Immediate Guided Implantation with Aesthetic Loading: A Case Report

Background: Immediate implant placement with aesthetic loading in the anterior maxilla is a highly demanding procedure that requires precision, atraumatic extraction, and optimal planning. The use of a digital surgical guide has improved the predictability of this protocol, offering enhanced accuracy, reduced morbidity, and improved patient satisfaction. Case Presentation: We report the case of a 54-year-old female patient who presented with an irrecoverable maxillary left lateral incisor. Following CBCT analysis and intraoral scanning, a tooth-supported surgical guide was designed using 3Shape TRIOS software. Atraumatic extraction was performed, and a 3.6 × 12 mm Biotech implant was placed immediately with the aid of the surgical guide. The implant achieved primary stability (>35 Ncm), allowing for immediate aesthetic provisionalization with a PMMA crown. After three months of successful osseointegration, a definitive zirconia crown was fabricated and cemented. Results: The patient demonstrated uneventful healing, satisfactory osseointegration, and stable soft tissues. Both functional and aesthetic outcomes were favorable, with high patient satisfaction. Conclusion: Immediate implant placement with guided surgery and aesthetic loading represents a predictable treatment option in selected cases, providing functional rehabilitation and optimal aesthetic integration. This approach highlights the importance of careful case selection, precise digital planning, and adherence to surgical protocols to minimize complications and ensure clinical success. Keywords: Immediate implant placement, Guided surgery, Aesthetic loading, CBCT, Digital dentistry.