Objectives: This prospective study evaluated the impact of timing of placement (immediate and early) on the horizontal ridge dimensional changes, clinical, and aesthetic outcomes of implants placed in single‐tooth gaps in the anterior maxilla.

Materials and methods: Implants were placed in single‐tooth gaps in the anterior maxilla of 30 patients, either immediately after extraction (Group A, n = 15) or after a healing period of 4–8 weeks (Group B, n = 15). In both groups, implant placement was followed by a 3‐ to 4‐month period of non‐submerged healing, after which definitive crowns were placed. Study models were obtained before extraction (T0), at implant placement (T1), at the insertion of a definitive crown (T2), and 1‐year thereafter (T3). Horizontal ridge dimensional changes were measured by superimposing the optical scans of the study models from different time‐points. Radiographs and photographs were used to evaluate changes in marginal bone levels and soft tissue recession. Aesthetic evaluation was carried out using the Pink and White Esthetic Score (PES and WES) indices. Patient‐reported outcomes were measured using a subjective questionnaire.

Results: A 100% implant survival rate was observed in both groups after a 1‐year follow‐up. Analysis showed a labial horizontal tissue dimensional change of 0.61 mm and 0.72 mm from T0 to T3 in Groups A and B, respectively. Acceptable PES values were observed in both groups (Group A: 9.40; Group B: 9.27) after the 1‐year follow‐up period. No incidence of advanced mucosal recession was observed between definitive crown insertion and 1‐year follow‐up in both groups. No significant changes were observed for all other measured variables at different time‐points.

Conclusions: Immediate and early placed implants in single‐tooth gaps in the anterior maxilla showed similar ridge dimensional changes as well as acceptable clinical, aesthetic, and patient‐centred outcomes in the short‐term (1‐year follow‐up).