Implant therapy has become a reliable and predictable treatment alternative for the replacement of missing teeth with conventional removable and fixed partial dentures. Recently though, in the pursuit for improved esthetics, the literature has dedicated a considerable amount of its research on the successful maintenance and regeneration of the surrounding gingiva and bone, which are lost following extraction of a tooth. Thoroughly analyzing the anatomic situation and well-planned treatment has become a requirement, because incorrectly planned and positioned implants may jeopardize long-term esthetic and functional prognosis. In addition, many types of biocompatible materials, autogenous hard and soft tissue grafts, and different surgical techniques have been developed, and their viability has been investigated. As a result, implant specialists have gained a greater understanding of the dynamics and anatomical and biological concepts of the periodontium and peri-implant tissues both at the surgical and prosthetic phases of treatment, which contributes to better soft and hard tissue management (SHTM). This may further contribute to achieving a superior final result which is obtained by having a harmonious soft tissue profile, a correctly placed and contoured final restoration, and the reestablishment of masticatory function and phonetics. 1. Introduction The increasing demand over the years for highly esthetic results in all facets of dentistry has also influenced dental implants and has made achieving optimal esthetic results more challenging for the implant specialist and subsequently led to a greater consideration and study of all the contributing factors, both at the micro- and macroscopical level to achieve such a result. The challenge lies in the successful management and modeling of the papilla and gingiva, which are harmonious with the soft tissues of the adjacent natural dentition, and must also be maintainable long-term. Implant esthetics has been thoroughly studied [1–4], and several authors have proposed esthetic indices to assess peri-implant gingival tissues [5, 6] and implant crowns [7]. Belser et al. (2009) proposed the New Esthetic Index: Pink Esthetic Score (PES)/White Esthetic Score (WES) [8], a variation of previously introduced indices. Thus, an esthetically accepted result not only depends on the shade and form of the final restoration, but also in order to be achieved, it needs careful consideration, and often manipulation of the soft and hard structures adjacent to the implant, the abutment, and final restoration. This demand for
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