Immediate implant placement into fresh extraction sockets has gained a lot of attention in implant dentistry. Besides
proper risk assessment, the evaluation of tooth anatomy aids the clinicians to select the finest treatment protocol.
Cone Beam Computed Tomography (CBCT) imaging was frequently used for alveolar bone analysis prior to tooth
extraction in immediate implant placement. As an ideal position is required to prevent a buccally tilted implant
or too palatal implant placement, various authors have proposed the treatment guidelines for immediate implant
placement in the anterior maxilla. Although insightful, the previous classification was lacking anatomic variant and
key anatomical features of alveolar bone and tooth angulation. Furthermore, there is no standardization method of
measuring the specific degree of tooth angulation in CBCT scans that could possibly be used in clinical setting for
appropriate treatment protocol. Thus, it is essential for the clinician to have adequate knowledge on the role of facial
alveolar bone, palatal alveolar bone and tooth angulation related to immediate implant before selecting the appropriate treatment guidelines based on the classification reviewed. In this review, the previous quantitative measurements
were categorized, and the previous classification was listed for the sake of familiarity by the dental practitioner with
the major updates on implant placement strategy, patient selection and to reduce the rate of surgical complications.