Dental Education Guide

Procedure detail

Front-Tooth (Anterior) Implants: The Hardest Implant to Hide

Replacing a single front tooth with an implant is technically the most demanding case in implant dentistry. This guide explains why — and what a high-quality anterior implant plan looks like.

Reading time
9–11 min
Medically reviewed
Reviewed by a licensed dentist
Last updated
2026-06-01

Written by

Dental Education Guide Editorial Team

Editorial team

Medically reviewed by

Medical Review Board (External Clinical Advisors)

Medical review

Editorial review

Evidence Review Lead

Editorial review

Last reviewed:
2026-06-01
Last updated:
2026-06-01
Reading time:
9–11 min
Version:
1.0

Overview

Functionally, a front-tooth implant is easy: anterior loads are light. Aesthetically, it is the hardest case in implant dentistry. The gum line above an upper incisor sits on a paper-thin shelf of bone called the facial cortical plate. Lose 1–2 mm of that bone and the gum recedes; the implant crown ends up visibly longer than the natural neighbour, with a grey shadow at the margin. Avoiding that outcome is the entire challenge.

Why the front is uniquely difficult

The facial bone over an upper incisor is often less than 1 mm thick and depends entirely on the root for its blood supply. When the tooth is extracted, that bone resorbs predictably in the first 3–6 months. Without active preservation, 40–60% of horizontal ridge width can be lost. Once gone, it is much harder to rebuild aesthetically than to preserve in the first place.

Techniques that protect the result

  • Immediate placement with socket preservation in carefully selected cases: intact buccal plate, thick biotype, no acute infection.
  • Connective tissue graft at the time of placement or uncovering to thicken the soft tissue.
  • Platform-switched, narrow-platform implants placed slightly palatal to protect facial bone.
  • Provisionalisation with a screw-retained temporary crown to shape the gum (the "emergence profile") before the final crown.
  • Custom abutments in zirconia or pink-anodised titanium to avoid greyness through thin gum.

A typical anterior workflow

  1. Atraumatic extraction (often with periotomes or piezo) preserving the buccal plate.
  2. Immediate or delayed implant placement based on the buccal plate, biotype, and infection status.
  3. Socket grafting and primary closure or a custom healing abutment.
  4. 4–6 month integration period, often submerged.
  5. Screw-retained provisional to shape the gum for 8–12 weeks.
  6. Final impression and custom abutment + crown.

Frequently asked questions

Scientific references

  1. 1. Moraschini V, Poubel LA, Ferreira VF, Barboza ES. (2015). Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 44(3):377-88. View source
  2. 2. International Team for Implantology. (various). ITI Consensus Conference Proceedings. ITI. View source