Digitally Planned and Guide-Delivered Provisionalization for Emergence Profile Shaping in the Esthetic Zone: Clinical Outcomes and Complications

Background/Objectives: Immediate provisionalization in the esthetic zone is a well-documented but technique-sensitive procedure, and the choice of provisional connection geometry (indexed vs. non-indexed) remains debated. The aim of this ret-rospective single-arm cohort clinical study was to evaluate the clinical performance of a digitally planned, guide-delivered provisionalization protocol using prefabricated provisional crowns connected to 5-degree Morse taper implants without an antirota-tional index, with emphasis on emergence profile shaping and peri-implant tissue sta-bility at one year; Methods: Twenty consecutive single-implant cases (19 female, 1 male; mean age 38.1 ± 12.7 years; 18 anterior and 2 premolar sites) were treated between January 2024 and February 2026. All implants were placed with primary inser-tion torque ≥ 30 N·cm (mean 34.75 ± 2.55 N·cm) and immediately restored with a digitally designed, non-antirotational provisional crown. Primary outcome was provision-al retention without major intervention; secondary outcomes included biologic com-plications, papilla score, marginal bone change at T0–T3 and T3–T4, and buccal con-tour change (T0 vs T2 intraoral scan superimposition). Wilson 95% confidence inter-vals, Fisher’s exact test, and Mann–Whitney U test were used (α = 0.05); Results: Pro-visional retention without major intervention was 75.0% (15/20; 95% CI 53.1–88.8). Biologic complications were uncommon (bleeding on probing, suppuration, midfacial recession, and chairside adjustment, each 5.0%). Mean total marginal bone loss at one year was 0.37 ± 0.20 mm; mean buccal contour gain was 1.41 ± 0.48 mm. A complete papilla was preserved in 70.0% of cases; Conclusions: Digitally planned, guide-delivered provisionalization on a non-antirotational 5-degree Morse taper interface appears clinically feasible for emergence profile shaping in the esthetic zone, with stable peri-implant tissues at one year.