Many clinicians today recommend implant therapy for patients requiring tooth replacement. This therapy can provide a highly successful restoration of both function and esthetics. As such, more and more dentists are providing restorations and patients are demanding these restorations. Along with such an increase in procedures comes a desire to simplify the experience in regard to many aspects including the time involved from starting the restoration to finishing the procedure. The shortest amount of time involved would be to place the restoration on the implant immediately after the surgical placement of the implant, a procedure called immediate restoration and/or loading. While immediate loading has been discussed in the literature and papers report on this technique, this procedure has not gained widespread acceptance. To understand the possibilities of immediate loading, one must take a careful look at the implant procedure from a historical perspective, from a biological perspective, and from a prospective of the available literature on the topic. This is the focus of this report. One confounding area when discussing immediate loading or any loading protocols is how various terms are defined. Different investigators define certain terms different ways and this can change the interpretation of the results of studies. An example is how Bimmediate loading[ is defined or even the term Bloaded.[ Some investigators suggest that placing an implant into bone and submerging it below the soft tissues results in loading of the implant. The rationale is that flexture of the jawbone upon opening and closing and during chewing exerts forces on the implant and thus Bloading[ the implant. Others would suggest that an implant is loaded when it becomes visible in the oral cavity. This would occur when a nonsubmerged implant is used or when a submerged implant’s closure screw becomes exposed through the soft tissue. The rationale here is that tongue movements, cheek pressure, and food could impact the top of the implant therefore placing a Bload[ onto the implant. Other individuals would suggest that the implant is not Bloaded[ until a temporary restoration or implant component of some shape is placed onto the implant and is in the oral cavity but is not in occlusion with the opposing dentition. Again the rationale in these cases would be tongue and cheek movements and food that would contact the temporary restoration and the opposing dentition. Last, other investigators and authors define Bloading[ as when the implant restoration is in direct contact with the opposing dentition. This is usually confirmed in centric occlusionwith colored occlusal marking paper or shim stock. This is a more objective measure of loading and the term that will be used in this report for the loading of an implant restoration.