Implants placed immediately after tooth extraction have been shown to be a successfully predictable treatment modality. Several clinical papers suggest that placing implants immediately after tooth extraction may provide some advantages: reduction of the number of surgical procedures or patient visits, preservation of the dimensions of alveolar ridge, and shortening of the interval between the removal of the tooth and the insertion of the implant supported restoration.

In this case report, three patients received single immediate implant placements to replace a maxillary anterior tooth at the time of extraction. As the three cases were somewhat different, treatment protocols had to be modified as follows:

Case 1. Immediate implant placement with healing abutment connection.

Case 2. Immediate implant placement with immediate provisionalization.

Case 3. Immediate implant placement with Guided Bone Regeneration(GBR).

Every implant of these cases was placed in proper position buccolingually, mesiodistally and apicocoronally. The procedures following implantation such as immediate provisionalization and GBR were free of problem. Healing of each case was uneventful. In all cases, treatment outcomes were mostly satisfactory and the results maintained during follow-up periods. However, one case (Case 3) showed some papilla loss due to failure in delicate soft tissue handling during surgery. This papilla loss was compromised by prosthetic means.

In conclusion, immediate implant placement in the fresh extraction socket can be a valid and successful option of treatment in aesthetic area. Moreover, this treatment protocol seems to maintain the preexisting architecture of soft and hard tissues in most cases.