Zurich, October 2, 2025<\/strong> \u2013 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: \u201cImmediate implantation: always, sometimes, or never?\u201d. What followed was an afternoon of lively, evidence-based debate between experienced practitioners and rising talents \u2013 an exchange that once again highlighted the AID\u2019s core mission: bridging generations through dialogue.<\/p>\n\n\n\n Opening Lecture: Dr. Grunder and Dr. Andreoni on the Fundamentals<\/strong><\/p>\n\n\n\n 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 \u2013 sometimes, they cautioned, even hype. Both speakers emphasized that immediate implantation, while valuable, is often misapplied in cases better suited for delayed protocols.<\/p>\n\n\n\n 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 \u2013 and without augmentation, resorption is likely. As Dr. Andreoni pointed out, \u201cImmediate placement can work beautifully \u2013 but only when it\u2019s done right.\u201d<\/p>\n\n\n\n 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.<\/p>\n\n\n\n The speakers also discussed advanced techniques such as the Socket Shield and Martins da Rosa methods \u2013 highly demanding approaches that can deliver outstanding results in skilled hands, but are due to their complexity not for every clinician.<\/p>\n\n\n\n Three Generations, One Goal: Many Paths to Success<\/strong><\/p>\n\n\n\n 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:<\/p>\n\n\n\n The discussions quickly showed that there is no single \u201cright\u201d 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 \u2013 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.<\/p>\n\n\n\n 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.<\/p>\n\n\n\n Balancing Risk, Skill, and Patient Expectations<\/strong><\/p>\n\n\n\n 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 \u2013 otherwise, valuable learning opportunities are lost. As one panelist noted, \u201cYou only grow by doing, not by delegating.\u201d<\/p>\n\n\n\n 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.<\/p>\n\n\n\n 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 \u2013 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.<\/p>\n\n\n\n Conclusion: Skill Over Speed<\/strong><\/p>\n\n\n\n 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 \u2013 when executed by the right clinician, for the right patient, in the right situation. The symposium\u2019s concluding discussion brought this philosophy into focus: excellence lies not in choosing immediate or delayed placement, but in knowing why<\/em> and when<\/em> to choose either.<\/p>\n\n\n\n\n