One-stage implantation is a procedure in which the implant and a temporary crown are placed at the same time, without waiting for the implant to integrate. Immediate dental implantation (also called instant implantation) involves inserting an artificial root right after tooth extraction. However, this method is not suitable for everyone or in every case.
How Two-Stage Implantation Works
The full implantation process usually consists of three separate parts:
• implant – an artificial tooth root;
• abutment – the technical element that connects the implant to the crown or another prosthesis;
• crown – the visible part of the tooth.
The dental implant (artificial root) must be surgically placed into the bone. After some time, a crown can be installed over the implant so that it looks like a natural tooth.
In two-stage implantation, implants are usually placed several months after tooth extraction and bone healing. After some time, the dentist assesses the area and checks if it is ready for implant placement.
Before drilling holes in the bone, a plan is required. To see where the bone is and how to place the implant, a special X-ray called cone-beam computed tomography (CBCT) must be done. Using dedicated software, the dentist can digitally plan the placement of the implant even before touching any surgical tools.
The next step is to place the dental implant into the bone. Then it is necessary to wait for the gum to heal and for the implant to integrate. Ideally, about six months should pass from the implantation date – that is how long it takes for the implant to stabilize and become surrounded with bone tissue.
Once the implant has healed in the bone, the gum is reopened, and the implant is exposed again. This step explains why this procedure is called two-stage. After reopening the gum, the dentist places a healing abutment on the implant. Then the gum heals around the abutment.
After a few weeks, impressions are taken for the crown, bridge, or denture that will eventually be placed on the implant.
One-Stage Implantation – What’s Different?
In the case of one-stage implantation, the implant is placed immediately after the tooth extraction. A temporary crown is placed on it, and later – a permanent one. This way, the patient leaves the dentist already with a tooth (even if only a temporary one), which looks like a natural one.
With one-stage implantation, the implant and abutment are placed immediately, instead of burying the implant under the gums.
During one-stage implantation, the patient receives a single anesthetic, under which the tooth is removed and the implant is inserted using a transgingival method – without cutting the gum. One-stage implantations typically use non-separable implant designs.
After approximately one week, a permanent crown is placed instead of the temporary one.
However, one-stage implantation may be impossible in cases where infection has destroyed a significant amount of the surrounding bone or if the bone is damaged or destroyed during tooth extraction.
The quality of the bone may also simply be insufficient for one-stage implantation, especially in certain areas of the mouth or in patients with specific medical conditions.
How One-Stage Implantation Is Performed
Before tooth extraction, a CT scan is done. Oral cavity preparation is also carried out before surgery, treating caries, gum disease, etc. if needed.
If necessary, a surgical guide may be made – a polymer structure 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 jaw. This way, the correct position of the implant is planned even at the modeling stage. When creating the implant guide, holes (channels) are made in it that determine the position and direction for the implant, allowing the implantologist to perform implantation flawlessly.
Then the tooth is removed, the implant is placed, and a temporary crown is installed
Contraindications for One-Stage Implantation
This method has the following contraindications:
• loose and porous bone tissue or bone deficiency;
• inflammatory processes in the implantation area;
• presence of cysts, granulomas, or periodontal disease;
• age under 18 years.
Advantages of One-Stage Implantation
The main advantage of this type of implantation is that it achieves proper gum contour formation, which helps avoid complications, including periodontal diseases. The gum acquires a correct and natural shape around the implant. Also, there is no need to drill a hole for the implant with special instruments.
It is also important that the patient immediately leaves the dental clinic with an almost complete tooth, which solves both aesthetic and practical issues: having a tooth helps prevent bone tissue atrophy.
Disadvantages of One-Stage Implantation
One-stage implantation carries a higher risk of failure, whereas two-stage implantation is more reliable. The reason is that after one-stage implantation, chewing and biting stress is applied directly to the implant. This may lead to implant rejection or instability.
Another disadvantage is the strict requirements for bone condition, as one-stage implantation requires sufficient bone volume.
Non-separable implants, which are usually used in one-stage procedures, are less flexible than two-component implants due to their solid construction. This lack of flexibility prevents more detailed modifications and adjustments during placement. The implant itself does not break, but the connection between the implant and the bone may fail.
Summary
Dental implantation is a surgical procedure that may be performed as either two-stage or one-stage. Choosing one or the other depends on the condition of the jaw bone and the needs of the patient — whether they prefer a quick result and immediate aesthetics, or choose a more reliable but longer process. Which option is best for you can be determined during a consultation with an orthopedic dentist at YAREMA DENTAL, where both implantation methods are successfully performed.