## 1 Introduction  
Ooseeintegration has been redefined according to current patients' increasing demands for reduced treatment time, improved esthetics, and increased comfort. The immediate implant placement into fresh extraction sockets may attain implants survival rates similar to those of delayed placement with considerable shortening of the healing period, providing that primary stability had been achieved [1; 2; 3; 4; 5; 6]. In addition to immediate implantation, the time gain has been further enhanced by reducing or even eliminating the load-free time following implant installation. Several researchers have demonstrated successful immediate loading in edentulous mandbles [7; 8; 9; 10] and maxillae [11; 12; 13; 14]. This has led to immediate single-tooth implant-retained provisional restoration [15; 16; 17; 18]. However, it has been shown that the implant's esthetic outcome may be hampered by recessions of the marginal peri-implant mucosa [19; 20; 21]. The occurrence and degree of the marginal mucosal recession have been associated with several factors, including tissue biotype [22], connection of a temporary crown immediately after implant insertion [23; 24], condition and width of the facial bone [25], orofacial position of the implant shoulder [26; 27], and grafting of the facial peri-implant marginal defect with bone or bone replacement grafts [28; 29]. Flap elevation that disrupts the vascular supply to the buccal bone, which is composed almost entirely of bundle bone, may be an important contributory mechanism in the etiology of buccal recession [30]. Adaptation of a temporary restoration contoured to mirror the removed tooth is intended to support the marginal gingva by providing a platform to promote soft-tissue healing and protect the healing extraction socket [23]. Notably, immediate implantation and restoration without occlusion achieve a significantly higher implant survival rate compared with restoration with occlusion [14]. An ideal three-dimensional (3D) implant position within the bone contour and the dimensions of the buccal bone as well as the anatomic height of the interproximal bone are strongly associated with achievement of successful aesthetic results [26; 31]. The height of the papilla next to dental implants is one of the main parameters that affects the aesthetic outcome of implant therapy [32; 33]. Implant-to-soft tissue attachment lacks Sharpey's fibers, which, taken together with the fact that a previous interidental bone peak will resorb following extraction of teeth adjacent to implants, may be considered of utmost importance in the process of reduced papilla height between adjacent dental implants [34]. Interestingly, the same applies to papilla between an implant and a pontic and, to a lesser extent, to papilla between adjacent pontics [35]. It has been proposed that a minimal distance of 1.5 mm between a dental implant and an adjacent tooth is necessary to compensate for remodeling processes following the establishment of the biologic width [36; 37]. If two dental implants are placed next to each other, an optimal distance of 3 mm between them was suggested to obtain a normal papilla [38]. Implant location relative to the bucco-oral and mesiodistal dimensions of the alveolar ridge is a factor that is thought to affect the degree of bone remodeling [39] and have an impact on the aesthetic outcome [40]. It has also been claimed that the buccal bone should measure at least 2 mm to avoid significant bone reduction after implant placement [41]. We are aware of only a few publications on a one-stage procedure aiming to achieve hard-tissue augmentation using the classic guided bone regeneration (GBR) technique and immediate non-functional loading of multiple implants in the maxillary esthetic zone.