Introduction: The concept of immediate implant placement has become popular due to reduced trauma and reduced overall treatment time. Removal of molar teeth provides a challenging and intriguing dilemma due to multiple root morphology. In cases of extraction and immediate placement of implants in the molar region, removal of the inter-radicular septum should be avoided to attain initial implant stability at the time of placement, and prevent slipping of the implant into the extraction socket. Following this technique prevents the slippage of the implant and allows the implant to be guided into the inter-radicular septum.

Objectives: To assess the accuracy of implant placement using the remaining roots of multi-radicular mandibular molars, evaluate bone density around implants and implant stability in fresh extracted site.

Materials and Methods: A prospective study was done on 10 patients with badly destructed mandibular molars. The technique of implant insertion consisted of a progressive preparation of the implant site using the anatomy of the root of the multi-radicular mandibular molars to be extracted as a reference and as an aid to engage the inter-radicular septum.

Inclusion Criteria:

• Badly destructed mandibular molar teeth.
• Integrity of the roots.
• Bone coverage of 2/3 of the root.
• Sufficient bone volume.
• Adequate interocclusal distance >7mm.
• Adequate amount of keratinized mucosa.
• Age ranging from 20-45 years.
• Medically fit patients.

Exclusion Criteria:

• Unfavorable position of the tooth or remaining roots.
• Molars with Fused roots.
• Root ankylosis.
• Patients with systemic conditions known to affect the periodontal status and healing such as uncontrolled diabetes and osteoporosis.
• Patients receiving chemotherapy or radiotherapy.
• Heavy smokers.