Clinical Feature DENTAL ASIA JULY / AUGUST 2019 42 Case presentation Extraction-Implantation: Immediate Loading of Prosthesis After Surgery By Dr. Patrice Margossian , Doctor of Dental Surgery Dr. Manon Vuillemin , Doctor of Dental Surgery Dr. Vincent Castillo , Doctor of Dental Surgery CDT Gilles Philip , Dental Prosthetist CDT Stevie Pasquier , Dental Prosthetist This article discusses how to accurately establish prosthetic and aesthetic projects before extractions. M odern implantology cannot separate surgical procedures from prosthetic reflection. Pre-surgical prosthetic design is the only way to ensure placements and implant axis which is consistent with the future final prosthesis. The Ditramax system sends aesthetic references (eye-centre line, median sagittal plane, Camper’s line) to the laboratory. Thanks to a more accurate maxillary model, the facial arch allows a more precise simulation of the mandibular kinematics. Initial situation showing the dental migrations and bone lysis associated with periodontal disease. The Ditramax system records the aesthetic parameters. The purpose is to transfer directly on the working model the eye-centre line, the median sagittal plane and the Camper’s line. The prosthesis will, thus, have all aesthetic references to complete the prosthetic design. Functional parameters are recorded with the use of a facial arch (Artex, Amann Girrbach, Arseus-lab), in order to assemble the arches on the articulator. The interarch relationship in this case is the centred relationship, as the dental migration has totally reprogrammed dental centring, locking and guidance.