The aim of this study was to assess bone and soft tissue changes after tooth extraction and immediate implant insertion in the anterior maxilla. A novel synthetic bone graft (VivOss, Straumann) was used to fill the gap between the implant surface and the alveolar bone. Implants with a reduced diameter compared to the size of the socket were used. A fixed or removable provisional restoration was provided immediately after implant placement. Cone beam computed tomography (CBCT) scans were taken to evaluate bone changes, showing minor variations after 12 months of follow-up. To evaluate soft tissue changes, clinical vertical measurements were performed. Based on the results obtained from 15 implants placed in 14 patients, it can be concluded that the use of an immediate implant in combination with a synthetic bone graft and immediate provisionalization seems to be a predictable treatment option with satisfactory esthetic results after 1 year.