The ultimate goal of implant restoration has shifted from merely achieving successful osseointegration to pursuing long-term functional and aesthetic stability. When alveolar bone height is insufficient, implant neck design, which seals the bone-soft tissue interface, affects marginal bone preservation, gingival contour and the final aesthetic outcome.This article reviews three different neck designs.impact on marginal bone and soft tissue, explores bone augmentation’s role in improving implant aesthetics, and analyzes related biological and biomechanical mechanisms. Evidence confirms microthreaded necks facilitate marginal bone preservation and bone augmentation enhances contour aesthetics, so clinicians should formulate individualized restoration strategies based on actual conditions.