After tooth extraction, the alveolar ridge will commonly decrease in volume and change morphologically. These changes are usually clinically significant and can make placement of a conventional bridge or an implant-supported crown difficult. If bone resorption is significant enough, then placement of an implant may become extremely challenging. Postextraction maintenance of the alveolar ridge minimizes residual ridge resorption and, thus, allows placement of an implant that satisfies esthetic and functional criteria. Recent advances in bone grafting materials and techniques allow the dentist to place implants in sites that were considered compromised in the past. This article focuses on the healing pattern of sockets, with and without the use of regenerative materials, and the rationale for preserving the dimensions of the extraction socket. Histologic and clinical evidence is reviewed to provide an in-depth understanding of the logic behind and value of socket preservation.