Single-tooth replacement in the esthetic zone has been one of the most common indications for dental implant placement. Compromised teeth are removed using atraumatic principles and immediately replaced by an implant-supported provisional restoration, with excellent esthetic, biological, and functional results. 

However, the clinical scenario presents a different dilemma in cases of compromised sites with bone loss/gingival recessions. Until now, all developed surgical recommendations required long-term treatment with possible undesirable complications in the tissue architecture. 

The Immediate Dentoalveolar Restoration (IDR) technique  is a surgical and prosthetic protocol established to broaden indications for immediate loading on individual teeth. In this way, tissue losses with various extensions are reconstructed in the same surgical session of implant placement and provisional crown installation, reducing the number of interventions and keeping predictability on esthetic aspects. The IDR technique was developed more than 15 years ago from the need to minimize the treatment time and morbidity of reconstructive procedures used in these cases. 

This course discusses the scientific basis, the step-by-step technique, and indications. The IDR technique advocates minimally invasive surgery and flapless procedures, is presented as a viable and reproducible alternative. 

Several clinical cases will be presented showing one or more compromised socket walls of the tooth involved, with or without gingival margin changes, with long-term clinical, radiographic, and CT scan follow-up.