Purpose <p>This study aimed to compare the accuracy of immediate implant placement (IIP) with different implant macrogeometry using a dynamic navigation in the maxillary aesthetic zone.</p> Methods <p>Seventy-six extraction sockets in the maxillary aesthetic zone from nineteen partially edentulous models were randomly divided into four implant system groups with different macrogeometry: non-progressive and trapezoidal (NP-T), progressive and trapezoidal (P-T), progressive and V-shaped (P-V), progressive and spiral (P-S). The coronal, apical, and angular deviations of the fully guided implants with navigation were measured and compared among different groups.</p> Results <p>Significant differences were detected in coronal, coronal buccolingual, coronal depth, apical, apical buccolingual, and apical depth deviations among the four groups (<i>p</i> = 0.035, <i>p</i> = 0.001, <i>p</i> = 0.004, <i>p</i> = 0.047, <i>p</i> = 0.007, <i>p</i> = 0.004, respectively). The P-V group demonstrated minimal coronal and apical buccolingual deviations (mean ± SD: 0.06 ± 0.35 mm and 0.00 ± 0.42 mm, respectively) for IIP with the guidance of dynamic navigation.</p> Conclusions <p>With the limitation of the in vitro study, different microgeometry of implants might influence the accuracy of IIP in the maxillary aesthetic zone with dynamic navigation. Implants with progressive and V-shaped thread designs perform best in reducing buccolingual deviations.</p>