4-year radiographic & esthetic evaluation of peri-implant tissue in immediate implants replacing single teeth in the esthetic zone

Objective: The purpose of this review was to examine how tissue architecture, surgical procedures, implant components and prosthetic factors contribute collectively toesthetic success in the maxillary anterior and premolar region (esthetic zone).Materials and methods: Pubmed, Embase and the Cochrane electronic databases weresearched for prospective human studies that investigate single tooth implants placed inthe esthetic zone. Two reviewers assessed the quality of search results independently.The outcomes assessed include implant survival, complications, and peri-implant softand hard tissue characteristics. Peri-implant soft tissue assessment included probingdepths, bleeding on probing, plaque index, keratinized tissue and papilla index. Hardtissue assessment included measurements made at the time of surgical procedures andradiographic analysis. Studies that measured esthetic outcomes utilizing estheticindexes and self-report were also included.Results and discussion: Of 51 primarily selected articles, 13 studies fulfilled theinclusion criteria. A variety of predictors for esthetic success were evaluated, such asexisting hard and soft tissue architecture, the effect of simultaneous soft and hardtissue augmentation, the use of different implant components and variousrestorative protocols. These factors ultimately influence the final esthetic success in