Considerations for avoiding esthetically poor results after immediate replacement

Content
According to a literature search for the period 1990- 2003 by Chen et al., the survival rate did not change if the gap at placement was no greater than 2 mm. From this perspective, over several years now flapless immediate implantation has been enthusiastically embraced for the following advantages: However, according to recent basic and clinical research resorption to a certain extent always occurs from the lateral aspect of the remnant facial bone. These valuable research endeavors were no exaggeration to say that warnings have been sounded about the simple selection of immediate implantation in the esthetic zone. In this lecture I report an analysis intended to elucidate the various effects on postoperative thickness of facial bone and facial gingival contour produced by differences in
(i) implantation procedure,
(ii) gap size,
(iii) type of concomitant treatment, and
(iv) facial gingival biotype
after immediate implant placement for the upper anterior teeth. At the same time, a comparative investigation was performed of postoperative results after concomitant use of delayed implantation and a staged approach. Furthermore, I also discuss treatment concepts and strategies of immediate implantation available at present.