Abstract: Objective To investigate the aesthetic outcomes of immediate implant restoration in the maxillary anterior region and the impact on bone volume and periodontal tissue health. Methods This study adopted a prospective cohort study design. Patients who presented to the Department of Stomatology of Puyang Oilfield General Hospital between January 2023 and January 2025 with severe maxillary anterior tooth defects and who were scheduled for extraction followed by implant restoration were included in this study. Based on the patients' wishes, personal conditions, and clinical evaluation, the final treatment plan was determined. The patients were divided into two groups: those who received immediate implant restoration were included in the immediate implantation group (n=55), and those who received delayed implant restoration after tooth extraction site preservation were included in the delayed implantation group (n=55). The alveolar bone resorption indicators, aesthetic indicators, patient subjective satisfaction, periodontal tissue health, and complications were compared between the two groups. Results Six months after immediate restoration, the bone resorption in the immediate implantation group was lower than that in the delayed implantation group (P<0.05); six months after permanent restoration, there was no statistically significant difference in bone resorption between the two groups (P>0.05). Six months after immediate restoration, the pink esthetic score (PES) and visual analog scale (VAS) scores of the immediate implantation group were higher than those of the delayed implantation group (P<0.05). At 1 month postoperatively, the immediate implantation group had a lower probing depth (PD) but a higher modified sulcus bleeding index (mBI) than the delayed implantation group (P<0.05). At 3 months post-surgery and 6 months after permanent restoration, PD improved significantly in both groups compared with their 1-month values (P<0.05), with the immediate implantation group maintaining lower PD (P<0.05). No significant difference in mBI was observed between the two groups at 3 months post-surgery and 6 months after permanent restoration (P>0.05). The incidence of complications was lower in the immediate implantation group (P<0.05). Conclusion In anterior tooth restoration, both immediate implant placement and delayed implant placement can achieve ideal long-term aesthetic outcomes. Immediate implant placement effectively controls early alveolar bone resorption, better maintains peri-implant soft tissue stability, provides superior early aesthetic results and patient satisfaction, and significantly reduces the risk of postoperative adverse reactions.

Key words: Immediate implant restoration of maxillary anterior teeth, Aesthetic outcomes, Bone volume, Periodontal health