Objective：Compare the 2-year stability of immediate implant and conventional implant restorations in anterior teeth of patients with periodontal disease, as well as their impact on aesthetic outcomes.Methods：We selected 86 patients who underwent implant treatment for periodontal disease in the anterior dental region and were diagnosed and treated in our hospital from January 2023 to September 2024, and divided into a control group (43 cases, 51 teeth) and a study group (43 cases, 52 teeth) using a block randomization method. After a 2-year follow-up, the stability of implants, probing depth (PD), cervical bone resorption, success rate, and complications were compared between the two groups.Result：There were no statistically significant differences in implant stability quotient (ISQ), probing depth (PD), cervical bone resorption, and periodontal esthetic score (PES) between the two groups at the time of restoration placement and after 2 years of restoration (P>0.05). However, the study group exhibited higher values in ISQ, PD, cervical bone resorption, and PES at 1 year of restoration compared to the control group (P<0.05). The implant success rate in the study group was 98.08%, which was not statistically different from the control group"s 96.08% (P>0.05). The overall complication rate in the study group was 5.77%, which was lower than that in the control group (29.41%) (P<0.05).Conclusion:The 2-year outcomes of immediate implant placement and conventional implant restoration in patients with periodontal disease are comparable, with immediate implant placement showing better early post-restoration results and lower complications.