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Objective This study compared the osseointegration of immediate implants in dogs in infection-free sites and in sites with periradicular lesions which were removed by simulated periradicular surgery. Study design Periradicular surgeries were performed to remove intentionally induced periradicular lesions, followed by teeth extraction and immediate implant placement with (experimental group 1) or without (experimental group 2) membranes. In the control group, implants were placed at healthy extraction sockets. After 12 weeks, the animals were killed and the results of histomorphometric study were analyzed by Kruskal-Wallis test. Results Both the control and the experimental implants were clinically acceptable. The control group showed significantly higher bone-implant contact (BIC; 76.03 ± 7.98%) than the experimental groups 1 (59.55 ± 14.21%) and 2 (48.62 ± 20.22%) ( P < .05). Conclusions Despite the lower BIC of the experimental groups, this pilot study showed the possibility that immediate implant placement might be successful in extraction sockets with periradicular lesions. Further studies with larger sample sizes are required.