Immediate dental implant placement in the esthetic zone

A successful aesthetic outcome is suggested to be dependent on establishment of an optimal threedimensional implant position within the available bone dimensions and the maintenance of adequate buccal bone along the implant axis. The size of the bony defect after extraction can be a considerable aesthetic risk for immediately placed implants. The combination of buccal extraction socket defects and thin overlying soft tissues is a considerable aesthetic risk for maintaining an acceptable long-term aesthetic outcome for immediately placed implants, despite ideal placement and synchronous hard or soft tissue grafting procedures. The outcome measure implant survival seems to be hardly affected by timing of implant placement relative to tooth extraction. Thus, as timing of implant placement seems not to be a major factor determining implant survival, the focus in outcome measures shifted towards the dynamics of hard and soft periimplant tissues. Establishment and maintenance of healthy hard and soft peri-implant tissues are crucial,particularly in the aesthetic zone.