The use of an immediately placed provisional restoration that mirrors the cervical contours of the extracted tooth at the time of implant placement may provide a platform to promote peri-implant soft tissue healing. This study examined the association of sulcular bleeding at the time of initial disconnection of the provisional restoration with stability of the buccolingual ridge dimension following immediate implant placement. Eighteen immediate implants grafted with particulate bone were restored with a screw-retained, single-unit, provisional restoration and abutment. The presence of sulcular bleeding was recorded after 5 to 7 months of healing. Stability of the buccolingual ridge dimension at the level of the free marginal gingiva and 1, 2, 3, 5, 7, and 9 mm apical was estimated using the contralateral tooth as a control. Gingival bleeding was associated with the disconnection of the provisional restoration in 11 (61.1%) of the grafted implant sites. Bleeding upon initial disconnection of the provisional restoration was significantly correlated with smaller changes, or greater stability, in the buccolingual ridge dimension at each reference point from 0 to 3 mm apical to the free gingival margin. The use of anatomically contoured provisional restorations may provide a platform to promote peri-implant soft tissue healing and minimize remodeling of the buccolingual ridge dimension.