This study aimed to assess the prolonged esthetic appearance and radiographic performance of dental implants positioned in the anterior maxilla following ridge preservation using a bovine-derived graft in combination with a collagen membrane. Fifteen participants who required extraction of a single tooth because of fracture, root resorption, or extensive decay were enrolled. Each socket was filled with Deproteinized Bovine Bone Mineral (DBBM) integrated with collagen and covered by a resorbable collagen matrix (CM). Implants measuring 3.8–4.2 mm in diameter were inserted five months after grafting. All subjects were followed clinically and radiographically for more than seven years. The esthetic evaluation was performed by three independent reviewers utilizing the Pink Esthetic Score (PES) system. After more than seven years, a 100% survival rate was recorded for all 15 implants, showing minimal marginal bone reduction. The mean PES values were 11.40 (±1.44) at the initial evaluation and 11.38 (±1.63) at the later one, with no significant difference (p = 0.978). These data indicate that grafting extraction sockets with collagen-enriched bovine bone and sealing them with a collagen matrix helps maintain the alveolar contour and ensures durable esthetic success.
