Abstract
Introduction: In the aesthetic context after tooth extraction for dental implants, the conservative nature, favorable long-term prognosis, cost-benefit ratio, and, more recently, the aesthetic predictability provided by the restoration of a single tooth with an implant stand out. Objective: This study aimed to highlight the main clinical approaches to conservative and aesthetic treatment after tooth extraction for dental implants with safety and efficacy. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted from January to February 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 116 articles were found, 36 articles were evaluated in full and 26 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. According to the GRADE instrument, most studies presented homogeneity in their results, with X2=92.7%>50%. It was concluded that to successfully treat patients facing the loss of a single tooth in an area of high aesthetic importance, the implant team should use a comprehensive strategy that begins with a systematic functional and aesthetic assessment, aiming to identify the factors that can improve or impair the final aesthetic result. This allows the selection and sequencing of the unique combination of orthodontic, surgical-periodontal, and prosthetic techniques on implants, necessary to ensure a harmonious restoration. An extraction socket filled with xenograft results in better preservation of the alveolar bone dimension, less crestal resorption, and better healing of soft and hard tissues with better satisfactory results. Six considerations should assist clinicians in clinical decision-making, highlighting the presence of infection, inability to achieve primary stability in the restored position, presence of damaged socket, periodontal phenotype, aesthetic demands, and systemic conditions.