Immediate loading, as well as immediate post-extraction implant insertion are well accepted procedures in Evidence Based Dentistry. In the case of immediate loading of implants placed immediately after teeth extraction, implants primary stability seems to be a keystone to complete a successful case. This is particularly true in the treatment of the upper jaw in elderly female patients. In this case the use of long implants with aggressive and stable shape could lead to excellent primary stability in both insertion torque and ISQ values. After abutment connection, the patient received immediate full arch provisional prosthesis. After three months a digital impression was taken with an intraoral scanning device and a computer designed mixed Implant Bridge/Toronto Bridge was delivered.