Clinical Casebook on Immediate Implants

BioHorizons Camlog Implant System. Vol. 1 — June 2025 CLINICAL CASEBOOK ON IMMEDIATE IMPLANTS. BioHorizons Camlog’s Implant Systems. Vol. 1 — September 2025

INTRODUCTION. DEAR READERS. It is a privilege to introduce the Immediacy Implant Casebook, a collection that reflects both the technical excellence and the collaborative spirit that define contemporary implant dentistry. The cases presented here capture a pivotal moment in our profession — one in which innovation, digital technology, and biological understanding converge to expand what is possible for our patients. The principle of immediacy in implantology is more than a procedural choice; it represents a commitment to providing prompt, functional, and aesthetic solutions without compromising biological integrity. This approach demands precision, sound clinical judgment, and mastery of emerging tools—from advanced implant designs and biomaterials to guided surgical protocols, photogrammetry, and AI-enhanced planning. As this casebook demonstrates, immediacy can be applied successfully across a broad spectrum of clinical scenarios, from single-tooth replacement in the aesthetic zone to full-arch rehabilitations, even in challenging situations with compromised hard or soft tissues. Each case in this volume offers more than a step-by-step record of treatment. It provides insight into the decision-making process, highlights critical technical nuances, and illustrates the profound impact of interdisciplinary collaboration. Together, these contributions underscore a shared philosophy: that patient-centered care, supported by evidence-based protocols and technological innovation, can deliver predictable outcomes with remarkable efficiency. I encourage readers to engage with these cases not only as a source of practical guidance but also as a catalyst for reflection and professional growth. The diversity of techniques and workflows presented here demonstrates that while there are many paths to success, they all rest upon the same foundation — thorough planning, precise execution, and a deep respect for the biology we are entrusted to preserve. May this casebook inspire you to refine your skills, explore new possibilities, and continue raising the standard of care for every patient you serve. Enjoy, Homa H. Zadeh, DDS, PhD VISTA Institute for Therapeutic Innovations Dr. Homa Zadeh DDS, PhD VISTA Institute for Therapeutic Innovations Immediacy Casebook 3

Introduction 3 Case Studies Dr. Alex Fneiche 6 CONELOG® PROGRESSIVE-LINE. Immediate Implant Placement (IIP) with Provisionalisation using the Natural Crown. Dr. Martijn Moolenaar 10 CONELOG® PROGRESSIVE-LINE. Immediate Implant Placement with Soft Tissue Enhancement using a Digital Workflow in the Aesthetic Zone. Dr. Frank Leusink 14 CONELOG® PROGRESSIVE-LINE. Immediate Implant Placement and Temporisation in the Posterior Maxilla using CONELOG® PROGRESSIVE-LINE implants. Dr. Jan Spieckermann 18 CONELOG® PROGRESSIVE-LINE. Immediate implant reconstruction — a Digital, Fully Guided Approach. Dr. Joerg-Martin Ruppin 22 CAMLOG® PROGRESSIVE-LINE. Immediate Implant Placement in the Anterior Zone using Socket Shield and Fully Guided Surgery. Dr. Frederic Hermann 28 CONELOG® PROGRESSIVE-LINE. Immediate Implant Placement in the Anterior Maxilla with Ridge Preservation and Soft Tissue Optimisation. Dr. Alfonso Gil 32 CONELOG® PROGRESSIVE-LINE. Immediate Implant Placement (IIP) in the Anterior Zone with a CONELOG® PROGRESSIVE-LINE implant. Dr. Alvaro Blasi, Dr. Gonzalo Blasi, Dr. Ricardo Palacios 36 CONELOG® PROGRESSIVE-LINE. Immediate Implant Placement and Soft Tissue Augmentation in a Compromised Lateral Incisor Case using a Fully Guided Workflow. Dr. Ramon Gomez Meda 40 CONELOG® PROGRESSIVE-LINE. Restoring a Central Incisor without compromising Soft or Hard Tissue Volume. Dr. Eric Normand 44 CAMLOG® PROGRESSIVE-LINE. Full-Arch Rehabilitation made Simpler with Immediate Protocols and a Digital Workflow. Dr. Gautier Dupont 48 CAMLOG® PROGRESSIVE-LINE. Immediate Implant Temporisation with an Anterior Three-Unit Bridge. Dr. Remy Tanimura 52 CONELOG® PROGRESSIVE-LINE. Full-Arch Rehabilitation in Patients with a History of Periodontitis. CONTENTS. 4 Immediacy Casebook

Dr. Mario Beretta 58 CONELOG® PROGRESSIVE-LINE. Transforming a Patient’s Smile with Double Full-Arch Rehabilitation. Dr. Tiziano Testori, Dr. Manuel Nanni, Luca Dondi 62 Tapered Pro Conical. A Minimally Invasive Approach to Full-Arch Rehabilitation. Dr. Nick Fahey 66 CONELOG® PROGRESSIVE-LINE. An Extreme Transformation — Immediacy in a Complex Situation. Dr. Nik Vourakis 70 CONELOG® PROGRESSIVE-LINE. Immediate Placement and Loading with a Fully Guided Workflow. Dr. Omar Iqbal 74 Tapered Pro Conical. Restoring Smiles with Confidence in Implant Stability and Aesthetics. Dr. Viraj Patel 78 CONELOG® PROGRESSIVE-LINE. Anterior Immediate Implant with Simultaneous Augmentation. Immediacy Casebook 5

Dr. Alex Fneiche AD Dental Clinic, Trazegnies, Belgium CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT (IIP) WITH PROVISIONALISATION USING THE NATURAL CROWN. A 38-year-old female physician presented with a root fracture on tooth 21. Due to her time constraints, she requested a simplified and efficient treatment solution with minimal visits and excellent aesthetics. TREATMENT PLANNING AND DIAGNOSIS Given the complexity of the case and the patient’s aesthetic expectations, a CBCT was performed to guide planning. A silicone positioner was fabricated preoperatively to ensure accurate repositioning of the patient’s extracted tooth onto a temporary abutment. In September 2024, tooth 21 was atraumatically extracted. Immediate implant placement was performed, using a 3.8 x 11 mm CONELOG® PROGRESSIVE-LINE implant with a temporary cylinder. The natural crown was recycled and adapted onto the temporary abutment as the immediate provisional. Although the initial surgery was successful and the patient left satisfied, the aesthetic result at the three-month review was disappointing (Fig. 2). The gingival margins were uneven, the soft tissue contours around the central incisors were inconsistent, and the proportions of teeth 11 and 21 were not harmonious. The need for comprehensive soft tissue management had been underestimated initially. THE SURGERY AND INITIAL OUTCOMES The first surgical phase involved atraumatic extraction and immediate implant placement with provisionalisation. Healing proceeded without complication; the patient strictly adhered to post-operative instructions. At three months, however, dissatisfaction with the aesthetic outcome led to a decision to resume treatment. Impressions were taken for implants 21 and 22 and two new provisional crowns were fabricated to optimise the emergence profiles (Fig. 3). A diagnostic wax-up was also completed for teeth 11 and 12 to guide smile design improvements (Fig. 4). A buried connective tissue graft (CTG) was harvested from the tuberosity and sutured into position using Ethilon 6-0 sutures to increase soft tissue thickness and volume (Fig. 5). TREATMENT TIME 7 months TOOTH NUMBERS 21 TREATMENT TYPE Immediate Implant Placement (IIP) in the Anterior zone using a CONELOG® PROGRESSIVE-LINE implant with temporisation and on-lay grafting. PRODUCTS USED CONELOG® PROGRESSIVE-LINE implant MinerOss® XP INITIAL PRESENTATION A 38-year-old female physician in perfect health presented following a root fracture of tooth 21. Due to her demanding professional schedule, she requested a fast, simple, and aesthetic solution, ideally minimising the number of visits. Notably, the patient had previous experience with immediate implant treatments, having undergone an extraction and implant restoration of tooth 22 a few years earlier. Clinically, tooth 21 exhibited a root fracture that could not be preserved. Disharmonious tooth alignment, inconsistent gingival levels between adjacent teeth, and a thin, soft tissue biotype compromised the anterior aesthetics. Particular attention was needed to manage the papilla between teeth 21 and 22 and harmonise the emergence profiles across the smile. 6 Immediacy Casebook

MAIN CLINICAL OUTCOMES One-month post-CTG, the improvement in soft tissue contour and symmetry was significant (Figs 6a, 6b, 7). Preparations were completed for teeth 11 and 21, and impressions of the definitive crowns on implants were taken (Fig. 8). Restoration of tooth 12 with a crown and veneer placement on tooth 11 further enhanced the final aesthetics. The final result exceeded expectations, delivering a balanced, natural and harmonious smile (Figs. 9a–9b). BENEFITS OF CHOSEN SOLUTIONS The CONELOG® PROGRESSIVE-LINE implant, in conjunction with MinerOss® XP and a matching connection temporary abutment, provides a comprehensive and advantageous solution for dental implant procedures. This case highlighted the critical importance of meticulous soft tissue management and careful planning to achieve high-level aesthetic outcomes. The CONELOG® PROGRESSIVE-LINE implant provided excellent primary stability and a predictable restorative platform. Recycling the natural crown offered immediate aesthetics, while MinerOss® XP grafting and the buried CTG enhanced the gingival architecture and long-term soft tissue stability. The CONELOG® PROGRESSIVE-LINE implant progressive thread design, characterised by its conical shape, optimises primary stability, particularly vital for immediate or early loading. It’s specialised surface treatment, significantly enhances osseointegration by promoting faster and more robust bone-to-implant contact, reducing healing time and improving long-term implant stability. The CONELOG® connection, known for its precision, minimises micromovement and stress distribution, reducing the risk of screw loosening and implant failure. This connection also ensures a tight seal, preventing bacterial infiltration. MinerOss® XP, is a reliable bone grafting material that effectively supports bone regeneration and augments the implant‘s foundation. The use of a temporary abutment with the same connection as the final restoration streamlines the restorative process, simplifies soft tissue management, and contributes to predictable aesthetic outcomes. This integrated system maximises stability, osseointegration, and restorative predictability, leading to improved patient satisfaction and long-term implant success. CONCLUSION A key learning point from this case was the reminder that successful implant therapy in the aesthetic zone extends beyond implant placement alone. Proper attention to soft tissue volume and emergence profile is vital. Investing more time in the initial planning phase would have streamlined the treatment and saved valuable time overall. The patient’s satisfaction was exceptional. Previously self-conscious about her smile, she appeared more confident, smiling and speaking freely without hesitation. This transformation was immediately noticeable, even in the waiting room. Immediacy Casebook 7

Fig. 1: Initial clinical presentation showing fractured tooth 21 Fig. 2: Outcome three months after immediate implant placement — aesthetic shortcomings visible Fig. 3: Emergence profile three months after the first surgery, we see that it would be necessary to thicken the tissues around the implant 21 Fig. 4: Diagnostic wax-up for teeth 11 and 12 to enhance smile harmony Fig. 5: Immediate outcome after CTG surgery and new provisionals crowns and mockup Fig. 6a: Soft tissue healing at one month post-CTG Fig. 6b: Occlusal view of improved emergence profiles at one month post-CTG Fig. 7a: Frontal view of soft tissue maturation one month after CTG CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT (IIP) WITH PROVISIONALISATION USING THE NATURAL CROWN. 8 Immediacy Casebook

Fig. 7b: Close-up of new papilla formation and contour around implants 21 and 22 Fig. 8: Impression phase for definitive restorations of teeth 11 and 21 Fig. 9a: Final clinical result showing balanced, aesthetic anterior smile Fig. 9b: Close-up of final restorations demonstrating natural symmetry and soft tissue harmony Immediacy Casebook 9

Dr. Martijn Moolenaar Dental Design Center Moolenaar, Blaricum, Netherlands CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT WITH SOFT TISSUE ENHANCEMENT USING A DIGITAL WORKFLOW IN THE AESTHETIC ZONE. A failing upper central incisor was managed using immediate implant placement with MinerOss® X and free gingival grafting. Through a digitally guided workflow, excellent aesthetic and functional results were achieved. TREATMENT PLANNING AND DIAGNOSIS During the initial consultation, it was noticed that the midfacial soft tissue level of the failing tooth 21 was not in harmony with the adjacent teeth. A face scan, intraoral scan (IOS), and CBCT were taken to address the soft tissue asymmetry and aesthetic challenges. These scans would help plan the implant position so that after healing and maturation the soft tissue position would be enhanced. The new anatomical dimensions for tooth 21 were digitally designed using 3Shape software, optimising its position in relation to the facial profile. This position was then used to guide the implant placement and the design of a guided surgical template. THE SURGERY AND INITIAL OUTCOMES Tooth 21 was extracted, and a 4.3 x 11 mm CONELOG® PROGRESSIVELINE implant was placed immediately using the guide. The socket gap was grafted with MinerOss® X, which was selected for its non-resorbable nature to maintain volume long-term. A connective tissue graft was harvested from the palate, specifically from the first premolar region to the first molar area and placed buccally at the 21 in a supracrestal pouch. This technique required careful dissection of the palate to avoid apical blood vessels and meticulous suturing with a polypropelene 6.0 to ensure full closure. A PMMA provisional restoration, milled to match the new anatomy of tooth 21, was bonded to adjacent teeth using two wings. After initial healing at two weeks, sutures were removed. At eight weeks, the provisional crown was connected to a temporary metal abutment and kept completely out of occlusion to protect the implant during the healing phase. The soft tissues surrounding the implant were then shaped to create an optimal surrounding for the ceramic restoration. TREATMENT TIME 6 months TOOTH NUMBERS 21 TREATMENT TYPE Immediate implant placement with soft tissue grafting, socket grafting, customised provisional and final restoration. PRODUCTS USED CONELOG® PROGRESSIVE-LINE implant MinerOss® X CLINICAL HIGHLIGHTS Immediate implant placement using a CONELOG® PROGRESSIVE-LINE implant in the upper central incisor with soft tissue augmentation Virtual planning with 3Shape and facial scanning to optimise final tooth position Socket grafting using MinerOss® X and free gingival grafting to support tissue contours Successful provisionalisation followed by final screw-retained lithium disilicate crown INITIAL PRESENTATION A patient was referred with a failing upper left central incisor (tooth 21), exhibiting cervical root resorption and mild gingival inflammation. The patient had a high smile line and thin midfacial soft tissue architecture that was not harmonious with the adjacent teeth. Given the aesthetic demands, digital planning and tissue management were crucial in this case. 10 Immediacy Casebook

MAIN CLINICAL OUTCOMES Five months post-surgery, intraoral scanning was used to capture the mature soft tissue contours and implant position. A screw-retained lithium disilicate crown was fabricated in the laboratory and connected to the implant 3 weeks later. The treatment objective to level the soft tissues in a more aesthetically pleasing way was successfully achieved. The result showed successful implant osseointegration, excellent aesthetic integration with adjacent teeth from the ceramic crown and highly stable peri-implant soft tissues. Postoperative care included using BlueM oral rinse and gel starting 48 hours after surgery for two weeks to promote healing. The patient reported high satisfaction with the outcome, and soft tissue contours remained stable throughout follow-up. BENEFITS OF CHOSEN SOLUTIONS 3Shape digital planning allowed for precise implant and crown design to correct tissue asymmetry. MinerOss® X provided stable volumetric graft support due to its slow resorption profile. The connective tissue graft significantly improved soft tissue thickness and contour in the aesthetic zone. The two-phase provisional restoration strategy enabled soft tissue shaping before final prosthesis delivery. Screw-retained final restoration ensured retrievability and longterm prosthetic stability. CONCLUSION This case demonstrates how immediate implant placement after extraction combined with digital planning, grafting, and soft tissue management can yield highly predictable and aesthetic outcomes in demanding anterior cases. Immediacy Casebook 11

Fig. 1: Initial situation Fig. 2: X-ray initial situation Fig. 3a: Implant planning Fig. 3b: Implant planning with face scan Fig. 3c: Implant planning with CBCT Fig. 4: Initial situation on the day of surgery Fig. 5: Implant placement and temporary restoration on the day of surgery Fig. 6: X-ray implant placement CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT WITH SOFT TISSUE ENHANCEMENT USING A DIGITAL WORKFLOW IN THE AESTHETIC ZONE. 12 Immediacy Casebook

Fig. 7: Connection temporary crown to implant Fig. 8: X-ray connection temporary crown to implant Fig. 9: Final soft tissue contour Fig. 10: IOS scanbody Fig. 11: Final result with ceramic restoration Fig. 12: X-ray final result Immediacy Casebook 13

Dr. Frank Leusink Kaakmeesterz, Hengelo, Netherlands CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT AND TEMPORISATION IN THE POSTERIOR MAXILLA USING CONELOG® PROGRESSIVE-LINE IMPLANTS. A 61-year-old male with failing posterior teeth in the upper left maxilla was treated using flapless immediate implant placement with a CONELOG® PROGRESSIVE-LINE implant. MinerOss® XP and BioPlug supported ridge preservation, while PIC photogrammetry enabled efficient and precise temporisation and restoration. TREATMENT PLANNING AND DIAGNOSIS Following panoramic imaging (Fig. 3), a CBCT scan was obtained to assess the alveolar process. Virtual implant planning confirmed the availability of sufficient native bone to support immediate placement of three CONELOG® PROGRESSIVE-LINE implants in regions 23, 25, and 26. Cross-sectional images (Figs. 4a–4c) illustrate the final planned positions, optimised for screw-retained restoration and soft tissue management. The plan called for flapless extractions, immediate freehand implant placement, and socket preservation using a combination of MinerOss® XP and autologous bone. BioHorizons BioPlug PDM would be placed to seal the grafted sites. Multi-unit abutments were to be torqued at surgery to allow for immediate digital impression-taking using PIC photogrammetry in combination with a 3Shape Trios 5 intraoral scanner. A screw-retained PMMA provisional would be delivered within 48 hours of implantation. At four months, a second intraoral scan would guide the fabrication of the final monolithic zirconia bridge. THE SURGERY AND INITIAL OUTCOMES Teeth 23, 25, and 26 were extracted atraumatically under local anaesthesia without flap elevation. Granulation tissue was removed from each socket before the osteotomies were prepared freehand, guided by the virtual plan. All three CONELOG® PROGRESSIVE-LINE implants achieved excellent primary stability, with ISQ values of 80, 78, and 76, respectively. Multi-unit abutments were immediately placed and torqued to 20 Ncm. The peri-implant gaps were filled with a mixture of MinerOss® XP and autologous bone, and the sockets were sealed with BioHorizons collagen BioPlug PDM material. The surgical site viewed occlusally (Fig. 5), shows intact mucosa and precise soft tissue management. A single resorbable suture was used to stabilise the papilla between sites 25 and 26. Photogrammetry scanflags were positioned onto the Multi-unit abutments (Fig. 6) and intraoral scanning was completed. The STL and PIC files were sent to the laboratory to fabricate a temporary PMMA bridge. Two days post implantation, the temporary bridge was immediately inserted onto the Multi-unit abutments with a passive fit. Lateral and occlusal views of the temporary restoration (Figs. 8 and 9) show ideal emergence profiles and soft tissue support. TREATMENT TIME 5 months TOOTH NUMBERS 23, 24, 25, 26 TREATMENT TYPE Immediate implant placement with CONELOG® PROGRESSIVE-LINE bone-level implants and immediate restoration using CONELOG® Multiunit abutments for trans-gingival healing in posterior sites. Grafting with MinerOss® XP and autologous bone. Socket sealing with BioPlug. PRODUCTS USED CONELOG® PROGRESSIVE-LINE implants CONELOG® Multi-unit abutments MinerOss® XP BioPlug PDM INITIAL PRESENTATION The patient, a 61-year-old male, presented with failing restorations in the left maxilla, teeth 23, 25, and 26. The clinical examination revealed deep caries, a fractured premolar, and a molar with a failing endodontic treatment and an overextended crown. The lateral view (Fig. 1) highlights the compromised restorations and soft tissue recession, while the occlusal view (Fig. 2) reveals plaque-retaining prosthetic margins and uneven occlusal architecture. Although oral hygiene was suboptimal, no pockets deeper than 3mm were probed. Teeth 23, 25, and 26 were deemed unsalvageable. Due to the workload and existing commitments, the patient accepted the removal of the teeth but demanded a quick rehabilitation with an immediate temporary bridge. 14 Immediacy Casebook

MAIN CLINICAL OUTCOMES At the four-month follow-up, the implants had osseointegrated with healthy, well-contoured peri-implant tissues and increased ISQ values. The lateral view (Fig. 10a) and occlusal follow-up (Fig. 10b) confirm tissue maturation and aesthetic integration. A second intraoral scan was taken to fabricate the final monolithic zirconia bridge. The final restoration (Fig. 11) was inserted without the need for occlusal or interproximal adjustment, and the final radiograph (Fig. 12) shows stable crestal bone levels and precise abutment fit. BENEFITS OF CHOSEN SOLUTIONS The CONELOG® PROGRESSIVE-LINE implant system delivered predictable primary stability without the need for guided surgery. An excellent system for freehand immediacy cases in the maxilla posterior zone, its prosthetic interface enables easy connection of Multi-unit abutments, simplifying the restorative workflow. MinerOss® XP mixed with autologous bone, proved its value as a slow, resorbable, demineralised porcine bone matrix, alongside BioPlug PDM to facilitate excellent socket sealing with extra attached gingiva and without requiring tension on the flap. The “extra” layer of attached gingiva protects the weakest link – the connection between the Multi-unit abutment and the implant itself. The combination of PIC photogrammetry and intraoral scanning, enabled an efficient and precise workflow, resulting in an immediate temporary bridge and a passive-fitting bridge restoration delivered within 48 hours. CONCLUSION This case demonstrates that immediate implant placement in the posterior maxilla can be predictably achieved using CONELOG® PROGRESSIVE-LINE implants and BioHorizons Camlog biomaterials. By combining PIC dental photogrammetry, intra-oral scanning, and a digital lab, clinicians can achieve passive-fitting bridges that are easy to fit and decrease micro-leakage at the implant-abutment or abutmentbridge connections, adding to the longevity of the implant. Finally, with a carefully planned digital workflow, efficient execution, and attention to soft tissue preservation, clinicians can confidently deliver fast, aesthetically pleasing, and functional outcomes, even in complex, Multi-unit posterior cases that require immediate freehand implantation. Immediacy Casebook 15

Fig. 1: Preoperative left lateral view showing failing restorations and gingival recession Fig. 2: Preoperative occlusal view of posterior maxilla Fig. 3: Panoramic radiograph showing structural failure of teeth 23, 25 and 26 Fig. 4a: Virtual plan for implant placement in site 23 Fig. 4b: Virtual plan for implant placement in site 25 Fig. 4c: Virtual plan for implant placement in site 26 Fig. 5: Post-extraction occlusal view showing implant sites filled and sealed with BioPlug PDM Fig. 6: PIC scanflags in position for photogrammetry CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT AND TEMPORISATION IN THE POSTERIOR MAXILLA USING CONELOG® PROGRESSIVE-LINE IMPLANTS. 16 Immediacy Casebook

Fig. 7: Immediate post-op radiograph confirming implant and abutment seating Fig. 8: Lateral view of PMMA temporary bridge two days post-op Fig. 9: Occlusal view of provisional restoration showing tissue adaptation Fig. 10a: Four-month follow-up, lateral view showing mature soft tissue Fig. 10b: Occlusal view at four months confirming peri-implant health Fig. 11: Final monolithic zirconia bridge in situ Fig. 12: Final radiograph showing stable bone levels and prosthetic fit Immediacy Casebook 17

Dr. Jan Spieckermann Praxis für Oralchirurgie & Implantologie, Chemnitz, Germany CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT RECONSTRUCTION — A DIGITAL, FULLY GUIDED APPROACH. A fully digital, guided workflow enabled precise implant placement and immediate restoration for a 78-year-old patient with an unstable denture, delivering fast, aesthetic and functional results. TREATMENT PLANNING AND DIAGNOSIS The case was meticulously planned using a fully digital workflow, enabling both the surgical and prosthetic teams to collaborate closely. Diagnostic steps included: Cone Beam Computed Tomography (CBCT) to assess bone quality and volume. Digital intraoral impressions to capture accurate dental arch anatomy. Facial scanning to aid in aesthetic planning and harmonize the prosthetic outcome with the patient’s facial structure. Based on these records, a virtual diagnostic wax-up was created to visualize the proposed final prosthesis. This was 3D-printed and virtual evaluated with the patient to ensure alignment with his expectations (Fig. 3 and 4). Once the patient approved the design, a detailed prosthetic-driven surgical plan was developed using SMOP surgical planning software. Two fully guided surgical templates were fabricated, incorporating PROGRESSIVE-LINE guide sleeves, ensuring a highly precise and accurate placement protocol (Fig. 5 and 6). THE SURGERY AND INITIAL OUTCOMES The surgical procedure was performed under local anesthesia, with a focus on minimal invasiveness and patient comfort (Fig. 7 and 8). Key Surgical Steps 1 First surgical template: Precisely anchored on the two remaining telescopic abutment teeth. Facilitated accurate placement of initial implants in ideal three dimensional positions. 2 Tooth extraction phase: After placing the initial implants, the two remaining teeth were extracted. 3 Second surgical template: Fixed to the freshly placed implants. Enabled immediate placement of additional implants into the extraction sockets with precision. TREATMENT TIME 2 hours surgery, ½-hour provisional same day TOOTH NUMBERS 16–26 TREATMENT TYPE Full-arch rehabilitation with CONELOG® PROGRESSIVE-LINE. PRODUCTS USED CONELOG® PROGRESSIVE-LINE implants CONELOG® Multi-unit Abutments INITIAL PRESENTATION A 78-year-old male patient presented with significant functional limitations in the upper jaw. Following the extraction of several maxillary teeth years prior, he had been wearing a removable telescopic denture. This solution had served him for an extended period; however, the recent fracture of a telescopic crown on a previously root canal-treated canine critically compromised the denture’s retention and stability (Fig. 1 and 2). The patient expressed increasing frustration due to the constant movement of the denture, which affected both his comfort and confidence. His primary desire was to regain a fixed, stable solution that restored natural aesthetics and function. The patient was otherwise in good general health, with no systemic conditions or contraindications for implant surgery. 18 Immediacy Casebook

CONELOG® Multi-unit abutments were immediately connected to all implants, allowing for a screw-retained provisional. The use of intraoral photogrammetry (Aoralscan Elite) was a pivotal step in the workflow (Fig. 9 and 10). This scanning technique accurately captured the implant positions, ensuring a passively fitting prosthesis without the traditional requirement for an intraoral verification jig or physical try-in. Immediate Provisional After surgery, a screw-retained, long-term temporary restoration was designed and 3D-printed with a resin material (NextDent C&B MFH “Micro Filled Hybrid”) designed specifically for provisional restorations (Fig. 11 and 12). Although the clinician typically mills immediate temporaries in most cases, a printed version was selected for this instance to explore its clinical potential. A milled provisional was also produced as a backup in the event of fracture or failure. While the printed restoration demonstrated excellent fit, occlusion and aesthetics in this case, further experience is required before recommending printed provisionals for routine use. Postoperative And Mid-Term Outcomes Following implant placement, the patient reported immediate improvements in function and comfort. The stability of the provisional restoration allowed proper soft tissue shaping and patient adaptation. At the 8 week follow-up, excellent hard and soft tissue stability was observed (Fig. 13–15). After six-month the long-term provisional will be removed, and the implant stability and aesthetic result will be evaluated. As final restauration a full-arch FP1 prosthesis is planned. MAIN CLINICAL OUTCOMES Excellent soft and hard tissue contour and health at two months post-surgery. High patient satisfaction regarding postoperative pain, comfort, function, and aesthetics. The digital workflow allowed efficient treatment with fewer appointments, eliminating conventional steps such as physical impressions or manual jig fabrication. BENEFITS OF CHOSEN SOLUTIONS This case exemplifies the benefits of combining immediate implant placement with immediate provisional loading, facilitated by a fully digital workflow. The synergistic use of tools like CBCT, digital impressions, guided surgery, and intraoral photogrammetry delivered: Highly accurate and predictable implant positioning. Passive fit of prosthetic components. Reduced chair time and accelerated treatment timelines. Minimization of analogue errors traditionally associated with manual processes. Improved aesthetic outcomes with patient-approved virtual planning. Less postoperative pain Enhanced collaboration between the surgical, restorative, and laboratory teams. CONCLUSION This case highlights how modern digital dentistry, when paired with advanced implant systems such as CONELOG® PROGRESSIVE-LINE, offers patients faster, more predictable, and aesthetically superior outcomes. Immediate functional loading combined with precise digital planning greatly enhances both clinician confidence and patient satisfaction. The use of technologies such as CBCT, SMOP-guided surgery, facial scanning, intraoral photogrammetry, and 3D-printed or milled provisionals demonstrates how fully digital workflows are no longer the future but the present standard in comprehensive implant rehabilitation. Immediacy Casebook 19

Fig. 1: Preoperative situation with old denture Fig. 2: Preoperative situation without denture Fig. 3: Digital wax-up Fig. 4: Face scan with digital wax up Fig. 5: SMOP stent design Fig. 6: Printed SMOP stent Fig. 7: Implant placement with SMOP guide Fig. 8: Post-op panoramic x-ray CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT RECONSTRUCTION — A DIGITAL, FULLY GUIDED APPROACH. 20 Immediacy Casebook

Fig. 9: AoralScan Elite intraoral photogrammetry coded scanbodies Fig. 10: AoralScan Elite intraoral photogrammetry capture — screenshot Fig. 12: Immediate temporary restoration occlusal view Fig. 11: Immediate temporary design Fig. 13: Preoperative Situation Fig. 14: Immediate temporary restoration 8 weeks Fig. 16: Planned final restorations (future image) Fig. 15: Soft tissue Situation 8 weeks Immediacy Casebook 21

Dr. Joerg-Martin Ruppin Implantatzentrum Dr. Ruppin and Colleagues, Penzberg, Germany CAMLOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT IN THE ANTERIOR ZONE USING SOCKET SHIELD AND FULLY GUIDED SURGERY. A fully guided immediate implant placement using the socket shield technique delivered high aesthetic results in a high-risk anterior case with minimal tissue resorption. Digital planning and fully guided immediate implant placement, using the PROGRESSIVE-LINE Guide System, enabled precise implant positioning. The socket shield (partial extraction) technique was selected to preserve the buccal plate and maintain soft tissue architecture. A CAD/ CAM pre-milled acrylic crown on a Titanium base (“free” system) was fabricated to serve as an immediate provisional restoration. THE SURGERY AND INITIAL OUTCOMES Under local anaesthesia, the ceramic crown and post of #11 were removed, and the buccal segment of the root was carefully preserved to create a socket shield (Figs. 5–6). Pilot and sequential drilling were completed with surgical guidance (Figs. 7–8), followed by guided place­ ment of a CAMLOG® PROGRESSIVE-LINE implant (Figs. 9–10). The implant was placed with 45 Ncm torque and achieved primary stability. Implant stability was further verified using resonance frequency analysis (Osstell® Beacon) with an ISQ value of 68/70 (Fig. 11). The clinician emphasised ISQ (Implant Stability Quotient) resonance frequency analysis as a more reliable indicator than insertion torque alone, particularly in immediate cases where apical bone contact is limited. Autologous bone chips collected during drilling were used to graft the space between the implant and shield. On the same day, out of occlusion, a screw-retained provisional restoration was fitted to seal the socket and support aesthetics (Fig. 12). The patient reported minimal discomfort post-operatively and experienced only minor swelling at the papillae. MAIN CLINICAL OUTCOMES At six months, ISQ readings had increased to 78/78, confirming successful osseointegration (Figs. 13–14). The soft tissue profile remained stable, as shown in both occlusal and frontal follow-up views (Figs. 15 and 13). Digital modelling for the final restoration was completed (Figs. 16–17), followed by fabrication of the final zirconia crown (Fig. 18). The final result showed excellent aesthetics in frontal, lateral, and smile views (Figs. 19–22), with radiographic confirmation of stable integration (Fig. 23). A follow-up CBCT confirmed the socket shield’s effectiveness in preserving the buccal plate (Fig. 24). TREATMENT TIME 1.5 hours TOOTH NUMBER 11 TREATMENT TYPE Immediate Implant Placement (IIP) in the anterior zone using a CAMLOG® PROGRESSIVE-LINE implant, with grafting and immediate temporisation. PRODUCTS USED CAMLOG® PROGRESSIVE-LINE implant INITIAL PRESENTATION A 39-year-old female patient presented with mobility in her upper right central incisor (#11), which had been traumatised more than two decades earlier and treated with root canal therapy, a ceramic post and a crown. The patient had undergone orthodontic treatment and was wearing a fixed retainer. Clinical and radiographic assessment revealed extensive external resorption and a fractured root (Figs. 1–3). Oral health was otherwise excellent, with no periodontal disease, systemic conditions or smoking history. TREATMENT PLANNING AND DIAGNOSIS As teeth #12 and #21 were healthy and intact, the patient asked for implant treatment to replace the fractured tooth #11. CBCT and full digital planning were performed using coDiagnostiX® software (Fig. 4). Due to a thin biotype with multiple recessions on the canines and premolars, a high scalloped soft tissue contour combined with a very thin buccal bone plate, and the risk of hard and soft tissue recession following extraction, the case was considered high-risk for immediate implant placement. 22 Immediacy Casebook

BENEFITS OF CHOSEN SOLUTIONS The selection of the CAMLOG® PROGRESSIVE-LINE implant provided the high primary stability required for successful immediate implant placement. Its features work very well in soft bone or limited residual bone height (simultaneous implant placement in sinus lift cases with reduced bone height) or in immediate implant placement. The socket shield technique allowed for preserving the buccal plate and maintaining soft tissue architecture, even in a high-risk aesthetic zone. Incorporating a Titanium base CAD/CAM “free” system enabled a screw-retained provisional restoration, despite implant angulation and anatomical limitations, ensuring prosthetic flexibility. Furthermore, resonance frequency analysis (ISQ) offered a non-invasive, objective method to assess implant stability at implant placement and over time, supporting confident immediate loading and providing valuable insights during the healing phase. CONCLUSION This case successfully demonstrates that even a high-risk immediacy case can be managed safely through precise digital planning, fully guided surgery, ISQ measurements and the socket shield technique, to achieve highly predictable functional and aesthetic outcomes with the CAMLOG® PROGRESSIVE-LINE implant. Furthermore, it highlights how careful planning and contemporary techniques push the boundaries of immediate implant placement without compromising long-term success. Immediacy Casebook 23

Fig. 1: Preoperative frontal view of the anterior region Fig. 2: Preoperative radiograph confirming root and post position Fig. 3: CBCT scan used for digital planning Fig. 4: Intraoral view following coronal access under local anaesthesia Fig. 5: Socket shield preparation with buccal root segment preserved Fig. 6: Sequential drilling under guided protocol Fig. 7: Implant presentation prior to placement Fig. 8: Implant placement through the surgical guide CAMLOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT IN THE ANTERIOR ZONE USING SOCKET SHIELD AND FULLY GUIDED SURGERY. 24 Immediacy Casebook

Fig. 9: Implant in situ following guided placement Fig. 10: Frontal view of the provisional restoration at six-month followup Fig. 11: Radiographic view at six-month follow-up confirming osseointegration Fig. 12: Digital modelling of the implant channel for final restoration (Titanium base CAD/CAM ‘free’ for angulated screw channel) Fig. 13: Fabricated final restoration prior to placement Fig. 14: Frontal view of the final restoration in situ Fig. 15: Lateral view of the final restoration (left side) Fig. 16: Lateral view of the final restoration (right side) Immediacy Casebook 25

Fig. 17: Final restoration in smile view Fig. 18: Postoperative radiograph showing final restoration and implant integration Fig. 19: CBCT scan demonstrating successful implant integration with the socket shield CAMLOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT IN THE ANTERIOR ZONE USING SOCKET SHIELD AND FULLY GUIDED SURGERY. 26 Immediacy Casebook

Dr. Frederic Hermann TEAM 15 – The dental clinic, Zug, Switzerland CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT IN THE ANTERIOR MAXILLA WITH RIDGE PRESERVATION AND SOFT TISSUE OPTIMISATION. Immediate implant placement in a previously endodontically treated central incisor with apical pathology and buccal fenestration was successfully managed using a CONELOG® PROGRESSIVE-LINE implant and MinerOss® XP, achieving long-term aesthetic stability. TREATMENT PLANNING From a medical perspective, revision of tooth 11, which was endodontically treated, was not viable. Extraction was therefore deemed necessary. Following risk assessment and informed consent, the treatment plan included immediate implant placement to preserve the peri-implant tissues and minimise disruption to the aesthetic zone. A CBCT scan was undertaken to assess the extent of apical pathology and bone loss. Thanks to the favourable alignment following orthodontic treatment, ideal conditions for implant placement were established. A minimally invasive surgical approach was planned to preserve the thin facial bone and papillae. SURGERY AND INITIAL OUTCOMES The periodontal fibres were severed with a sharp blade, and the tooth was carefully extracted from the socket and stored in sterile saline for later use as a provisional restoration (Fig. 4). The socket was curetted and the granulation tissue thoroughly removed. A pilot drill was guided into the palatal socket wall to achieve alignment, allowing for a palatally screw-retained hybrid abutment crown. Parallelisation pins confirmed ideal 3D implant positioning and prosthetic screw channel emergenc (Fig. 5). To achieve high primary stability, osteotomy was under-prepared according to the surgical protocol. A CONELOG® PROGRESSIVE-LINE implant (4.3 x 13 mm) was then inserted with a final torque of 45 Ncm (Fig. 7). Autologous bone chips were collected from the flutes of the form drill (Fig. 6) and mixed with MinerOss® XP. This graft mixture was used to fill the jumping distance between the implant and the buccal socket lamella, and to augment the apical fenestration (Fig. 9). An aesthetic buccal flap approach allowed for the placement of a resorbable collagen membrane (Mem-Lok® Pliable) over the apical defect (Fig. 8). As the implant was to heal submerged, a second collagen membrane was fixed over the implant site with tension-free cross sutures (Fig. 10). The extracted crown was modified from the basal side and used as a bioactive provisional (BAP-concept (Dr. Frederic Hermann)). It was precisely positioned using a silicone stent and bonded to the adjacent teeth with light-curing composite (Fig. 11). The bioactive provisional allowed anatomical shaping of the basal soft tissue and supported faster tissue maturation. At the two-week review, suture removal confirmed excellent healing. TOOTH NUMBER 11 TREATMENT TIME Four months active treatment with a four-year follow-up. TREATMENT Immediate implant placement with grafting and submerged healing in the anterior maxilla. PRODUCTS USED CONELOG® PROGRESSIVE-LINE implant MinerOss® XP Mem-Lok® Pliable collagen membrane INITIAL TREATMENT PRESENTATION The 36-year-old female patient presented with pain and an aesthetically compromised restoration on tooth 11, following completed orthodontic treatment. The orthodontic therapy in our clinic had corrected an Angle Class I and deep bite, resulting in a more harmonious appearance, improved interocclusal distance and a corrected smile line (Fig. 1). Clinical examination revealed a metal-ceramic crown restored with a root post, along with inflamed periodontal soft tissue. Radiographic evaluation confirmed the failure of the post-and-core crown restoration with persistent apical pathology. The patient had reported a history of dental trauma in her youth and had undergone two previous endodontic treatments elsewhere. An apical recession with a draining fistula was now evident, causing hard and soft tissue inflammation (Figs. 2–3). 28 Immediacy Casebook

MAIN CLINICAL OUTCOMES A monolithic zirconia hybrid crown with labial veneering, bonded to a 2 mm cuff height titanium base CAD/CAM with an individual emergence profile, was inclined four months post-surgery (Figs. 12–14). At the four-year follow-up in March 2025, clinical and radiographic assessments confirmed stable, healthy peri-implant tissues, with wellpreserved papillae and gingival contours, and stable bone levels, as well as excellent osseointegration, without signs of inflammation or resorption (Figs. 15–16). BENEFITS OF THE CHOSEN SOLUTIONS The implant provided excellent primary stability despite challenging anatomical bone conditions. Its progressive thread design and the conical apical implant area enabled precise placement. Autologous bone combined with MinerOss® XP supported both preservation of the facial bone lamella and integration. The use of the patient’s own crown as a biologically active provisional proved to be an excellent alternative to immediate temporary implant restorations. This approach avoided premature loading while supporting soft tissue during healing. CONCLUSION This case demonstrates that even in the presence of apical pathology and labial bone defects, immediate implantation in the aesthetic zone can yield stable, long-term outcomes. The four-year follow-up in March 2025 confirmed healthy peri-implant conditions and maintained aesthetic integration. The success of this case was due in part to the use of a 2 mm high titanium bonding base, which enabled the development of an ideal submucosal emergence profile, which supports the thick, stable soft tissue collar. Digital planning, minimally invasive surgical technique, biomaterials, and provisionalisation with the natural crown each contributed to a reliable and efficient treatment outcome. The CONELOG® PROGRESSIVE-LINE implant system, in combination with the underpreparation drilling protocol, provided a reliable and efficient solution for immediate implantation in this complex anterior case. Immediacy Casebook 29

Fig. 7: Insertion of CONELOG® PROGRESSIVE-LINE 4.3 × 13 mm implant Fig. 1: Pre-orthodontic frontal view showing diastema and asymmetrical alignment. Post-orthodontic view showing changed smile line and improved anterior spacing. Fig. 8: Apical fenestration defect exposed with aesthetic buccal flap access within tension lines Fig. 2: Preoperative frontal view showing apical fistula at tooth 11 Fig. 3: Preoperative periapical radiograph showing apical lesion at tooth 11 Fig. 4: Minimally invasive extraction of tooth 11 Fig. 5: Verification of palatal trajectory with parallel pin after pilot drilling Fig. 6: Harvested autologous bone chips collected during implant bed preparation CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT IN THE ANTERIOR MAXILLA WITH RIDGE PRESERVATION AND SOFT TISSUE OPTIMISATION. Gap > 2 mm 30 Immediacy Casebook

Fig. 9: Grafting of the buccal defect using MinerOss® XP and autologous bone chips Fig. 10: Stabilisation of membrane with sutures after graft placement Fig. 11: Post-operative view showing the BAP-concept (by Dr. Frederic Hermann) Fig. 12: Screw retained full ceramic crown (veneered) on Titanium base GH 2 mm Fig. 13: Final view Fig. 14: Smile line, lateral view Fig. 15: Periapical radiograph showing implant integration a 4 year post-surgery result Fig. 16: Radiological follow-up documentation Immediacy Casebook 31

Dr. Alfonso Gil DDS, MsC, PhD Clinica Dental Albia, Bilbao, Spain CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT (IIP) IN THE ANTERIOR ZONE WITH A CONELOG® PROGRESSIVE-LINE IMPLANT. A 40-year-old female presented with mobility and discolouration of tooth 12. The tooth had been traumatised 15 years prior and had a history of palatal abscesses. Radiographic evaluation revealed external root resorption, and the tooth was deemed unrestorable. THE SURGERY AND INITIAL OUTCOMES Surgery began with the extraction of tooth 12 and debridement of the socket. A surgical guide was seated to verify fit, and implant drilling was performed through the guide. A CONELOG® PROGRESSIVE-LINE implant (3.8 x 16 mm) was placed at a screw-retained position with a torque of 40 Ncm, exactly as planned. The buccal jumping gap was grafted with a bovine bone substitute. A Cerec® Scanbody was placed on the implant, and an intraoral scan was taken to fabricate the immediate provisional. The provisional crown was milled in the laboratory from a resin-based CAD/CAM material and screw-retained on the implant. The implant was left to heal under the provisional for 10 weeks. After the healing period, osseointegration was confirmed, and the soft tissue emergence profile was of ideal dimensions for the definitive crown, mimicking the contralateral incisor. A final intraoral scan was taken, and a CAD/CAM veneered lithium disilicate crown was fabricated and cemented onto a titanium base. The definitive crown was screwed onto the implant at 25 Ncm with a passive fit and required no occlusal adjustments. BENEFITS OF CHOSEN SOLUTIONS The key advantage in this case was the immediacy protocol, which significantly streamlined treatment. The approach required only three visits: 1 Extraction, implant placement, grafting, and provisionalisation 2 Digital impression with IOS 3 Definitive restoration delivery This simplified pathway was ideal for the busy physician patient, who particularly appreciated the reduced number of appointments and the excellent aesthetic outcome. TREATMENT TIME 3 months TOOTH NUMBER 12 TREATMENT TYPE Immediate Implant Placement (IIP) in the Anterior zone using CONELOG® PROGRESSIVE-LINE implant with grafting and immediate provisionalization. PRODUCTS USED CONELOG® PROGRESSIVE-LINE implant INITIAL PRESENTATION A 40-year-old female patient presented with mobility and discolouration of tooth 12, which had a history of trauma and recurrent abscesses. As a practising physician with limited availability, she was seeking a fast, aesthetic and minimally invasive treatment solution. TREATMENT PLANNING AND DIAGNOSIS The treatment plan consisted of extraction of a tooth with root resorption, with guided immediate implant placement, bone grafting, and immediate provisionalization. Following healing, a ceramic implantsupported restoration would be delivered. An intraoral scan and CBCT were performed and imported into digital software to plan the implant placement virtually and ensure optimal prosthetic positioning. 32 Immediacy Casebook

MAIN CLINICAL OUTCOMES & CONCLUSION The treatment successfully rehabilitated a failing lateral incisor using a streamlined immediate implant protocol. The integration of digital technology allowed for minimal chair time and an excellent aesthetic outcome. The patient was delighted with the reduced treatment duration and the simplified process, which accommodated her professional schedule. This case highlights the predictability and efficiency of immediate implant protocols in the aesthetic zone. Immediacy Casebook 33

Fig. 1: Initial clinical situation with a failing 12 Fig. 2: Extraction of tooth 12 with external root resorption Fig. 3: Guided implant surgery Fig. 4: Implant placed at a screw-retained position Fig. 5: Cerec® Scanbody for intraoral scan of the implant Fig. 6: Periapical radiograph of the immediate implant 12 Fig. 7: Delivery of immediate resin-based implant provisional crown Fig. 8: Emergence profile after 10 weeks of healing CONELOG® PROGRESSIVE-LINE. IMMEDIATE IMPLANT PLACEMENT (IIP) IN THE ANTERIOR ZONE WITH A CONELOG® PROGRESSIVE-LINE IMPLANT. 34 Immediacy Casebook

Fig. 9: Definitive digital impression (IOS) of the integrated implant Fig. 10: Veneered lithium disilicate screw-retained implant restoration Fig. 11: Final radiograph with implant restoration in place Fig. 12: Final clinical situation with the delivery of the all-ceramic implant-supported restoration Immediacy Casebook 35

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