Abstract: Molar sites with advanced periodontitis often caused severe bone loss. Maxillary second molar lies in the distal area of the maxillary arch, where oral hygiene is difficult to perform and implant treatments has higher risk. Ridge preservation is performed after tooth extraction to facilitate implant placement by maintaining hard and soft tissue contour. This article presents a case with bilateral maxillary second molars receiving different methods of ridge preservation prior to implant reconstruction at 6 years of function, which provides evidence and clinical experience for the treatment plan and management for such kind of cases.