Immediate Replacement of Four Mandibular Anterior Teeth with a Conventionally Loaded Implant-Supported Fixed Dental Prosthesis

General Risk Assessment

Patient-related Factors

Oral hygiene	Good
Compliance	Good

Patient-medical Factors

Medical Fitness	Healthy, able to undergo planned anesthesia and surgical procedure (ASA I)
Medications	No medications that would negatively affect the surgical procedure and outcomes.
Radiation Treatment	None
Growth Status	Complete

Site-related Factors

Periodontal Status	History of periodontal disease, or active periodontal disease that is controlled and stable.
Pathology near the implant site	None
Previous surgeries in planned implant site	No previous procedures.

Surgical Classification

Surgical Complexity

Timing of placement	Immediate Placement (extraction sockets) (Type I)
Simultaneous or Staged grafting procedures	Implant placement without adjunctive procedures
Number of implants	Two - Three

Anatomy

Keratinized Tissue	Sufficient (>4 mm)
Soft Tissue Quality	No scars or inflammation
Proximity to vital anatomic structures	Minimal risk of involvement

Adjacent Teeth

Papilla	Deficient
Recession	Present
Interproximal attachment	Below CEJ

Extractions

Radicular morphology	Uniradicular
Available apical bone to achieve primary stability	Sufficient height ( ≥ 4 mm) and width (> 2 mm around apex of planned implant)
Socket walls	Intact
Thickness of buccal wall	2mm or greater
Anticipated residual defect after implant placement	2 mm or less

Prosthodontic Classification

Complicating Factors

Biological	Screw-retained restorations with appropriate contours
Mechanical/Technical	Absence of contributing factors
Planned contour of tissue-fitting surfaces	Appropriate contours (hygienic - accessible for maintenance)

Prosthesis Factors

Prosthetic volume	Adequate. Space available for ideal anatomy of the restoration
Inter-occlusal space	Adequate. Capable to create an anatomically & functionally correct planned restoration
Volume and characteristics of the edentulous ridge (fixed)	Adequate. No adjunctive therapy or prosthetic soft tissue replacement will be necessary

Occlusal Factors

Occlusal scheme	User-defined occlusal scheme achievable
Involvement in occlusion	Involved with guidance
Occlusal parafunction	Absent

Complexity

Loading Protocol	Early/Conventional
Interim prosthesis	Tooth supported
Implant-supported provisional restoration	Required, elevated esthetic and/or functional demands
Number of implants	>2 (non-splinted) or ≥ 2 (splinted)
Timing of placement	Immediate Placement (extraction sockets) (Type I)