Purpose: The purpose of this study is to evaluate the clinical and radiographic outcomes of using a wide-body implant with external hex connection (de novo Max® implant, Southern Implants®, Irene, South Africa) to be placed immediately in fresh mandibular first molar extracted sockets. Using a specific surgical technique and evaluating its effect on the oral mucosa and density of surrounding bone by using CBCT.Materials and Methods: We studied 10 patients (all patients were women). Twelve dental implants (ø8.0 mm and ø9.0 mm diameter with 9.0 mm or 11.0 mm length) placed at the time of tooth extraction. The surgical protocol involves a crown sectioning, subsequent shaping within the socket between roots using specially designed dedicated drills with profuse irrigation and then removal of the residual roots before the last bur.Results: Cumulative success rate (CSR) after four months (i.e. osseointegration period) was 91.7%. The mean of HU of bone at immediate placement was 568.42 HU, and increased to 737.75 HU at sixteenth week from implantation, which indicated statistically significant differences (p < 0.05). Conclusion: Use of wide Max implants into posterior area is a reliable procedure over time but needs further investigations.