Factors Affecting Immediate Anterior Implants Esthetics.

This retrospective cohort study evaluates clinical, surgical, and prosthetic factors associated with early and mid-term outcomes of immediate implant placement in the anterior maxilla. The primary objective is to identify predictors of implant survival and complications (e.g., infection, soft-tissue dehiscence, esthetic failure) within 12 months following placement. Secondary objectives include assessment of peri-implant marginal bone loss, prosthetic complications, and esthetic outcomes (pink esthetic score).

Study design: Retrospective observational cohort study using existing patient records and radiographs from IDCE between September 2022 -March 2026. Data extraction will be performed blinded to outcome assessment. Participants: Subjects who received immediate implant placement in the anterior region (canine to canine) during the study period with at least 12 months follow-up. Expected sample size: approximately 500 patients/implants

Inclusion Criteria: * flapless immediately placed implants in esthetic zone with 3 years follow up CBCT, * presence of immediate postoperative CBCT, * initial intact thick gingival biotype with at least 2 mm band of keratinized tissue * thin intact labial bone plate (\< 1mm) extending 7 mm apically assessed by CBCT with good apical bone * patients who had provided an informed consent. Exclusion Criteria: * patients with medical conditions that would compromise the surgical procedures, uncontrolled diabetes mellitus, taking IV bis-phosphonates for treatment of osteoporosis * patients with active infection related at the site of implant and patients with untreated active periodontal diseases.