In the maxillary anterior area, the esthetic outcome is a critical determinant in the overall success of implant therapy and yet remains a challenge. Besides osseointegration, a long lasting soft tissue integration is a key factor for implant succes, but restorative components may interact with the peri-implant soft tissue tant serves as a biological seal and have an impact on the outcome. Current concepts involve the management of the – so called – tissue integration consisting of bone, soft tissues as well as restorative components. The presentation will give an overview of the main factors that may influence the outcome of esthetic implant treatments. It will show proofed protocols that allow for successful treatment of demanding patients.