Purpose: To evaluate the alterations of the buccolingual width of the alveolar ridge after immediate implant placement using a fully synthetic biphasic calcium phosphate (BCP) consisting of a mixture of 60% hydroxyapatite and 40% ß-tricalcium phosphate in esthetic regions. Materials and Methods: The buccolingual widths of the alveolar ridge in 20 extraction sites in 20 patients were assessed using computed tomography. Measurements were performed before and 6 months after extractions and immediate implant placement. In group 1 (11 patients), BCP was in the space between the buccal wall of the alveolar ridge and implant. In group 2 (9 patients), the same evaluations and procedures were performed but without using BCP. Results: The buccolingual dimensions of the alveolar ridge in group 1 (BCP) showed no significant preoperative differences (8.49 ± 1.1 mm) during the 6-month period after surgery (8.82 ± 0.9 mm) (P = .14). In group 2, the differences in buccolingual dimensions of the alveolar ridge were statistically significant (P = .01) with reduction in dimensions from 8.12 ± 0.7 mm during the preoperative period to 7.01 ± 0.4 mm 6-months after surgery. Conclusion: The use of BCP was effective in preserving buccolingual dimensions of alveolar ridges in immediate implant surgeries.