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ePaper created 2017-12-06, 11:14:19 | version 1.38.0
case report | Fig. 11 Fig. 12 and predictable treatment option with failure rates approaching those of the traditional two- stage surgery.14 The most important factors of im- mediate loading are the primary stability and im- mediate torque. The torque should be at 35 N at least.14 The choice of the implant or the surgical procedure is also important to achieve a high-in- sertion torque. It seems that a self-taping implant may increase implant stability and high-insertion torque.13 The macro-design of the implant is very import- ant because a tapered implant may condense the bone around the implant to achieve greater im- plant stability.15 Immediate temporisation can be an interesting technique to reduce the treatment time and to make it more comfortable for the pa- tient. This technique is predictable if the condi- tions of insertion torque and the provisional crown being out of occlusion are respected. The patient selection and cooperation are also crucial factors for the treatment success. Conclusion Before starting the surgery, the surgeon should decide if he or she wants to perform an immediate load procedure or not. The decision should be based on the surgeon’s ability, the residual bone height and width, the occlusion of the patient and the patient’s motivation and hygiene. As the stability is one of the crucial factors in the success of the immediate loading or immediate tem- porisation procedure4, the surgeon should be able to secure this stability of at least 35 N7 by following an appropriate drilling protocol and choosing the right implant. The combination of implant design and sur- gical osteotomy plays an important role in the im- plant stability. In this case, we chose an implant that allowed us to achieve this crucial condition in almost all cases. To achieve a high primary stability which allows to use the immediate load procedure, it is better to Fig. 13 choose a tapered implant that facilitates bone con- densation around the implant and with this offering the wanted primary stability. The implant length is also important: the bigger the implant, the bigger the implant/bone contact and the bigger the stability. A long implant also allows a fixation in the cortical area which increases the stability of the implant._ Figs. 11–13: Final crown. contact Dr Mohamad El Moheb 148 Avenue Jean Jaurès 93320 Les Pavillons-sous-Bois, France Tel.: +33 148 486358 Author details Literature implants 3 2017 21