As modern criteria for implant success have expanded to include parameters not only at the implant, peri-implant soft tissue and prosthesis levels, but also the patient's subjective evaluation, the planning and execution of implant rehabilitation in the anterior maxilla has become increasingly complex (Papaspyridakos, Chen, Singh, Weber, & Gallucci, 2012). In these cases, anterior implant treatment should satisfy the high aesthetic demands of the patient in order to obtain a result that best imitates the natural dentition. Prosthetically driven implant 3-D positioning is crucial and in order to optimize the aesthetic outcome and reduce the risk of post-operative bone loss and soft tissue recession, a minimum of 1.5 mm of BBT has been recommended (Monje et al., 2019). Numerous studies, however, have demonstrated a reduced thickness of the cortical bone in the anterior maxilla, with some reporting a high incidence of thin buccal