SupplementPages 17-27, Language: EnglishChu, Stephen J. / Östman, Pär-Olov / Nicolopoulos, Costa / Yuvanoglu, Petros / Chow, James / Nevins, Myron / Tarnow, Dennis P.A prospective cohort clinical study was performed to evaluate the concept and design of a novel macro hybrid implant placed into maxillary anterior postextraction sockets. Thirty-three patients with an equal number of hybrid implants were used to replace nonrestorable single anterior teeth with immediate tooth replacement therapy (immediate implant placement and immediate provisional restoration). The macro features of this hybrid implant are unique in geometry, as it combines two different shapes-a cylindrical coronal and tapered apical portion-into a singular body design, each comprising roughly half of the implant length. The hybrid design of this platform-switched implant also has a subcrestal angle correction, or Co-Axis feature, that facilitates screw-retained restorations. Mean implant survival at 1 year relative to primary stability, labial bone plate thickness with socket grafting at two reference points (L1 and L2), tooth-to-implant interproximal bone crest thickness, and pink esthetic score (PES) were evaluated. A mean insertion torque value of 65 Ncm (range 45 to 100 Ncm) was reached with the use of the tapered apical half of the implant body. No implants failed during an average healing period of 1 year. A labial plate dimension between 1.8 and 2.1 mm was attained immediately posttreatment and remained stable over time. A toothto- implant interdental bone crest distance and dimension of 2.3 to 2.6 mm was reached; it was also sustained at the 1-year follow-up. The average PES was 12.5 (range 9.0 to 14.0), with nearly 90% of treated sites with an "almost perfect" score. This macro hybrid implant in concept and design may be useful in immediate tooth replacement therapy of maxillary anterior postextraction sockets to achieve successful implant survival and esthetic outcomes, specifically labial plate and papilla preservation without midfacial or interdental tissue loss and discoloration.