Immediate loading (placing a provisional prosthesis within 48 hours of surgery) is the "holy grail" for patients. However, for the clinician, it removes the safety net of the healing period.

To achieve success with same-day implants, the surgical guide planning must be perfect. Here is how we optimize digital planning for immediate protocols.

1. Prioritizing Primary Stability

Achieving sufficient insertion torque (usually >35 Ncm) is non-negotiable.

* Virtual Bone Analysis: We analyze Hounsfield units (HU) in the CBCT to identify the densest bone for optimal anchor pin and implant placement.

* Strategic Positioning: We plan implants to engage cortical bone wherever possible to maximize initial stability.

2. Prosthetically Driven Planning

In immediate loading, the temporary restoration often dictates the surgery.

* Screw Channels: We align implant axes to ensure screw access holes emerge through the cingulum or occlusal table, avoiding facial perforations on the provisional.

* Pre-Fabricated Temporaries: We can design the immediate provisional (PMMA) simultaneously with the guide so it is ready to seat immediately after surgery.

3. Stackable Guide Protocols

For full-arch immediate loading, we often recommend stackable (reduction) guides. These multi-part guides ensure that bone reduction, implant placement, and provisional seating all happen in a single, rigid, indexed workflow.

Conclusion

requires a "zero-tolerance" approach to error. Partner with a design service that understands the biology of stability.

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