The success of osseointegrated implants as a treatment option is extremely high. In recent years the emphasis in implant development has moved towards improved aesthetics. This paper reviews some of the recent advances associated with aesthetics and implant supported restorations. The techniques of bone grafting and guided tissue regeneration have allowed more ideal placement of implant fixtures in many situations. Implant companies continue to improve their components making implant supported prostheses possible for a wider variety of patients. Further advances in the management of the soft tissues, particularly the interdental papillae, are required to optimise aesthetic results.