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Achieving predictable anterior implant esthetics is often a challenge for clinicians. The creation of anterior implant restorations with harmonious gingival contour that emulate nature is a fusion of science and art. Understanding the biologic and physiologic limitations of the soft and hard tissue along with proper implant positioning facilitates predictability in both simple and complex esthetic situations. This presentation focuses on current implant treatment philosophies and methodologies for the replacement of missing or failing teeth in the esthetic zone. Equal emphasis is placed on the diagnosis and treatment planning, current protocols for optimal 3D implant positioning, periodontal plastic procedures, bone grafting maneuvers, and prosthetic management for optimal anterior implant esthetics.