Delayed Implant Placement With Immediate Loading In The Molar Region

This case involving delayed implant placement in the molar region with immediate loading of a provisional prosthesis on the same day of operation. A 57-year-old male presented with a 6-month history of missing mandibular left first molar. Preoperative radiographic evaluation confirmed sufficient residual bone volume, with no pathology or need for grafting. A Straumann BLX® implant (Institute Straumann AG) was placed assisted by autonomous implant robot, using a delayed protocol, followed by closure with a healing abutment. Immediate postoperative digital intraoral scanning facilitated fabrication of a 3D-printed resin provisional crown, delivered the same day and its occlusion was adjusted to light centric occlusion contact. After 3 months, the definitive prosthesis was fabricated by duplicating the provisional restoration parameters. Clinical evaluation revealed a peri-implant keratinized tissue width>2.5 mm, accompanied by a Jemt papilla index score of 2. Radiographic assessment demonstrated stable implant marginal bone levels, no significance marginal bone resorption was observed. The primary challenge of immediate loading in the molar region lies in mitigating detrimental effects of excessive occlusal forces on implant stability. To address this, implant achieved insertion torque> 50 Ncm through precisely place Straumann BLX® implant with robot-assisted surgical guidance, and the provisional prosthesis was adjusted to achieve light contact in centric occlusion with complete disocclusion during eccentric movements. Delayed implant placement with immediate loading in the molar region achieved rapid occlusal recovery with limited hard and soft tissue dimensional changes while decreasing the overall treatment time.