficult to insert an implant immediately. A paper by [PERSON] et al. [6; 7; 8; 9] describes a new technique to preserve the bucco-lingual volume of bone after tooth extraction. In this technique, healing by secondary intention results in a good quantity and quality of keratinized gingiva along with a good quality and density of newly formed bone. They suggested using three layers of pericardium membrane to seal the alveolar socket and showed that this technique would allow the preservation of a good quantity of bone. When dealing with the upper anterior area, where the volume of buccal bone is often very thin, a staged approach may be wiser. Another approach, which has become quite popular in recent years, involves preserving part of the tooth to protect the thin buccal plate and prevent resorption of the bundle bone. This approach is called the socket shield technique (SST), and it has been revised under different names by many authors [10]. The SST involves extracting only the palatal aspect of the hopeless tooth, leaving the buccal portion of the root to support the buccal plate and prevent remodeling. The implant is placed more palatally so that the gap between the root remains and the fixture is filled with blood clots, later turning into new bone formation and providing osseointegration for the implant. There is a line of thought suggesting that after tooth extraction, it is necessary to place a bone graft into the socket along with the implant [11; 12; 13; 14; 15; 16; 17]. Many authors have suggested placing immediate implants with the addition of autogenous bone grafts [18], biomaterials, or a combination of both [19; 20; 21]. Studies have proven that these procedures are effective, but other authors have criticized the quality of the newly formed bone achieved with such procedures, especially when the density and elasticity of the new bone are taken into account. Ultimately, the quality and quantity of new bone depend on many different factors, such as the origin of the graft, the dimensions, and the way in which the biomaterial can provide new bone regeneration [22; 23; 24]. The gap between the implant and the walls of the implant socket can be filled with many different kinds of bone substitutes, and the resulting new bone can differ depending on the material used [25]. It is not clear whether it is useful for the final result and the integration of the implant to insert something inside the socket along with the implant. This paper evaluates a new topic: whether it is possible to avoid socket remodeling by focusing our attention on the outer portion of the alveolar socket. In fact, bone remodeling was revisited in a study by [PERSON] et al. looking at what happens to the outer portion of the extraction socket rather than the inside [26]. The authors reported that upon extraction, they placed a PTFE membrane between the perisoteum and the buccal plate without adding any graft or biomaterial into the socket, and this process led to uneventful healing with good maintenance of the overall volume.