Background: There is a growing tendency to place single tooth implants immediately after extracting a failing tooth in the posterior region. The aim of this prospective case series pilot study was to evaluate immediate implant placement in molar-premolar post-extraction sites during a 1-year follow-up period. and to evaluate the effect of using Autogenous Partially Demineralized Dentin Matrix (APDDM) versus xenograft around Immediate implant. Methods: twelve patients who have bilateral badly decayed tooth in premolar-molar area in a split mouth study. Group I: includes 12 Immediate implant in one side with autogenous partially deminaralized dentin matrix (APDDM) as a grafting material around the implant. Group II : includes 12 Immediate implant in the other side with  Xenograft as a grafting material around the implant. Following parameters will be evaluated before treatment and recorded at baseline and after 6 months Plaque index (PI), Bleeding index (BI), Gingival recession (GR), Probing depth (PD), Conebeam Ct radiograph at baseline,6 month and 12month. Results: Four out of 15 of the mobile implants had to be removed before the 1-year evaluation. The implant and restoration survival rates were 73.3% at the 1-year evaluation (n = 15). The mean marginal bone loss, from loading to the 12-month follow-up, was 0.17 mm (n = 11). The mean plaque, calculus, peri-implant mucosa, bleeding, and pocket probing depth scores were low, depicting healthy peri-implant conditions. The patients were very satisfied. Conclusion: immediate placement of regular diameter implants in molar post-extraction sites of maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period