This study evaluated the use of autogenous bone grafts for the augmentation of small bone defects adjacent to implants placed into immediate extraction sockets. Fifty-four consecutively placed implants were evaluated in 30 patients (15 men and 15 women). Autogenous bone chips were harvested from bony ledges and protuberances adjacent to the extraction sites. Implants were placed entirely within the alveoli. Defect height was measured from the top of the implant cylinder to the base of the defect; defect width was measured from the top of the cover screw to the buccal crest of the alveolar bone. For buccal dehiscences, defect height and the number of exposed threads were recorded. Autogenous grafts were placed into all defects adjacent to implants. At second-stage surgery, there was an average of 5.4 mm change in defect depth (mean residual depth 0.3 mm) for implants placed entirely within the alveoli. The average change in defect depth for sites with buccal dehiscences was 4.7 mm (mean residual depth 0.6 mm). Changes in defect depth for both groups was statistically significant (P .001). Changes in thread exposure for the dehiscence group was statistically significant (P .001); the average change in thread exposure was 3.7 threads. Similarly, defect width was statistically improved for both groups. To date, 50 implants have been loaded with no loss of implants. The results of this study indicate that localized bone defects adjacent to implants placed into immediate extraction sockets and grafted with autogenous bone will heal with clinically and statistically significant amounts of bone. Keywords: autogenous bone grafts, bone protuberances, harvesting bone, immediate implant placement