Title: Advances in implant macrogeometry and surgical protocols for implant placement: Clinical outcomes and surgical perspectives
Abstract:
Implant dentistry has experienced significant progress in the last decade, particularly regarding the optimization of implant macrogeometry and the refinement of surgical protocols. These developments have aimed to address the clinical challenges of achieving predictable primary stability, reducing treatment time, and minimizing complications in both immediate and delayed implant placement. One of the main advances involves the design of wide-thread and tapered implants, which have been shown to enhance mechanical stability, especially in low-density bone or in post-extraction sockets. Their geometry allows for improved distribution of occlusal forces and better engagement of cortical bone, which is crucial for long-term success. Clinical evidence also suggests that thread design influences bone remodeling and marginal bone preservation, supporting better esthetic and functional outcomes. Parallel to these innovations in implant design, digital workflows and guided surgery have transformed surgical protocols. Computer- assisted planning enables prosthetically driven implant positioning with higher precision, reducing surgical risks and improving predictability in complex cases. Guided protocols also facilitate the simultaneous integration of regenerative procedures, such as sinus floor elevation or bone augmentation, broadening the spectrum of treatable cases with minimally invasive approaches. From a clinical perspective, immediate implant placement continues to gain acceptance when supported by evidence-based protocols. The combination of atraumatic extraction, adequate implant macrogeometry, and digital planning provides the basis for achieving primary stability and reducing patient morbidity. Furthermore, the incorporation of biomaterials for gap filling and the use of guided surgery for precise angulation contribute to higher survival and success rates. This presentation will integrate both a literature-based review and documented clinical cases to highlight the impact of macrogeometry and surgical protocols on outcomes. Case examples include immediate placement in the esthetic zone,posterior rehabilitation with sinus augmentation, and management of compromised extraction sockets. Each case emphasizes step-by-step digital planning, choice of implant macrogeometry, and strategies for complication prevention. In conclusion, the integration of advanced implant macrogeometry with refined surgical protocols represents a major step toward predictable and minimally invasive implant therapy. These innovations provide clinicians with tools to manage challenging clinical scenarios, improve efficiency, and enhance patient satisfaction. By combining scientific evidence with practical clinical application, implant dentistry continues to expand the boundaries of what can be safely and predictably achieved in daily practice.
