Abstract The immediate placement of dental implants in esthetic areas is a primary challenge for modern implantology. The underlying treatment goal is to preserve the natural periodontal architecture; in recent years, however, a concurrent goal has been to reduce the period between implant placement in the fresh extraction socket and delivery of the definitive restoration, but adequate long-term data are still lacking on the efficacy of this technique. A 3- to 5-year retrospective analysis of 282 dental implants immediately placed into extraction sockets, and temporized with nonoccluding provisional prostheses has been undertaken. All recorded outcomes and complications, as well as a proposed protocol for management of immediate function, are discussed.