Speakers - 2026

Background: Guided implant surgery has evolved from a planning tool into a clinical protocol capable of supporting immediate loading with increasing predictability. Achieving primary stability and prosthetically driven positioning remain critical challenges, particularly in compromised bone situations. Understanding how digital workflows, implant macrogeometry, and loading strategies intersect is essential to ensure consistent outcomes.

Materials and Methods: Consecutive implant placements were performed using CBCT-based planning and fully/partially guided protocols. Atraumatic extraction was applied when indicated, with prosthetically driven positioning. Implant macrogeometry (tapered and/or wide-thread) and undersized osteotomy strategies were selected according to bone density and anatomical conditions. Documented outcomes included provisionalization strategy (immediate vs. early loading), peri-implant soft-tissue response, and short-term crestal bone behavior. A focused literature synthesis— addressing insertion torque and ISQ thresholds, macrogeometry-related stability, and the accuracy of guided surgery—was integrated to analyze how guided protocols support predictable immediate loading.

Results: Clinical cases demonstrated favorable integration of guided workflows with immediate or early loading. Prosthetically driven implant placement was achieved without compromising stability, while digital planning allowed for simultaneous consideration of soft tissue emergence and restorative pathways. Literature evidence confirmed that primary stability can be reliably enhanced through macrogeometry optimization and osteotomy undersizing, reducing the biological risk associated with early functional loading.

Conclusions: The combination of guided surgery and immediate loading protocols allows for predictable outcomes when supported by careful case selection, implant design, and evidence-based decision-making. Digital workflows facilitate accuracy and prosthetic alignment, while stability thresholds reported in the literature provide a scientific framework for clinical decision algorithms. These findings highlight the synergy between guided protocols and loading strategies, supporting their role as a standard in contemporary implantology.