Day 1 – Friday, 3 May 2024

Compromised fresh extraction sites in anterior locations present a real challenge to many clinicians, the treatment decision is often in the favor of delaying implant placement (the early placement protocol) that claimed that immediate implant placement in compromised sites did not offer any clinical reliability and posed higher risk to the overall treatment outcome. However delaying implant placement has shown several drawbacks that include; the drop of both vertical and horizontal socket profiles, the higher tendency to post restorative recession as a result of the mucoperiosteal flap reflection, longer treatment time, multiple surgical innervations, the hardship of fabricating several provisional restorations during the treatment time , and the poor esthetic results specially when restoring  continuous adjacent sockets or in thin phenotypes patients  .  This presentation describes a novel clinical protocol to treat wide varieties of fresh extraction sites (thin, or deficient labial plate of bone, severely compromised, actively infected) using a single minimally invasive techniques that allows immediacy, shorten the treatment time to only 8 weeks from the start to the final prosthetic insertion. The protocol is designed to rehabilitate the defective socket environment while placing immediate implant at the same surgical setting thus providing immediacy. The VST protocol is an evidence based concept drawn from an extensive research work conducted in the past 5 years , the VST offered a spermine esthetic outcome, long term stability of the marginal tissues,  preserved the original socket topography during the steps of the treatment until the treatment completion, no mid facial post restorative recession, and offered a long term predictable clinical outcome in sockets presented with active signs of infection .