One-stage implantation is a procedure during which the implant and a temporary crown are installed at the same time, without waiting for implant osseointegration. Immediate dental implantation (also called instant implantation) involves placement of an artificial root immediately after tooth extraction. However, this method is not suitable for everyone and not in all cases.
How Two-Stage Implantation Is Performed
The full implantation complex usually consists of three separate parts:
- implant — an artificial tooth root;
- abutment — a technical element that connects the implant with a crown or another prosthetic structure;
- crown — the visible part of the tooth.
The dental implant (artificial root) must be surgically placed into the bone. Then, after a certain period of time, a crown can be placed on top of the implant so that it looks like a natural tooth.
With two-stage implantation, implants are usually placed several months after tooth extraction and bone healing.
After some time, the doctor evaluates the area and checks whether it is ready for dental implant placement.
However, before drilling holes in the bone, planning is required. To see where the bone is located and how to place the implant, a special X-ray scan called cone beam computed tomography (CBCT) is required. Using special software, the doctor can digitally plan implant placement before touching any surgical instrument.
The next step is placing the implant into the bone. Then it is necessary to wait for the gums to heal and for the implant to integrate. Ideally, about six months should pass from the date of implantation — this is how long it takes for the implant to become stable and be surrounded by bone tissue.
After the implant heals in the bone, the gums are reopened and the implant is exposed. This step explains why the procedure is called two-stage. After opening the gums, the doctor places a healing abutment on the implant. Then the gums heal around the abutment.
After several weeks, impressions are taken for a crown, bridge, or denture that will eventually be placed on the implant.
One-Stage Implantation – What Is the Difference
In one-stage implantation, the implant is placed immediately after tooth extraction. A temporary crown is placed on it, and later replaced with a permanent one. Thus, the patient leaves the dentist immediately with a tooth, even if temporary, which looks like a natural one.
In one-stage implantation, the implant and abutment are placed immediately, instead of burying the implant under the gum.
During one-stage implantation, the patient receives one anesthesia session, under which the tooth is extracted and the implant is placed using a transgingival method — without cutting the gums. In one-stage implantation, one-piece implant designs are usually used.
Approximately one week later, a permanent crown is placed instead of the temporary one.
However, one-stage implantation may be impossible if infection has destroyed a significant part of the surrounding bone, or if the bone was damaged or destroyed during tooth extraction.
Bone quality may also be insufficient for one-stage implantation, especially in certain areas of the mouth or in patients with certain diseases.
How One-Stage Implantation Is Performed
Before tooth extraction, CBCT scanning is performed. The oral cavity is also prepared for surgical procedures — if necessary, caries, gum diseases, etc. are treated.
If necessary, a surgical guide may be fabricated — a polymer construction visually resembling a mouthguard. Such guides are created individually for each patient using a digital model based on a 3D scan of the patient’s dentoalveolar system.
Thus, already at the modeling stage of the restored dentition, the correct implant position is planned.
During the fabrication of the implant guide, holes (tunnels) are created to define the position and direction of the implant and allow the implant surgeon to perform precise implantation.
Then the tooth is extracted, the implant is placed, and a temporary crown is installed.
Contraindications for One-Stage Implantation
Contraindications include:
- loose and porous bone tissue or bone deficiency;
- inflammatory processes at the implantation site;
- presence of cysts, granulomas, or periodontal diseases;
- age under 18 years.
Advantages of One-Stage Implantation
The main advantage is proper gum contour formation, which helps avoid complications, including periodontal diseases. The gums acquire a correct and natural shape around the implant.
It is also important that the patient immediately leaves the dentist with an almost fully functional tooth, solving two problems at once — aesthetic and functional: presence of a tooth helps prevent bone tissue atrophy.
Disadvantages of One-Stage Implantation
One-stage implantation is associated with a higher risk of failure, while two-stage implantation is more reliable. The reason is that after one-stage implantation, chewing load is immediately applied directly to the implant. This may lead to implant rejection or instability.
Another disadvantage is strict requirements for bone condition, as one-stage implantation requires sufficient bone volume.
One-piece implants usually used in one-stage procedures are less flexible than two-component implants due to their solid construction. This lack of flexibility limits detailed modification and adjustment during placement. The implant itself usually does not break, but the connection between the implant and bone may fail.
Dental implantation is a surgical procedure that can be either two-stage or one-stage. The choice depends on the condition of the jawbone and the patient’s needs — whether they prefer fast results and aesthetics immediately, or a more reliable but longer process.
Which option is best for you can be determined during a consultation with a prosthodontist at YAREMA DENTAL clinic, where any implantation protocol can be successfully performed.
This article does not replace a medical consultation. For complete and personalized information, please consult your dentist.