Tooth loss can occur due to several factors including dental caries. Immediate replacement of posterior teeth with dental implants facilitates to plan and to obtain consistent results with good prognosis. Factors such as minimally traumatic extraction, primary implant stability, maintenance of proximal bone ridges, buccal and lingual bone plates, in addition to a temporary or customizable component for tissue stabilization are important parameters to make the case predictable. The immediate technique for implants placement in the posterior regions has been described in the literature since the 1990s, presenting a high success rate and predictability of patients rehabilitation with shorter waiting times and maintenance of soft and bone tissue architecture. This study reports a clinical case of extraction of an upper molar tooth (26) with dental caries and placement of an extra-wide diameter implant, followed by filling of the surgical alveolar socket with bioactive calcium phosphate ceramic and placement of a customizable healing abutment. Clinical and radiographic control was performed after 8 months with success, with maintenance of soft tissue and marginal bone.