Immediate implant placement in fresh extraction sockets, with or without immediate provisionalization, is a well-documented treatment concept in contemporary oral implantology. Achieving adequate primary stability is critical in these clinical situations and is influenced by implant macrodesign, particularly in the apical region. While pronounced thread structures can enhance primary stability, coronal and mid-body threading in healed sites with limited ridge dimensions may increase the risk of soft tissue complications when peri-implant bone support is insufficient. This course examines an implant design concept that combines apically located threads for primary stability with a smooth, non-threaded implant body extending coronally to prosthetic platform. This design aims to reduce the need for lateral hard and soft tissue augmentation in narrow or knife-edge shaped alveolar ridges. Throughclinical case presentations, participants will explore indications, biological considerations, and surgical workflows associated with this approach. Emphasis is place on treatment planning, soft tissue management, and the potential to expand implant indications in residual bone while minimizing surgical morbidity.