The long-term predictability of osseointegrated implants has been well documented. Nevertheless, a significant number of early and late complications have also been largely reported. Current hypothesis associates bacterial infection and/or biomechanical overload as etiologic factors of late implant failure and what else? What about implant positioning and emergence profile critical zone? The titanium physical-chemical characteristics or frankly speaking “surface quality” remain, together with the initial implant positioning, the most important periimplantitis risk factors. According to H. L Wang and co-workers 2016, more than 40 % of periimplantitis problems are due to bad implant positioning. The innovation in digital products and processes for implantology is constantly increasing. This success is due to the fact that digital workflows provide today a reliable therapeutic solution. The use of these techniques is not only interesting for immediate loading rehabilitations but also for the tissues supporting implants quality and stability. This lecture will show that the key to negotiate the best emergence profile is the use of 3D guided surgery together with novel prosthetic hybrid components insuring in two clinical steps, an optimal/stable gingiva contour, and easy data acquisition and provisionalisation.

Learning Objectives

1. Explain the complexity of the osseointegration phenomenon and the impact of surface quality on the long-term success of prosthetic and surgical implant rehabilitations.
2. Understand the real meaning of a full digital workflow following the SCAN, PLAN, MAKE, DONE concept
3. Understand the sequencing and usage of 3D imaging, digital models, planning software and the surgical guide for all kind of edentulism.
4. Provide an overview of the latest developments in computer imaging technologies, as the 3D segmentation, guiding systems and abutment design for an optimal tissue stability.
5. Understand the long-term benefits of guided surgery together with a comprehensive abutment design, for tissues supporting implants.
6. Through well documented cases, the latest treatment protocols, like socket shield or full arch rehabilitations using stackable guides, will be detailed step by step.