CATEGORY 80 AUSTRALASIAN DENTIST CLINICAL Immediate implant placement and loading have become increasingly prevalent in modern dentistry, especially in the aesthetic zone, where patient demands for both functional and aesthetic outcomes are usually mandatory. This approach involves the insertion of an implant immediately after tooth extraction, followed by the positioning of a provisional or final restoration when indicated. The predictability of such procedures depends on the meticulous diagnosis and adequate selection of surgical and restorative protocols as well as materials, which are critical to ensuring both immediate success and long-term stability. Introduction A significant advancement in this area is the development of implant systems specifically designed to meet the demands of immediacy. The Straumann® BLX implant, created for challenging clinical scenarios where immediate insertion and loading are indicated, is a prime example. Fabricated from Roxolid® material – an alloy combining titanium and zirconium – the BLX implant provides enhanced strength, allowing for smaller diameters without compromising stability. This characteristic is particularly beneficial for preserving hard and soft tissues, which are crucial for achieving optimal aesthetic outcomes in anterior restorations. Additionally, the TorcFit™ connection further augments the implant’s versatility, offering a secure and flexible interface between the implant and the abutment, which is essential for attaining optimal results in immediate restoration cases. One notable advantage of the TorcFit™ connection is that the abutment’s transmucosal design is the same, from the healing abutment to the definitive abutment. This unique feature prevents bone remodelling promoted by the connection and disconnection of restorative components during the restorative phase. This case report presents the successful treatment of a hopeless anterior tooth using the Straumann® BLX implant. The patient underwent immediate implant insertion and loading, with a follow-up period of two years after the delivery of the definitive restoration. The outcome demonstrated not only the functional stability of the implant-prosthetic complex but also the high level of aesthetic maintained over time, highlighting the efficacy of the BLX implant system in achieving reliable and lasting results in the aesthetic zone. Initial situation A 62-year-old healthy female (ASA I), a non-smoker with no history of medication use or allergies, presented to our clinic with complaints of pain and crown mobility at tooth #21. The patient expressed a desire to restore function while preserving aesthetics and a natural appearance. During the intraoral examination, it was observed that the patient had multiple dental restorations and a crown on tooth 21 (Fig. 1). Probing revealed depths less than 3 mm around all sides of the crown on #21, with no bleeding or suppuration noted upon probing (Fig. 2). The patient’s plaque index (PI) was 8%, and there were no signs of inflammation. She mentioned that she had undergone periodontal cleaning treatment prior to the consultation. However, the crown was mobile, and a horizontal fracture was clinically observed (Figs. 3,4). The tomography revealed a horizontal fracture in tooth #21, which had a crown with a post and root canal treatment. The CBCT analysis demonstrated a favorable anatomical situation for extraction, immediate implant placement, and immediate loading (Fig. 5) Immediate implant placement in the aesthetic zone: 2-year follow-up Alejandro Lanis A clinical case report by Alejandro Lanis, Chile Figure 1 Figure 3 Figure 5 Figure 2 Figure 4 Figure 6
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