Immediate placement/load protocol

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Surgical considerations

  1. No pathology, no significant grafting
  2. Primary stability of implant with insertion torques of 35-45Ncm min. Meta-analysis says 20Ncm
  3. Eliminate occlusal overload (interferences)
  4. Cross arch stabilization (splinted restorative)
  5. Patient compliance


  1. Support and maintenance of gingival and bony architecture
  2. Min. post op discomfort
  3. Fixed provisional restoration
  4. Prevention of soft and hard tissue grafting
  5. Reduction in need of number of surgical procedures
  6. Reduction of time to complete and clinical chairtime


  1. More complex surgery
  2. Correction of placement more difficult
  3. Need materials, procedures, and laboratory support at time extraction
  4. Risk of infection/failure
  5. Risk of failure to osseointergrate

Karen McAndrew


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