Development of gingival esthetics in the edentulous patient with immediately loaded, single-stage, implant-supported...

Many clinicians have reported on the success of immediately loaded implants supporting a bilaterally stabilized provisional fixed prosthesis. This protocol offers several advantages, including increased masticatory function, minimized uncontrolled transmucosal loading through cross-arch stabilization, improvement of psychologic well-being, and reduction in treatment time. However, the development and maintenance of proper dentogingival esthetics in the edentulous maxilla presents substantial challenges for the implant team. This article presents the specific pretreatment diagnostic requirements for immediate loading of single-stage implants and demonstrates a new surgical technique, followed by appropriate prosthodontic management, to develop an optimal gingival profile with interdental papillae surrounding a natural-looking dentition. One hundred fifty-one ITI implants were placed into 22 dental arches and immediately loaded with a 1-piece fixed prosthesis. The results of this technique over the last 5 years are presented.