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Numerous studies demonstrate successful immediate loading of dental implants. The purpose of this study was to evaluate the long-term survival of single-tooth implants immediately placed in fresh extraction sites at the anterior maxilla with immediate infraocclusion-provisional restorations and nonfunctional immediately loading.A total of 24 implants were placed in 16 patients. The fixed provisional restorations were connected to a prefabricated plastic abutment. Occlusal contacts were avoided. Follow-up starting at implantation day ranged from 24 to 72 months with a mean of 40.7 months.One implant failed 1 month after placement due to the unscrewing of a temporary abutment that resulted in implant overload. Overall implant survival rate resulted in 95.8%. The mean marginal bone loss increased by 0.9 +/- 1.1 mm. starting from implant placement.Within the limits of this study, the data indicate that nonfunctional immediate loading of single-tooth implants placed in fresh extraction sites in the anterior maxilla can result in successful implant integration and stable peri-implant conditions up to 6 years.

STATEMENT OF PROBLEM Despite careful attention to waxing, investing, and casting, marginal discrepancies are inevitable. Vertical and horizontal discrepancies can result in crestal bone resorption, peri-implantitis, and loss of osseointegration. PURPOSE The aim of this study was to evaluate marginal gap and overhang in 3 casting techniques for implant framework fabrication. MATERIALS AND METHODS A total of 24 frameworks, 8 each with the Burn-out Cap (ITI; Straumann) (group BC), with Impression Cap (ITI; Straumann) (group IC), and with conventional wax-up technique (group WX) were fabricated. All specimens were waxed on the analog abutments and cast with Type IV gold alloy. All castings were fixed on the analog abutments with cyanoacrylate and embedded in acrylic resin. Specimens were sectioned and prepared for scanning electron microscope evaluation. Frameworks were analyzed for vertical and horizontal discrepancies with x200 magnification (scanning electron microscopy). Data were analyzed statistically by multivariate analysis and the post hoc tests (alpha = 0.05). RESULTS The vertical discrepancy measurements for the 3 groups showed mean values of 53.74 +/- 11.0 mum, 63.6 +/- 13.2 mum, and 50.1 +/- 17.3 mum, respectively. The interfacial gap differences were not statistically significant in all groups (P > 0.05). Waxing the frameworks with impression caps significantly increased the horizontal discrepancy at the interfaces (P < 0.001). CONCLUSIONS Within the limitations of this experiment, it was demonstrated that the vertical discrepancy of the frameworks made with the 3 techniques were comparable in lack of accuracy with each other. Although conventional waxing produced the least horizontal discrepancy, the difference with burn-out cap group was not statistically different.

Placing an anterior single-tooth implant requires thorough planning, informed abutment selection and precise surgical technique. Planning procedures are outlined; abutments, including UCLA's non-segmented, Nobelpharma's single-tooth, CeraOne and non-rotational, implant innovations' pre-angled and non-rotational and DIA's anatomic, are described, with indications and contraindications; and placement considerations are discussed.