The abutment of the "immediate" implant is used to keep an immediate provisional in place.  The provisional covers the sites of #19 (Fig.9) and 18 (arrow).  Perio dressing (D) is applied for further protection and security against graft leakage.

Atypical Immediate Implant

Xin Wei, DDS, PhD, MS 1st edition 05/07/2015, last revision 05/09/2015