Implants in Adolescents: Clinical Outcomes After Growth-Pattern-Adapted Implant Placement

(1) Background: Dental implants in adolescents remain controversial. This retrospective study aimed to evaluate the esthetic outcome of implants placed during adolescence using a growth-pattern-adapted concept, with implant survival, peri-implant health, and patient satisfaction as secondary outcomes. (2) Materials and methods: Primary implant survival was retrospectively evaluated based on treatment records in 305 patients (612 implants) affected by tooth loss or congenital tooth agenesis. A subgroup of 68 anterior maxillary implants (50 patients, mean age at implantation: 16.2 ± 2.3 years; range: 12–20) were clinically re-examined after a mean follow-up of 92.4 ± 61.2 months (range: 36–288). (3) Results: Primary implant survival was 93.8% overall (tooth loss: 97.7%; tooth agenesis: 92.3%). The clinical follow-up cohort showed no cases of peri-implantitis and patient satisfaction was high. Anterior maxillary implants demonstrated favorable esthetic outcomes (Pink Esthetic Score [PES]: 12.0 ± 1.1), with females exhibiting significantly higher scores than males. Vertical discrepancies between the implant crown and the contralateral tooth were observed in 41.2% of implants (infraocclusion: 32.4%; supraocclusion: 8.8%). They were significantly associated with tooth loss, non-mesofacial growth patterns and younger age at implantation, without significant influence on PES. (4) Conclusions: The growth-pattern-adapted implant placement met the predefined esthetic threshold and resulted in high primary implant survival, stable peri-implant health, and high satisfaction, supporting its feasibility for anterior maxillary implant placement during adolescence.