When planned and implemented appropriately, single-unit implant dentistry in the smile zone can be an excellent alternative to attempting to save a failing natural tooth. Historically, implant success has revolved around assessment of osseointegration and the healing of bone around the implant, without much regard for esthetics upon completion. As implant dentistry has evolved, the expectations of both restoring clinicians and patients have expanded to emphasize the esthetic outcome as well as faster treatment with immediate implant placement. Advancements in dental radiography have increased the accuracy of diagnosing and planning, enabling more timely recognition of potential inadequacies and providing more predictable results. Even with the advances in implant dentistry over the past several decades, however, it is virtually impossible to reproduce nature; therefore, every effort should be made to preserve natural dentition. This article, which presents two case reports, will discuss differentiation between surgical success and restorative success of implants in the smile zone, identify key predictive factors associated with restorative implant success, and identify benefits of immediate implant placement.
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