Straumann® ProTalk Ep. 21 “Clinical Edition” with France Lambert: Immediate implants, immediate impact

Clarifying what immediacy means in clinical reality

In this conversation, Professor France Lambert and Dr. Christian Jarry clearly define and contextualize immediate implant treatment protocols. They distinguish between immediate implant placement (placing an implant in a fresh extraction socket) and immediate loading (placing a restoration on the day of surgery), explaining that these two steps can be combined or performed independently. The ITI Treatment Guide 14 on Immediate Treatment Protocols serves as a kind of “cookbook,” providing structured, evidence-based recipes for partial edentulism scenarios. For clinicians coming out of dental school and feeling overwhelmed by buzzwords like “immediacy” and “immediate loading,” this framework offers a solid foundation and shared language.

Indications, risk assessment, and the role of biology

Professor Lambert emphasizes that immediacy is only truly valuable when it is reliable and produces outcomes comparable to conventional timing. She highlights a structured risk assessment approach focusing on soft tissue quality and quantity, phenotype, presence and integrity of the buccal bone plate, infection status, and the ability to obtain primary stability without compromising ideal 3D implant position. The concept of the “remaining socket” or buccal gap is central: a gap of at least 2–3 mm, filled with biomaterial, supports predictable regeneration. She recalls earlier days when clinicians placed wide implants close to the buccal bone, hoping to “hold the wall,” and explains how preclinical work on socket healing shows that implants alone do not prevent post-extraction remodeling—success depends on biology, proper positioning, ridge preservation, and in selected cases, soft tissue grafting.

Patient-centered benefits and a digitally driven future

The discussion then shifts to why immediacy matters from a patient and workflow perspective. Patients want teeth, minimal pain, fewer surgeries, less time in the chair, reasonable cost, and immediate esthetics—especially in the anterior zone. Immediate protocols, when well indicated, reduce the number of surgeries, shorten treatment time, and can better preserve gingival architecture from day one with well-planned provisional or even final restorations. Professor Lambert describes today as a “golden age for immediacy”: clinicians plan prosthetically and biologically driven treatments using CBCT, digital smile design, virtual abutments, prefabricated provisionals, and guided or navigated surgery. She sees the future in expanding indications—safely pushing the limits in sites with less favorable bone or larger defects as new techniques, biomaterials, and evidence emerge, always grounded in science rather than shortcuts.

Key takeaways

• Immediacy is here to stay: immediate implant and immediate loading in the esthetic zone are evidence-backed and reliable when strict selection and risk assessment criteria are met.
• Success depends on respecting biology and 3D prosthetically driven positioning, ensuring adequate soft tissue phenotype, intact or manageable buccal bone, infection control, primary stability, and a regenerative buccal gap.
• Digital workflows, guided surgery, and structured education (such as the ITI Treatment Guide and dedicated masterclasses) transform immediacy into a reproducible, patient-centered, and time-efficient protocol for both anterior and posterior cases.

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