Holding the Margin in Immediate Implants

You can't graft your way out of the wrong position — a three-tier strategy for midfacial stability.

By Dr. Jonathan Misch, DDS, MS · Aug 12, 2026 · 8 min read

Immediate placement is the most demanding thing we do in the esthetic zone, and midfacial recession is how it fails. The instinct, when the tissue looks thin, is to reach for a graft. But margin stability isn't one move — it's a stack, and each tier can only protect what the one above it earned.