Implant restorations delivered with the traditional Brånemark protocol have proven to be highly predictable. However, clinicians should not consider implant survival as the only success parameter but also address different aspects of the esthetic result and long-term stability of soft tissues. This presentation will include a variety of topics related to immediate loading in the esthetic zone. A review of the available literature will be presented along with the biologic rationale for immediate loading. The case selection process and step-by-step surgical and prosthetic procedures to achieve a predictable result will be discussed, as well as a new implant designed to preserve crestal bone.