 Background and Objectives A recent systematic review investigating dimensional alveolar bone changes after insertion of post-extraction implants reported that there is a lack of randomized controlled trials that would serve as a scientific base for building clinical guidelines on alveolar site treatment after insertion of post-extraction implants. Different studies suggest that insertion of post-extraction implants should be performed after fully elevating a flap and inserting bone graft in the residual space between the implant surface and the alveolar socket. Other investigations report insignificant differences between open flap and flapless approaches, whereas the insertion of bone grafts remains controversial. 