COLOCACION INMEDIATA Y CARGA INMEDIATA (PROTOCOLO TIPO 1A) DE IMPLANTE DENTAL, UNITARIO, Y CON CIRUGIA GUIADA EN ZONA ESTETICA MAXILAR: SEGUIMIENTO A UN (1) AÑO

This case report describes the rehabilitation of a 78-year-old patient through the immediate placement of a single dental implant with guided surgery and immediate loading in the esthetic maxillary region. The patient required extraction of the upper right central incisor due to root fracture and chronic apical periodontitis. The diagnosis was based on clinical and radiographic examinations, which revealed a metal-ceramic crown supported by a metal post, as well as chronic apical lesions and discontinuity in the root contour. The treatment planning involved intraoral scanning and cone-beam computed tomography (CBCT) to design a surgical guide fabricated using CAD/CAM technology. One week after planning, minimally traumatic tooth extraction was performed, followed by the immediate placement of the implant using the surgical guide. The implant was immediately loaded with a definitive abutment and a temporary acrylic crown, providing esthetics and function during the osseointegration period. Four months later, the temporary crown was replaced with a definitive zirconia crown, milled within a digital workflow. The results, in the one (1) year follow-up, demonstrated the success of the protocol, with high clinical predictability and significant functional, esthetic, and psychosocial impact. This case highlights that, under favorable conditions and with proper planning, immediate implant placement with guided surgery and immediate loading is a safe and effective approach, particularly in esthetic maxillary regions.