Immediate implantation: experts debate indications and limits at the 5th AID Symposium in Zurich (english version)

Zurich, October 2, 2025 – At Lake Side on the shores of Lake Zurich, the Alliance for Implant Dentistry (AID) welcomed clinicians to its fifth annual symposium under the guiding question: “Immediate implantation: always, sometimes, or never?”. What followed was an afternoon of lively, evidence-based debate between experienced practitioners and rising talents – an exchange that once again highlighted the AID’s core mission: bridging generations through dialogue.

Opening Lecture: Dr. Grunder and Dr. Andreoni on the Fundamentals

The scientific program opened with a joint lecture by Dr. Ueli Grunder and Dr. Claude Andreoni, who traced the evolution of immediate implant placement from its early case reports in the 1970s to its current popularity – sometimes, they cautioned, even hype. Both speakers emphasized that immediate implantation, while valuable, is often misapplied in cases better suited for delayed protocols.

They reminded the audience of a biological reality that remains unchanged: following tooth extraction, both vertical and horizontal bone resorption occur. When an implant is placed immediately, the alveolar bone still remodels – and without augmentation, resorption is likely. As Dr. Andreoni pointed out, “Immediate placement can work beautifully – but only when it’s done right.”

A key factor, stressed several times, is the gingival biotype. Thick soft tissue provides far better conditions for long-term esthetic and structural stability. Dr. Grunder, known internationally as a leading expert in soft-tissue management, also underlined that immediate implantation often results in vertical soft-tissue loss. However, he noted that this can be significantly mitigated through soft tissue grafting.

The speakers also discussed advanced techniques such as the Socket Shield and Martins da Rosa methods – highly demanding approaches that can deliver outstanding results in skilled hands, but are due to their complexity not for every clinician.

Three Generations, One Goal: Many Paths to Success

After the lecture, nine panelists took the stage to analyze clinical cases and discuss treatment choices from multiple perspectives, moderated by Dr. Thomas Truninger and Dr. Christian Ramel. The panel represented three generations of clinicians:

• Council of Elders: Dr. Ueli Grunder, Dr. Claude Andreoni, Dr. Konrad Meyenberg
• Mid-Career Minds: Dr. Sven Mühlemann, Dr. Marco Zeltner, Dr. Julien Kirchhoff
• Future Dental Minds: Dr. Katrin Zumstein, Dr. Quirin Döbelin, Dr. Kevser Pala

The discussions quickly showed that there is no single “right” approach to immediate implantation. Depending on the case, clinicians weighed the benefits of immediate versus delayed placement differently. In some situations, more experienced clinicians leaned toward immediate placement, while in others, younger colleagues opted for delayed protocols – reflecting differences in clinical judgment, experience, and treatment philosophy. What everyone agreed on was that immediate implantation demands careful case selection, patient-specific planning, and refined surgical skills.

Many of the mid-career and younger clinicians also highlighted the growing role of guided surgery in achieving precision during placement. Especially in immediate cases, digital planning and guided workflows were praised as tools that not only enhance accuracy but also increase safety and predictability in daily practice.

Balancing Risk, Skill, and Patient Expectations

The conversation also touched on the question of when to refer cases that could be solved with immediate implant placement, but the treating clinician does not have the required skill set yet. The consensus: if a clinician can achieve a predictable result using their current skills and a delayed protocol and the patient agrees with the treatment plan, they should proceed – otherwise, valuable learning opportunities are lost. As one panelist noted, “You only grow by doing, not by delegating.”

Patient communication was an important recurring theme. Every patient has different esthetic priorities and risk tolerance, and while it is often assumed that speed is key for many patients of today, sometimes, a less invasive or delayed approach may actually better align with their expectations.

Finally, the panel addressed the frequently discussed issue of higher failure rates after immediate implantation. While scientific data generally support this trend, the panelists shared their own interpretation, suggesting that many of these outcomes could be influenced by clinician experience – in other words, by who performs the procedure and how. They agreed that in skilled hands, and with proper case selection, the risk difference may be far less pronounced or not even there at all.

Conclusion: Skill Over Speed

By the end of the afternoon, the message was clear: immediate implantation is neither a universal solution nor a technique to fear. It is a valuable option – when executed by the right clinician, for the right patient, in the right situation. The symposium’s concluding discussion brought this philosophy into focus: excellence lies not in choosing immediate or delayed placement, but in knowing why and when to choose either.

Autor: Dott.ssa Anna Stelling-Germani