This article aims to evaluate the effect of anatomically designed, single-unit provisional restorations on soft tissue preservation following immediate implant placement. Patients in need of a single-tooth replacement in the esthetic area were recruited for this study. An immediate provisional restoration with a transmucosal area anatomically designed to support the soft tissue was used for every patient. The horizontal volumetric tissue changes and the presence and amount of vertical recession were measured at baseline (T0) and after 1 month (T1), 3 months (T2), and 6 months (T3). Sixty-three patients received 66 implants that were placed into fresh extraction sites. The average follow-up time was 48 months (range: 24 to 60 months). All implant restorations were successful, and the cumulative implant survival rate and success of restorations was 100%. After 6 months, the mean horizontal ridge measured midbuccally had increased by 0.10 ± 0.10 mm at 1 mm from the free gingival margin, had decreased by 0.09 ± 0.10 mm at 3 mm, and had decreased by 0.20 ± 0.10 mm at 5 mm. In addition, the mean recession at the midbuccal surfaces was 0.04 ± 0.37 mm. Measurements were made clinically and compared to measurements made on the casts. According to the results of this study, the use of customized anatomically designed immediate provisional restorations following single-tooth extraction and immediate implant placement appeared to minimize the loss of tissue volume that results from postextraction bone remodeling, thus optimizing the final esthetic result.
