Immediate Implant Placement and Provisionalization Without Guided Bone Regeneration or Connective Tissue Grafting: A Case Report

Immediate implant placement in the maxillary esthetic zone remains a challenging procedure, requiring careful case selection and precise technique to achieve optimal esthetic and functional outcomes. This case report describes the successful immediate placement of an implant (Straumann BLX, 3.75 mm diameter, 12.0 mm length; Institut Straumann AG, Basel, Switzerland) in the maxillary right central incisor position following the atraumatic extraction of a vertically fractured tooth. A fully guided surgical approach was used without flap elevation or bone grafting. Immediate provisionalization was performed using a screw-retained provisional crown designed to support soft tissue healing and maintain esthetic outcome. At the six-month follow-up, clinical and radiographic examinations demonstrated successful osseointegration, healthy peri-implant soft tissue, and spontaneous buccal bone regeneration without guided bone regeneration. The provisional restoration maintained excellent esthetic outcomes, with stable gingival contours and no complications. This case demonstrates that immediate implant placement and provisionalization in the maxillary esthetic zone can be successfully performed without bone grafting when appropriate case selection criteria are met, including intact buccal bone walls and adequate primary stability.