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This clinical decision tree illustrates numerous case scenarios with various esthetic complications around an esthetically compromised, but clinically healthy single implant and provides clinicians with possible solutions as a predictable map for horizontal and vertical soft tissue augmentation in order to manage different clinical circumstances. According to current evidence, the key to treating such esthetic complications is the use of an adequate pre-surgical prosthetic interdisciplinary approach with proper surgical techniques in order to optimize soft tissue dimensions and create better esthetic results. This may be accomplished through a purely surgical, combination of surgical and prosthetic, or purely prosthetic approaches.

The present report describes a series of successfully treated periimplant esthetic complication cases in accordance with the decision-making tree that
the authors recommend in order to achieve better long-term esthetic outcomes

This clinical investigation evaluated a specific surgical/prosthetic protocol for full-arch fixed dental restorations supported by immediate loaded axial and axial and tilted implants in a multicenter cohort study. Evaluation was based on a comparison of the survival rates of axial and tilted implants, as well as the overall prosthetic survival rate. Mid-study results confirmed that immediate loading of axial and tilted implants following the studied protocol provides a viable treatment modality for the rehabilitation of edentulous arches and terminal dentition.

A multicenter cohort clinical investigation evaluated the change in horizontal ridge dimension associated with immediate implant placement and provisionalization in anterior extraction sockets. Following the surgical veneer grafting (SVG) protocol, a combination of a bone and connective tissue graft (CTG) was performed in 37 patients. All 37 implants were successfully integrated, demonstrating stable and healthy peri-implant soft tissues as documented by standard clinical parameters.

Preservation of the surrounding hard and soft tissues associated with an immediate postextraction socket implant to replace a nonrestorable tooth in the esthetic zone is one of the greatest challenges facing the dental team. Several studies have documented the biologic and esthetic benefits of bone graft containment with either a custom healing abutment or provisional restoration.