The aim of this presentation is to report on an immediate loading protocol that was developed over the years with a team of senior and junior practitioners.
Immediate loading has been now widely accepted as a predictable treatment modality, especially for the edentulous and the to-be-edentulous patient. On the theoretical and conceptual level, the protocol seems simple and easy but in fact, it requires redoubling awareness at each step of the surgical and prosthetic stages.
Success with immediate loading lies within the details, therefore each surgical and prosthetic step will be dissected in order to identify the possible mistakes and how to avoid them. Errors and corrections through a Tips & Tricks approach will be illustrated with an abundance of cases. The aesthetic concern will be likewise addressed on the short and longer term. The short term issue is directed to the to-be-edentulous patient with a gingival smile. A specific challenge with this type of patient is avoiding finishing with a functional but non aesthetical implant treatment displaying the prosthesis-soft tissue junction while smiling. A simple and reliable technique to obtain a predictable aesthetic result through the appropriate placement of the prosthesis/soft tissue junction in the edentulous patient will be showed. The long term aesthetic issue will address what can be done against tissue ageing during the surgical and first prosthetic steps in order to lean toward long term aesthetic results in the anterior area of the maxilla. Evolution of our modus operandi will be critically analyzed and our present systematic immediate loading protocol will be discussed and confronted with data taken from the literature.