One-Month Loading following Immediate Implant Placement with ALX Implant

Case Summary 🔎

Patient Information

• Past Medical History: None

• Drug allergy: None

Introduction

Immediate implant placement after extraction is now widely adopted, offering advantages such as alveolar bone preservation, reduced treatment time, and greater patient satisfaction.

This case report describes the immediate placement of two ALX implants in the maxillary left premolar region (#24 and #25) following extraction of mobile teeth with periodontal compromise. Both sites showed dense bone quality (D2), allowing sufficient primary stability without excessive compression.

With favorable stability, early functional loading was achieved, and the final restorations were delivered one month after placement. This case demonstrates a predictable and efficient protocol for immediate implant placement in the maxillary premolars, ensuring functional and esthetic success within a shortened treatment timeline.

Treatment Plan

1. Extraction of #24 and #25 was planned on the same day as implant placement.

2. Gap filling was considered if necessary.

3. Early loading was planned, aiming to deliver the final restoration 4 weeks post-operatively.

Case Presentation

1️⃣ Pre-Op

• Both #24 and #25 teeth exhibit mobility, and widening of the periodontal ligament space is evident.

2️⃣ Surgery - ALX Implant Placement

• Pre-operative intraoral view of #24 and #25. Both teeth have mobility, with compromised periodontal support.

• Extraction of #24 and #25.

• Post-extraction view of sockets #24 and #25. Both extraction sites present with intact buccal and palatal walls, and the bone quality appears dense, providing favorable conditions for immediate implant placement with ALX fixtures.

• Osteotomy preparation completed for immediate implant placement at #24 and #25. The bone density was assessed as D022. ALX implant fixture is shown prior to insertion.

• ALX implants were placed at #24 and #25. Both fixtures (ALX-IT 4.5 × 10 mm, Cuff 3 mm) achieved adequate primary stability. The insertion was performed without excessive compression, ensuring favorable conditions for early loading.

  • Insertion torque

    • #24: 70 → 40N

    • #25: 30N

• Scan body healing abutments are connected for intraoral scanning. ISTV was measured at 72 (+6) for #24 and 79 (+6) for #25.

• Filling a gap using Neobone.

• Digital impression captured using intraoral scanner.

3️⃣ Post-Op

• Both implants show proper positioning and integration within the maxillary bone, with no pathologic findings.

4️⃣ Final Restoration

• After a month, the soft tissue had healed.

• The final prosthesis was delivered with the CL-link system, enabling efficient connection without the need for cement.

• Final prostheses delivered on ALX implants at #24 and #25. It shows proper occlusion and contour, with stable peri-implant soft tissue adaptation.

• Panoramic radiograph after final restoration

5️⃣ Follow-Up

• At the 3-month follow-up, the prosthesis remained stable, showing no complications.

💡Conclusion

This case highlights the clinical predictability of immediate implant placement with early loading in the maxillary premolar region, when adequate bone quality and primary stability are achieved. The use of ALX implants provided secure fixation without excessive compression, supporting prosthetic restoration within one month. Careful planning and appropriate implant selection contributed to efficient treatment and stable functional outcomes.