Narrow dental implant (NDI) is defined as implant with a diameter <3.5 mm [1] and is divided into three categories based on their diameters, such as category 1: <3.0 mm (“mini‐implants”); category 2: 3.0–3.25 mm; and category 3: 3.30–3.50 mm [2]. In the literature, the use of these implants is well documented in cases of the anterior edentulous sectors of the ridges, not subjected to excessive chewing loads [3–5]. In these regions, the replacement of dental elements with implant‐supported prostheses can not only be based on the biological principles of osseointegration described by Branemark [6] and on the success criteria of Albrektsson [7], but must also guarantee an adequate aesthetic result [8], obtaining a correct proportion between the white color of the tooth and the pink of the gingiva. The esthetic outcome can be evaluated through various indices that take into consideration fundamental anatomical parameters, including the presence of the interproximal papillae and the positioning of the gingival zenith [9, 10]. Tarnow et al. clarified that the papilla between two natural teeth is guaranteed when the distance between the bone crest and the contact point is equal to or less than 5 mm [11]. Following the tooth loss, the papilla retracts, and the possibility of its reappearance will depend exclusively on the maintenance of the interproximal bone peaks of the neighboring teeth and on the positioning of a provisional or definitive prosthetic device that will again determine the interdental contact point. Likewise, the correct location of the gingival zenith is guaranteed by the preservation and/or regeneration of the buccal cortex of the edentulous alveolus [12]. To guarantee the respect of these bone structures, an adequate surgical procedure, an appropriate implant diameter, and a correct implant position are necessary [13]. Since the establishment of the implant biological width, as described by Adell et al., determines an unavoidable marginal bone [14], it is essential to respect safety distances. The ideal implant position is 1.5–2 mm from the buccal plate, 1.5 mm from the adjacent teeth, and 2–3 mm from their cemento‐enamel junction (CEJ). If these parameters are not respected a vertical bone reabsorption will occur, so that the gingival zenith and the presence of the papillae will be compromised.

In general, it is considered that a minimum of 1 mm of bone tissue must surround the entire implant surface [2]; however, in the anterior sector, this measure is not sufficient to guarantee aesthetic success. When replacing dental elements with aesthetic impact, the choice of the implant diameter must be calculated by subtracting 3 mm (1.5 mm per side) from the mesio‐distal dimension of edentulousness (distance at the crestal level between the two neighboring roots) to ensure the survival of the bone peaks following the occurrence of the Adell et al. phenomenon. Where the chosen implant diameter does not guarantee the minimum thicknesses required in the vestibule‐palatine direction, regenerative surgical techniques will be required to increase the available bone. Considering that the average width of the upper lateral incisors is between 6.1 in females and 6.6 in males, it is necessary to use reduced‐diameter implants for their replacement [15]. This consideration is even more evident for the lower arch incisors that have an average mesio‐distal size of 5 mm [16–17]. (CASE 1)