In recent years, implant dentistry has undergone a profound shift in emphasis. The focus evolved first from a surgically driven approach to a prosthetically driven approach and now to a more biologically driven approach with the goal of optimizing and maintaining esthetics. While traditional implant protocols are well established for management of implants placed in healed edentulous sites, the data available offer little clarity on the factors and procedures for long-term esthetic success, particularly in terms of maintained stable soft tissue outcomes around implant restorations in the esthetic zone. Unfortunately, the 90%+ success rates indicated in most studies of dental implant systems today do not represent the success of the esthetic outcome. This has created a demand-certainly among clinicians in private practice focused on the ongoing maintenance of esthetic outcomes- for clear treatment protocols to achieve esthetic results that are not only predictable and consistent but that can withstand the test of time.