Immediate fixed restoration of the edentulous maxilla after implant placement

Immediate loading of the edentulous maxilla is possible when sufficient bone is available to provide primary stability of implants located in positions congruent with an ideal prosthesis. Treatment planning, implant placement with immediate provisionalization, and final prosthodontic rehabilitation are best integrated by a process that uses the immediate provisional prosthesis as a surgical and restorative guide. Designating the planned tooth position is a prerequisite step to the identification of possible implant positions. The cervical contours of the planned prosthesis are critical determinants of this relationship. Defining the planned tooth/residual alveolar bone relationship aids in selecting both the possible type of prosthesis and implant locations. When the treatment plan is transferred directly from the tomographic template to the surgical template to the conversion prosthesis used for immediate loading, the surgical and prosthodontic management of this procedure is well defined.