Today patients are living longer and demanding more stable prostheses to replace teeth as they are lost. Replacing mandibular dentition with immediate load hybrid prostheses via the OSU protocol allows patients to have a definitive restorative solution immediately following surgery. In this retrospective evaluation we review the success rates of hybrid restorations regardless of success or failure of individual variables. The records of 60 patients that had implant surgery for hybrid restorations with immediate load between October 2001 and May 2006 were initially examined. These records were sorted based on the following five inclusion criteria: case performed in the resident clinic, restored with a mandibular hybrid, implant/hybrid complex immediately loaded, patients with a minimum follow-up time of 3 months and, lastly, complete records. Of the original cases reviewed 48 met all of the inclusion criteria. The variables examined for the implant fixture included the following: crestal bone loss, immobility, absence of symptoms (infection, pain and neurosensory disturbances), soft tissue free of inflammation and ability to maintain adequate hygiene. Variables examined for the hybrid prosthesis included the following: passive fit of framework, adequate occlusion, adequate function, esthetics, a design that enables adequate hygiene, and component integrity. Descriptive statistics. One patient (2.08%) had measurable crestal bone loss after one year, seven patients (14.58%) had mobility of at least one implant as established by Periotest (Bensheim an der Bergstrasse, Germany), five (10.41%) had continued symptoms after 3 months, nine (18.75%) had continued areas of soft tissue inflammation after 3 months of healing, and five (10.41%) were not able to adequately maintain hygiene secondary to the surgery. One prosthesis (2.08%) had a non-passive framework, one (2.08%) was found to have inadequate occlusion, eight (16.67%) were found to have inadequate function, and none were found to have poor esthetics. In eight patients (16.67%) the prosthesis inhibited adequate hygiene practices. Eighteen patients (37.5%) were found to have failed component integrity. We found multiple minor issues associated with the surgery as well as the prosthetic reconstruction. However, most of these individual issues were addressed and the patients went on to heal and function uneventfully. This shows that regardless of a number of failures in individual categories evaluated, the overall success rate of the implant/hybrid complex with immediate loading was 93.75% (44 cases). The clinical success rate of the immediate load mandibular hybrid prostheses following the OSU protocol in the resident clinic is very high. Healing time between implant placement and delivery of definitive prosthesis is decreased from 6-9 months to 2 days following the OSU immediate load protocol. This eliminates the need for an interim removable denture for esthetic or functional purposes. The fixed stability of the prosthesis allows the patient to function better and more naturally than any type of removable prosthesis. The anxiety of being seen without teeth is overcome with this treatment decreasing the amount of patient self-awareness.