T he original Branemark protocol for successful implant osseointegration required a healing period of 3–6 months during which the implants were submerged for protection from premature loading. As a result, the use of provisional implants during the osseointegration period, as a means of stabilization of a full-arch interim fixed restoration, has gained popularity in implant prosthodontic treatment. Recently, implant reconstructive dentistry has strongly evolved into 1-stage surgery, such as immediate postextraction, implant placement, and immediate (occlusal/nonocclusal) loading. Nowadays, the cumulative implant survival rate after 10-year-in-function ranges between 96.52% and 98.05% for implants placed in healed and postextractive sites, respectively. One of the main contributions to the successful, long-term, clinical outcomes has been the development of an oxidized implant surface that may improve bone-toimplant contact in virgin healed bone, as well as regenerated bone. On the other hand, the treatment of periodontally susceptible patients is still controversial. Patients with periodontitis often experience early tooth loss that requires implant therapy. Nevertheless, smoking and a history of periodontitis have been associated with a higher prevalence of peri-implantitis. Since their introduction in the early 1970s, fixed partial dentures and implant-supported milled bar overdentures have developed into reliable treatment options in cases of partial as well as total edentulism in both the mandible and the maxilla. A high success rate for implant-retained overdentures has been reported, even if some late implant failures have been observed. Biomechanical evaluation suggests that implant overload is a major contributor to cortical bone loss. A favorable prognosis requires proper bar design and selection of the attachment system, based not only on retention or cost, but also on biomechanics since the attachment is the most fragile link between prosthesis and implant. This case report describes long-term results of a patient with a history of trauma from a motorcycle accident, chronic periodontal disease, recurrent decay, American Society of Anesthesiology (ASA) III clinical condition, insulin-dependent diabetes, and previous implants that had not been restored. The patient was treated in both jaws with multiple extractions of all remaining teeth, immediate implant placement, and implant-retained bar overdentures. Immediate provisional implants (IPIs) were placed between submerged implants to provide support and esthetics for a provisional restoration during healing. A multifactorial approach as well as a clinician-patient relationship was needed in order to ensure optimal treatment planning and a long-term successful result. 1 Cleveland ClearChoice Dental Implant Center, Pepper Pike, Ohio; Case School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio. 2 Department of Oral Rehabilitation, University of Rome Tor Vergata, Rome, Italy. * Corresponding author, e-mail: cab@thedentalimplantcenter.com DOI: 10.1563/AAID-JOI-D-12-00311