In recent years oral implantology has presented a scenery, also influenced by the changes in the current socio-economic context, of radical and rapid change with a protocol variation where simplicity, velocity, mini invasivity and economic management have become the guide parameters. For this reason a procedure which can foresee “One-day immediate loading and Final restoration”, the use of “Super-Short Implants with 4/5/6 mm length”, the protocol “Fixed-on-2” or the insertion of “Machined Implants” could be considered challenging horizons rather than a violation of the dogma. Since 10-15 years in our centre we think to a different relationship between being dentist and the accepted guide lines, and we are convinced that the surgical and/or the prosthetic protocol should be “available to us” and not vice versa. Following the myth of the possible maximum efficacy means to evaluate only the technical problem with the result of years of “ECONOMIC AND BIOLOGIC OVERTREATMENT”, not being able to understand how the possibility to take care of does not result exclusively linked to science and technology. Therefore the patient is at the centre of our therapy, which should be guided by himself, with a historic passage from a STATIC AND OBJECTIVE STEP-BY-STEP to a DYNAMIC procedure, GUIDED BY THE PATIENT! Then, considering the successful results of few clinical works where the flapless technique (1) and the immediate loading of single implants with high insertion torques (2-5) were studied with the RCT method, and focusing on the high performance macrostructure of the new SYRA implants, the successful parameter of the immediate loading on SYRA implants with a “Machined” or “Roughened” surface with definitive prosthesis fitted in one day has been compared: “Immediately loaded and oneday final restoration single implants inserted flapless with Machined or Roughened surfaces. A Splitmouth Randomised Controlled Trial.” The trial includes 50 patients and the hypothesis of the test should be that there are no clinical differences between a procedure with immediate loading a SYRA implant with a ZirTI surface and an identical implantwith a machined surface. The patient of this report, being part of the study, of male gender and 54 years old, presented a medical history of hypertension (therapy: Losartan Potassium), hypercholesterolemia (therapy: rosuvastatin calcium salt) and asymtomatic carotid atherosclerosis (therapy anti-aggregant platelets with aceylsalicylic acid). Besides, he smoked less than 10 cigarettes a day. The implants were placed according to the “One Drill - One Implant” technique with a minimum torque of insertion of 80 Ncm, with flapless method and was immediately performed the impression with the final completion of prosthesis in 24 hours. The study results are at their conclusion and will be submitted to EJOI.
