The continuing development of innovative surgical and prosthodontic techniques has led to a greatly increased interest in and demand for restorations on immediately loadable implants, due to the numerous clinical advantages offered by this treatment mode. By now, numerous clinical observations supported by histological studies have shown that dental implants placed in fresh extraction sockets with subsequent immediate loading result in clinical success.1 Software-assisted approaches to prosthetically driven surgery combined with CAD/CAM methods can result in highly esthetic and functional all-ceramic restorations for single missing teeth or more extensive edentulous areas using an immediate-loading protocol. The most important objectives in this respect are to reduce treatment times, prevent postextraction bone resorption, and preserve the residual periodontal tissues. Implant-supported restorations have become a frequently employed treatment method for the partially or completely edentulous jaw, well documented in long-term observations and histological studies of the osseointegration process.1-4 Numerous treatment protocols have been proposed and employed, depending on the number and distribution of implants used, to obtain a functional rehabilitation, using diagnostic templates during the restorative process to ensure a better axial alignment of the transmucosal units relative to the occlusal load.12 The choice of implant in terms of shape and diameter must be consistent with immediate functional loading with a provisional or definitive restoration, taking into account the effects and specifics of the occlusal loading situation as well as the need for conditioning the soft tissues. Primary stability, biological stability and the BIC (bone-implant contact) index all define the basic parameters of osseointegration, just as with the treatment modalities and osseointegration processes associated with conventional loading protocols.6-11 In this case report, the surgical procedure was driven by the subsequent restoration. We describe the chairside definitive restoration of a single missing tooth 3513 in a single visit by placement of a tapered, immediately loaded implant, a titanium/zirconia abutment, and an all-ceramic crown, including tollow-up and evaluation of the clinical result.
Keywords: prosthetically guided surgery, immediate loading, CAD/CAM technology, all-ceramic restorations.