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In this presentation, discussed will be the diagnosis and treatment planning for the utilization of small diameter implants as well as techniques utilized to enhance the soft tissue profile. In addition, the use of orthodontics in achieving the appropriate space will also be demonstrated. Implant dentistry continues to impact the quality of care for patients with missing teeth. However, clinical situations with limited or reduced horizontal space continue to be a challenge. In cases of congenitally missing maxillary laterals or mandibular incisors, the situation can be severe. With the ability of small diameter implants less than 3.5 mm, such as Astra OsseoSpeed 3.0 implant, the narrow sites can be readily managed and aesthetic outcomes can be successfully achieved.