A Step-by-Step Description of Immediate Loading Provisionalization Following Computer-Guided Surgery and Provisional Printed Prosthesis Placement: A Case Report

Dental implants have revolutionized the scope of oral rehabilitation in patients requiring tooth replacement. Immediate loading procedures for edentulous patients have become increasingly popular among both clinicians and patients. This report aimed to describe the installation of four flapless-placed implants through prototyped guided surgery and the immediate loading of a printed and prototyped temporary prosthesis. The report presents the digital planning and execution of a full-arch implant rehabilitation in a 49-year-old edentulous male patient with congenital tooth absence. Through the integration of cone beam CT (CBCT) imaging, intraoral scanning, and specific software, a virtual treatment plan was developed to guide implant placement. A custom three-part stackable surgical guide and a stereolithographically printed provisional prosthesis were fabricated to ensure precision. Guided implant surgery was performed under local anesthesia, with all implants achieving primary stability (>32 N·cm), allowing for immediate loading. The provisional prosthesis was relined and secured on titanium abutments. The procedure was completed efficiently within two hours and 10 minutes, demonstrating the effectiveness of a fully digital workflow in complex oral rehabilitation cases. The use of provisional prototypes and guided surgery can yield satisfactory and immediate results for these patients, bringing comfort and practicality to this dental procedure.