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PURPOSE: To retrospectively evaluate peri-implant bone loss and health status associated with the long-term use of laser surface-treated implants. METHODS: For control study, total of 23 titanium ASTM F136 grade 23 implants were placed in the edentulous molar area of the mandible. When the Implant Stability Quotient (ISQ) ≥ 70 and insertion torque value (ITV) ≥ 35-50 Ncm at the insertion site, an immediate provisional restoration was connected to the implant within a week after surgery. The definitive restorations were placed 2 months after surgery for all implants. 13 implants were immediately loaded, while 10 implants were conventionally loaded. For comparative study, Radiographs were taken from third years for and then annually for the subsequent eight years to monitor marginal bone loss. RESULTS: After eight year of implant installation, the average change in vertical bone loss was 0.009 mm (P < 0.001), while the average change in horizontal bone loss 8 year after implant placement was 0.026 mm (P < 0.001). The mean marginal bone loss was < 0.2 mm on average. CONCLUSIONS: In this retrospective study, laser-treated implants exhibit a low rate of bone absorption around the implants.

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Implant-supported complete dentures are a common procedure for patients with mandibular edentulism problems. This article documents the protocol for immediate functional loading of fixed transient mandibular prostheses with fully moldable attachments and distal extensions to prevent fractures. A 56-year-old female patient was referred to the Oral Rehabilitation and Implantology Service due to periodontal problems, difficulty in chewing capacity and aesthetic compromise. The patient was treated in a single surgical procedure with dental extractions, guided regularization of the alveolar process and guided placement of five interforaminal implants and placement of functional fixed mandibular prostheses with immediate loading with personalized UCLA'S, distal extensions and short arc occlusal scheme. At 3 months postoperatively, the definitive placement of fixed mandibular metal acrylic prostheses and conventional upper prostheses was performed. The functional and aesthetic integrity of the fixed mandibular prosthesis implant preserved with UCLA'S documents that implant placement in the interforaminal zone with an immediate loading protocol is a viable treatment option for prosthetic rehabilitation of the fully edentulous mandibular arch and that design with distal extensions in the posterior sector of the mandibular arch is an effective option to avoid fracture of the prostheses, presenting a survival of the five mandibular implants of 100% at 1 year postoperatively.

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OBJECTIVES: To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional. MATERIALS AND METHODS: Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05. RESULTS: Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation. CONCLUSIONS: Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.

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OBJECTIVES: Evaluate the 5-year safety and efficacy of a narrow-diameter (3.0 mm) implant that was immediately provisionalized with a single crown in the maxillary lateral incisor or mandibular central or lateral incisor area. MATERIALS AND METHODS: An open, prospective, single-cohort, multicenter study was conducted, in which narrow-diameter implants were placed in fresh, healed extraction, or congenitally missing sites. All patients were required to meet strict criteria for immediate loading. The primary endpoints were marginal bone levels (MBL) and MBL changes (MBLC) from implant placement to 5-year follow-up. Secondary endpoints included cumulative 5-year survival and success rates, soft tissue health, and esthetic parameters. RESULTS: A total of 91 implants were placed in 77 patients. The mean MBL remained stable from the 1-year (- 0.79 ± 0.73 mm, n = 75) to 5-year (- 0.74 ± 0.87 mm, n = 65) follow-up. A marginal bone gain of 0.11 ± 0.83 mm was observed from the 1-year to 5-year follow-up. The cumulative 5-year survival rate was 96.5%, and the cumulative 5-year success rate was 93%. The clinical parameters, including the modified plaque index, modified sulcus bleeding index, Jemt's papilla index, and pink esthetic score improved throughout the 5-year study. CONCLUSIONS: The study demonstrated that narrow-diameter implants represent a safe and predictable treatment option for subjects suitable for immediate loading and with limited bone volume or limited inter-dental space. CLINICAL RELEVANCE: Narrow-diameter implants with immediate provisionalization can be considered for use to restore missing or damaged teeth with predictable functional and esthetic outcomes. This trial was registered with ClinicalTrials.gov (NCT02184845).

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In the significant atrophic jaws, it is difficult to place dental implants since there is a qualitative and quantitative shortage of future implant beds. Basal implants, also known as cortical or bicortical implants, offer a viable alternative for dental rehabilitation in patients with significant alveolar bone loss. These implants are anchored in the dense basal bone, providing immediate stability and allowing for immediate loading, thereby reducing overall treatment time and eliminating the need for extensive bone grafting procedures. This case report demonstrates the efficacy of basal implants in providing immediate functional and aesthetic restoration for patients with significant alveolar bone loss, by describing a 49-year-old patient who presented with severe alveolar ridge resorption, making traditional implant placement unfeasible. Basal implants were successfully placed, and an immediate prosthesis was delivered, resulting in excellent functional and aesthetic outcomes.

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Background/Objectives: The insertion of dental implants using dynamic 3D navigated surgery while applying immediate function protocols for full-arch rehabilitations warrants further research. This study aimed to evaluate the outcomes of All-on-4® rehabilitations using 3D Dynamic navigated surgery (X-Guide™). Methods: This study included 10 patients (women: 7; men: 3; average age: 59.9 years) rehabilitated with full-arch prostheses through the All-on-4® concept, with 48 dental implants inserted using navigated surgery. The primary outcome evaluation was prosthetic/implant cumulative survival (CS), estimated using life tables. Secondary outcome evaluations were marginal bone resorption (MBR), biological complications, and mechanical complications. The evaluation parameters were measured between 1 and 3 years. Results: No patients were lost to follow-up. Two implants (4.2%) were lost in one patient (10%) with smoking habits, resulting in an implant CS rate of 95.8%. The average MBR was 0.51 mm ± 0.62 mm at the 1-year follow-up. The incidence rate of mechanical complications was 40% (n = 4 patients), all occurring in provisional prosthesis. No biological complications were registered. The patients maintained their prostheses in function throughout the follow-up of the study. Conclusions: Within the limitations of this study and based on the results, it can be concluded that the insertion of dental implants assisted by dynamic navigation for full-arch rehabilitation through the All-on-4® concept may be a valid treatment alternative in the short-term follow-up. However, more studies are necessary to validate this treatment modality.

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PURPOSE: This prospective case series aimed to investigate the effect of vertical alveoloplasty on the changes in keratinized mucosa width (KMW) following full-arch immediate implant placement and rehabilitation. MATERIALS AND METHODS: A total of 17 potential edentulous patients were enrolled and received implant placement and full-arch implant-supported immediate rehabilitations. The main outcome was to analyze the effect of vertical alveoloplasty on the changes in KMW. The amount of vertical alveoloplasty during implant surgery as well as the changes in KMW at buccal aspects from the day of surgery to 6 months post-surgery were recorded on the implant-level using a periodontal probe. The secondary outcome was to analyze the other possible factors that affected the changes in KMW. The included factors were the initial KMW, the distribution of implants in the maxilla and mandible, the distribution of implants in the anterior and posterior regions, the distribution of implants in extraction sockets and healed ridges, and gender. Mann-Whitney non-parametric tests and multiple linear regression adjusted by generalized estimating equations (GEE) were used to statistically analyze the data. RESULTS: A total of 121 implant positions were analyzed. The KMW was 4.1± 2.0 mm on the day of the surgery and 4.1± 1.7 mm 6 months post-surgery. The mean changes in KMW following 6 months were -0.1± 1.6 mm (p = 0.824). From the results of GEE, the vertical amount of alveoloplasty had no significant effect on changes in KMW. Both initial KMW and the distribution of implants in the anterior and posterior regions had significant impacts on the changes in KMW (p < 0.0001). CONCLUSION: The amount of vertical alveoloplasty during implant surgery has no significant impact on the KMW. The KMW remained stable from baseline to 6 months after alveoloplasty, implant placement, and immediate rehabilitations in potential edentulous arches. The initial KMW and the distribution of implants in the anterior and posterior regions were the possible factors affecting changes in KMW.

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This report describes a step-by-step staged digital protocol for the terminal dentition patient using a Provi-guide. This protocol will improve implant placement accuracy, shorten treatment time, and assure an implant-supported fixed complete denture immediately loaded after extraction of the remaining terminal dentition and complete edentulism. The novelty of the Provi-guide technique described is that it serves 2 objectives: (1) a nonlimiting surgical guide, and (2) a fixed interim prosthesis. Implants placed in the described digital stagged protocol can serve both the interim and the final prosthesis.

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PURPOSE: As the population gets older, the prevalence of complete or partial tooth loss is increasing, significantly impacting people's quality of life. Scientific research demonstrates that implant-fixed complete dentures offer high levels of satisfaction. In certain cases, tooth loss can lead to significant bone atrophy, necessitating pre-implant bone reconstruction. We conducted a retrospective cohort study involving 43 arches, including or not bone grafts, rehabilitated using a stackable guided approach, which included an immediate loading protocol. The primary outcome measure was the survival rate of the implant at 4 months. MATERIAL AND METHODS: The digital workflow helps the design of the provisional prothesis before the implant surgery, which will be loaded immediately after the implant's placement. The stacked guides integrate both surgical and prosthetic considerations into a digital workflow. RESULT: A total of 284 implants were placed. After a 4-month follow-up period, 10 implants (3.5%) exhibited no osseointegration and were subsequently replaced, resulting in an overall success rate of 96.5%. After 1 year of follow-up, a prosthetic success rate of 100% was observed, with all patients being able to progress to the stages for the permanent fixed dentures. CONCLUSION: Our findings support the use of this protocol for all patients, whether they require bone grafts or not. However, a long-term follow-up is essential for a comprehensive evaluation of these treatment outcomes.

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This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone-level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health-related quality of life (OHRQoL), and patient satisfaction at a 2-year follow-up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone-level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant-supported screw-retained complete porcelain-fused-to-metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2-year follow-up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone-level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition.

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PURPOSE: To evaluate, within a period of 5 years, the bone level in mesial, distal, palatal, and buccal areas around scalloped shape implants immediately placed and loaded with temporary crowns fixed on final prefabricated abutments, and also to evaluate the thickness of buccal bone. MATERIALS AND METHODS: 18 implants were inserted and loaded immediately using computer-assisted design/computer-assisted manufacturing technology on 18 patients to replace single tooth in the esthetic part of the maxilla. The marginal bone level across the scalloped implant neck was measured mesially and distally using intraoral standardized radiographs after crown fixations and 1, 3, and 5 years later. Cone beam computed tomography para-axial cuts images were used to measure bone level buccally and palatally from the implant neck to the implant-to bone contact after 5 years of loading and to evaluate the thickness of the buccal bone at the implant neck and 4 mm apically, immediately after implant placement and 5 years later. RESULTS: All implants were assessed clinically and radiologically after 5 years. No implant failure was recorded, and the average marginal bone variation on mesial and distal sites was 0.114 ± 0.135 mm at crown cementation, 0.239 ± 0.158 mm 1 year later, 0.233 ± 0.182 mm 3 years later, and 0.180 ± 0.182 mm 5 years later. Our findings indicate that at T0, the average thickness of the buccal bone was 2.27 mm at implant neck M0 (ranging from 1.9 to 2.4) and 2.33 mm at 4 mm apically to the implant neck M1 (ranging from 1.9 mm to 2.9 mm). By T4, the mean had decreased to 1.94 mm at M0 (with a range of 1.7 mm to 2.3 mm) and 2.14 mm at M1 (with a range of 1.8 mm to 2.4 mm). After 5 years the mean changes at buccal and palatal bone for all implants were +0.187 ± 0.52 mm and +0.06 ± 0.38 mm respectively. Minor prosthetic problems were observed over the five years: incisal ceramic chipping occurred in two crowns, and two crowns were replaced for esthetic reasons after one year. No loosening of crowns or abutments was reported. CONCLUSIONS: Scalloped neck implants demonstrated a comparable behavior to regular neck implants with similar designs in an immediate implantation and temporization protocol over a five-year period.

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Titanium implants undergo an aging process through surface hydrocarbon deposition, resulting in decreased wettability and bioactivity. Plasma treatment was shown to significantly reduce surface hydrocarbons, thus improving implant hydrophilicity and enhancing the osseointegration process. This study investigates the effect of plasma surface treatment on bone-to-implant contact (BIC) of implants presenting a nanostructured calcium-incorporated surface (XPEED®). Following a Randomized Controlled Trial (RCT) design, patients undergoing implant surgery in the posterior maxilla received additional plasma-treated (n = 7) or -untreated (n = 5) 3.5 × 8 mm implants that were retrieved after a 4-week healing period for histological examination. Histomorphometric analysis showed that plasma-treated implants exhibited a 38.7% BIC rate compared to 22.4% of untreated implants (p = 0.002), indicating enhanced osseointegration potential. Histological images also revealed increased bone formation and active osteoblastic activity around plasma-treated implants when compared to untreated specimens. The findings suggest that plasma treatment improves surface hydrophilicity and biological response, facilitating early bone formation around titanium implants. This study underscores the importance of surface modifications in optimizing implant integration and supports the use of plasma treatment to enhance osseointegration, thereby improving clinical outcomes in implant dentistry and offering benefits for immediate and early loading protocols, particularly in soft bone conditions.

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An optimal esthetic result is essential for an implant-supported restoration in the anterior zone. In the esthetic zone, providing immediate interim restorations following implant surgery has been proposed as a reliable and desirable treatment approach. A well-contoured interim restoration following implant placement minimizes hard and soft tissue changes in the peri-implant zone. This in turn has the potential to enhance the esthetic outcome and, therefore, patient satisfaction. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the intended final result. This is a report describing the steps involved in recontouring the gingiva to achieve an optimal emergence profile following the immediate loading of a single implant in the esthetic zone.

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AIMS: The aim of this prospective study was to evaluate and compare the implant survival rate, marginal bone levels and prostheses failure rate, of three-unit fixed dental prostheses (FDPs) supported by three vs. two implants immediately loaded in the posterior area. MATERIAL AND METHODS: Partially edentulous patients in need of a three-unit implant supported FDP in the maxillary/mandibular posterior region were recruited and randomly split into two groups: Group 1 with three-unit FDP supported by three implants (Control); Group 2 with three-unit FDP supported by two implants (Test). Implants were inserted and immediately loaded with a temporary FDP. RESULTS: Sixty-three patients were included in the study. A total of 178 implants were placed and immediately loaded (128 maxillary/50 mandibular) to support 74 immediate provisional fixed prostheses (52 maxillary and 22 mandibular) delivered on the same day of implant insertion/placement; 30 in Group 1 and 44 in Group 2. The comparison of three vs. two implants resulted in comparable implant survival rate, marginal bone loss, and prostheses failure rate. All implants healed uneventfully with no adverse clinical and radiographical signs or symptoms except for one implant failure in Group 1 resulting in a cumulative success rate of 99,5%, 98,9% for Group 1 and 100% for Group 2 with a follow-up of 6-to-10 (mean 7 years). Once loaded, the implants remained in function from a minimum of 6 years to 10 years. CONCLUSIONS: Although more studies and larger sample sizes are needed to validate this study, the results showed no difference between the two Groups, demonstrating the potential viability of both clinical options.

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AIM: The objective of this study was to assess marginal bone level around single implants inserted in fresh extraction sockets in the anterior maxillary region and instantly restored with computer-aided design/computer-aided manufacturing customized temporary crowns cemented on the final abutment. MATERIALS AND METHODS: A total of 20 patients (15 females and 5 males, with a mean age of 30 years), where 20 were placed in fresh extraction sockets. After raising a full-thickness flap, atraumatic extraction was performed the implant site was prepared and fixtures were stabilized on the palatal bone wall. The implant location was immediately transmitted to the prepared master model using the pick-up impression coping seated in the surgical guide template. Prefabricated abutments were used as the final abutment on the master model, scanned and the crown was planned using computer-aided manufacturing customized software. Later on 8th weeks, abutments were torqued as per the manufacturer's recommendation, and the final crowns were cemented. Using personalized intraoral radiographs marginal bone level was evaluated mesially and distally to the implant shoulder as a reference at implant placement, 8 weeks, 1, 3, 5, and 10 years after loading. RESULTS: Wholly implants were osteo-integrated positively after 10 years of practical loading, but only 18 were available for clinical and radiological follow-up, and 2 patients with two implants were excluded from the study due to relocation abroad without any implant failure. The average marginal bone loss (MBL) in the current report was 0.16 ± 0.167 mm at crown cementation, 0.275 ± 0.171 mm after 1 year, 0.265 ± 0.171 mm after 3 years, 0.213 ± 0.185 mm after 5 years, and 0.217 ± 0.194 mm at 10 years. CONCLUSION: The strategy of inserting and not removing the final abutment at the time of implant placement facilitates the establishment of adequate attachment of both soft and hard tissues to the abutment surface, ensuring uninterrupted organization of tissue architecture and offers advantages in helping maintain soft tissue maturation and preventing marginal bone level. CLINICAL SIGNIFICANCE: Immediately loaded implants in freshly extracted sockets lead to a significant reduction in marginal ridge resorption. The use of a temporary crown on a prefabricated abutment, exclusive of successive abutment manipulation, proved effective in preserving the primarily founding blood clot and served as a prototype for shaping the soft tissue around the previously wounded gum. How to cite this article: Berberi A, El Zoghbi A, Aad G, et al. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024;25(3):213-220.

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PURPOSE: The objective of the present study was to ascertain the effect of immediate occlusal loading after implant placement on osseointegration and the micro/nanostructure of the surrounding bone. METHODS: After extraction of a rat maxillary right second molar, an implant was placed immediately with initial fixation (2 N< ). The implants were placed to avoid occlusal loading due to mastication, and in the loaded group, a superstructure was fabricated and subjected to occlusal loading. Bone morphometry, collagen fiber anisotropy, and biological apatite (BAp) crystallite alignment were quantitatively evaluated in both groups after extraction and fixation of the jaw bone at Days 7 and 21 after surgery. RESULTS: Osseointegration was observed in both groups. Bone morphometry showed significant differences in bone volume, trabecular number, trabecular thickness and bone mineral density (BMD) at Days 21 postoperatively (P < 0.05). A significant difference was also found in the trabecular separation at Days 7 postoperatively (P < 0.05). In the evaluation of collagen fiber anisotropy, collagen fiber bundles running differently from the existing bone were observed in both groups. In terms of BAp crystallite alignment, a specific structure was observed in the reconstructed new bone after implantation, and preferential orientation of BAp crystallite alignment was observed in the longitudinal direction of the implants in the Day 21 postoperative loaded group. CONCLUSION: When sufficient initial fixation is achieved at the time of dental implant placement, then the applied masticatory load may contribute to rapidly achieving not only bone volume, but also adequate bone quality after implant placement.

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(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome.

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The aim of the presented retrospective study was to evaluate the early crestal bone changes around an implant type designed for high primary stability. A total number of 111 implants placed clinically were evaluated regarding insertion torque, bone density, implant stability quotient (ISQ) and early crestal bone loss from standardized digital radiographs. The implants were allocated in two groups: the "regular torque " group contained all implants that achieved less than 50 Ncm as final insertion torque (n = 63) and the "high torque" group contained the implants that achieved 50-80 Ncm (n = 48). To avoid possible damage either to the implant´s inner connection or to the bone by application of excessive force, a limit of 80 Ncm was set for all surgeries. All implants underwent submerged healing for three months. ISQ measurements and standardized digital radiographs were taken at day of insertion and at day of second stage surgery. The bone loss was measured on the mesial and distal aspect of the implant. The data evaluation showed the following results: Mean bone loss was 0.27 ± 0.30 mm for the high torque group and 0.24 ± 0.27 mm for the regular torque group. The difference was not statistically significant (p = 0.552). In the two groups, no complications nor implant loss occurred. For the evaluated implant type, there was no significant difference in crestal bone changes and complication rate between high and regular insertion torque in the early healing period.

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In edentulous arches, alveolar ridge atrophy after tooth extraction is a common problem that affects patient comfort and quality of life. Implant-supported fixed restorations are a well-proven treatment option for edentulism. The concepts of implant dentistry have developed over time to produce better aesthetics and functional results. To reduce cantilever length and enable prostheses with 12 teeth, the all-on-four technique entails inserting two anterior implants axially and distally orienting two posterior implants. Compared to conventional loading, immediate loading offers various benefits without compromising quality. An instantaneous fixed provisional allows patients immediate function and preserves their quality of life while also promoting a high degree of patient satisfaction in terms of aesthetics, phonetics, mastication, and psychological comfort.

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Background: This randomized controlled trial aimed to compare the aesthetic outcome and patient perception of immediate versus DL of implant-supported single crowns. Methods: A total of 60 patients with a single missing tooth were enrolled and randomly assigned to two groups: immediate loading (IL) and delayed loading (DL). Each group consisted of 30 patients with a total of 30 implants. In the IL group, crowns were loaded onto implants immediately after placement, while in the DL group, a healing period of 3 months was observed before crown placement. Aesthetic outcome was assessed using the Pink Esthetic Score (PES) for soft tissue and the White Esthetic Score (WES) for the crown. Patient perception was evaluated through a visual analog scale (VAS) for satisfaction, comfort, and overall experience. Results: The IL group demonstrated comparable aesthetic outcomes to the DL group, with mean PES and WES scores of 10.2 ± 1.5 and 8.7 ± 1.2, respectively, in the IL group, and 10.5 ± 1.3 and 8.5 ± 1.4 in the DL group. Patient perception in terms of satisfaction, comfort, and overall experience was similarly high in both groups, with VAS scores above 8 for each parameter. Conclusion: This randomized controlled trial suggests that both IL and DL of implant-supported single crowns result in favorable aesthetic outcomes and high levels of patient satisfaction.