Esthetic Management of Single Implants in the Anterior Area: From Surgical Planning to Digital Prosthetic Workflow
Carmen López-Carriches
*
Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
Cristina Madrigal-Martínez-Pereda
Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
Cristina Meniz-García
Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
Isabel Leco-Berrocal
Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
*Author to whom correspondence should be addressed.
Abstract
Restoration of a single missing tooth in the maxillary anterior region requires coordinated surgical, periodontal and prosthetic planning because implant survival alone does not ensure an acceptable aesthetic outcome. Successful treatment depends on recreating stable peri-implant soft-tissue architecture, preserving buccal volume, and reproducing natural crown form, colour and texture. This review synthesises the clinical principles governing three-dimensional implant positioning, timing of placement, minimally invasive surgery, hard- and soft-tissue management, immediate provisionalisation, and emergence-profile development, while integrating these elements with a contemporary digital prosthetic workflow. Particular emphasis is placed on prosthetically driven planning, careful selection of candidates for immediate implant placement, risk-based use of connective tissue grafting, and controlled modification of provisional restorations. The digital workflow combines CBCT, intraoral scanning, virtual planning, scan bodies, and CAD/CAM procedures, but its accuracy remains dependent on correct clinical execution. Transfer of the emergence profile is a critical stage because peri-implant tissues may collapse after provisional restoration removal; scanning the provisional restoration or using indirect digital transfer techniques can help preserve the clinically established contour. A reproducible sequence from diagnosis to definitive restoration can therefore support tissue stability, minimise aesthetic complications, and improve communication between clinician and laboratory. Digital techniques enhance planning and transfer but do not replace clinical judgement, accurate implant positioning, or appropriate management of hard and soft tissues.
Keywords: Dental implants, aesthetic zone, anterior maxilla, immediate implant placement, immediate provisionalization, emergence profile, connective tissue, intraoral scanning, scan body, digital workflow, peri-implant aesthetics