The zones in immediate esthetic implantology. From periodontium to peri-implant.

OBJECTIVE: Immediate implant placement and immediate provisional (IIPIP) are widely accepted by patients because they minimize overall treatment time. The aim of the present article is to describe all the zones that could influence esthetic outcomes and provide biologic plausibility of their relevance. CLINICAL CONSIDERATIONS: Six zones are identified in the alveolar postextraction socket: anchorage zone (Zone A), bone compartment (Zone B), clot compartment (Zone C), dermal compartment (Zone D), esthetic zone (Zone E), and fixed restoration (Zone F). Three zones are intra-alveolar (Zones A, B, and C), and three are extra-alveolar (Zones D, E, and F). Zone F (fixed restoration) is further subdivided into F1, F2, and F3. In the present article, the authors explain the effect on the esthetic outcome of these six different immediate implant zones (related to the alveolus and fixed restoration), aiming to elucidate the reasons why immediate implant therapy is effective in transitioning a tooth-gingival complex into a peri-implant complex. CONCLUSIONS: Immediate implants in the esthetic region must be addressed from the perspective of the integration of planning, surgical intervention, and prosthetic restoration. The approach adopted to each area of the tooth to be extracted and its periodontium plays a significant role in the final healing of the peri-implant tissue. CLINICAL SIGNIFICANCE: The topic of IIPIP is highly relevant in the current dentistry scenario due to the growing demand for time-efficient and esthetically pleasing dental treatments. The 'zones' concept provides a detailed analysis of the specific areas that influence esthetic outcomes, offering insights that can refine clinical practice.