OBJECTIVE: To evaluate the bone profile around dental implants placed in the esthetic zone through periodontal assessment and radiographic analysis using cone-beam computed tomography (CBCT). METHODS: We conducted a clinical observational study of 35 subjects who received dental implants placed in the esthetic zone to replace lost anterior teeth. Clinical evaluation included a comprehensive periodontal examination. The esthetic outcomes of the soft tissue around the implants were assessed using the pink esthetic score (PES). Patient satisfaction was assessed by using a specially designed questionnaire. The Oral Health Impact Profile (OHIP)-14 was used to assess the quality of life. The bone profile around the implant was assessed using CBCT. All the values were compared and statistically analyzed. RESULTS: A soft tissue graft (STG) was associated with the presence of >
2 mm of bone thickness 1 mm from the implant shoulder (p <
0.01). The STG was also significantly associated with bone thickness at 3 and 5 mm (p = 0.04). PES was not significantly associated with the bone thickness, OHIP score, or satisfaction score. Patients with fenestrations had significantly higher scores for functional limitations and pain than those without fenestrations (p = 0.01 and 0.04 respectively). CONCLUSION: The bone profile around the anterior implant is not ideal. Although the buccal bone was thin around the implant placed in the esthetic zone, it did not affect the esthetic outcomes or overall satisfaction of the patient. However, fenestration defects may affect patients' quality of life.