Immediate implant placement and provisionalization in edentulous, extraction, and sinus grafted sites

The incorporation of restorative procedures during implant placement, as well as during the creation of natural emergence profiles and lifelike ceramic restorations, has become the focus of implantology over the last few years. Recent publications have provided guidelines for success with the immediate restoration procedure and have presented basic surgical protocols for the implant team. Enhancement of the healing phase through the local delivery of growth factors to the surgical site, as well as through advancements in bone grafting materials, has allowed the implant surgeon to accomplish multiple surgical procedures during the initial surgical visit. In addition, advancements in surgical stent designs have allowed the restorative dentist to adequately communicate to the surgeon during surgery the parameters required in the final restoration to replace the natural tooth system with form, function, and esthetics. This article presents the results of more than 400 immediate restored implants placed in edentulous sites, fresh extraction sockets, and sinus grafted sites. Also highlighted are guidelines for surgical success, as well as a description of a surgical stent design that communicates requirements for restorative success to the surgeon, while also serving as an esthetic provisional restoration.