Modern dental implant therapy has advanced significantly since its inception in the 1970s. Part of the significant advancements were related to the transition from conservative, staged treatment protocols, marking the onset of dental implantology, to immediate single-tooth to full-arch restorations, which are now associated with high success and survival rates.
The selection of an implant placement modality remains critical for implant success. Specifically, the healing duration, i.e. the timing between placement and tooth extraction which might include immediate or delayed placements, and the consideration of grafting procedures and its staging with implant placement remain pivotal in deciding the appropriate placement strategy. The selection of implant placement modality is influenced by various factors, comprising anatomical, local, aesthetic, and patient-centric aspects, as well as patient preferences and economic considerations. Significant advancements in implant design and surgical and prosthetic techniques and materials have increased the complexity of factors influencing treatment success in routine clinical decision-making. This thesis aimed to broaden scientific knowledge by researching various aspects of implant placement across various placement modalities, from immediate to delayed implant procedures requiring simultaneous or staged grafting strategies. The thesis finally elaborated on using and applying digital technologies as a supporting tool to enhance implant placement in challenging situations.
Particularly, a first pilot study within this thesis demonstrated comparable esthetic, clinical, and patient- and clinician-centric outcomes of immediate and delayed implant placement in a direct in-patient comparative split-mouth study design, challenging previous notions favoring delayed procedures. Another aspect focused on the role of customized healing abutments as part of immediate placement procedures, emphasizing the value of such abutments as part of immediate protocols. An additional exploratory study demonstrated that superhydrophilic implant surfaces might elicit potential clinical benefits in terms of peri-implant bone formation as part of procedures adopting simultaneous grafting when compared to hydrophobic counterparts, an aspect remaining hitherto clinically undocumented. Further studies investigated the clinical efficacy of alveolar ridge preservation and reconstruction as a critical element to mitigate insufficient bone support subsequent to tooth loss and more extensive loss of alveolar bone as part of early to late implant placement modalities, respectively. Finally, a retrospective analysis of clinical cases critically reviewed computer-guided procedures' benefits to achieve more predictable outcomes and deliver tailored patient care across a wide range of dental implant placement modalities and indications.