Forty patients received a total of 43 implants placed in fresh extraction sites in the anterior maxilla. Within 1 week, a provisional crown was placed without occlusal contact. After 1 year, the implant survival rate, marginal bone resorption, and papillae preservation were assessed. The overall survival rate was 95.3%. The 1-year marginal bone loss was not statiscally significant when compared to the marginal bone level at implant placement. In 78% of patients, the papilla was completely preserved. Single-tooth rehabilitation patients with buccal or circumferential defects can be predictably treated with a favorable esthetic outcome using the immediate provisionalization approach.