One vs Two Stage Dental Implant Surgery
One Stage Procedure
One stage dental implant surgery refers to doing one surgery only and allowing an abutement to stick out of the gums, which allows us to place a tooth over the top. This procedure has the benefit of quick aesthetics and you walk out of the surgery with a tooth.
The one stage dental implant surgery is a great choice for the front teeth, as most people want a front tooth after they walk out of the dental chair. However one stage procedure is not always possible. When the surgery is performed, we aim to tighten the implant to a torque of 35 newtons. However you may have thin bone or implant spins in your socket, or we can torque only to less than 35 newtons. In such cases it is better to perform a two stage procedure.
The benefit of the one stage procedure is less surgery, less pain, and quick aesthetics. The negative is that you load the dental implant during the osseointegration (bone fusing to the implant) phase, and can result in overload. Once a patient has the implant, they do not feel any different with a dental implant, chew normally and can cause damage to the osseointegration.
The dental implant does not break but it’s the bonding of the dental implant to the bone that can break, which often results in "Doc, I forgot you told me not to bite too hard on it and I heard a big crack when I chewed”. That’s why two stage surgery has a higher success rate than one stage surgery.
Two stage procedure
The two stage dental implant procedure is where you have two surgeries which allows for a higher success rate. The first stage of dental implant surgery is when we place the implant into the jaw bone and allow the tooth and the dental implant 2-3 months to osseointegrate, or fuse together. No pressure or biting or loading forces are applied to the dental implant which results in the 98% success rate of the two stage procedure.
Once the dental implant has fused to your bone after two months, then we can start with the second stage surgery which involves uncovering the dental implant and connecting the abutement to the fixture. Discomfort and pain after the second stage dental implant surgery is minimal compared to the first stage dental implant surgery where swelling and discomfort is present.
So which procedure is best? The two stage dental implant surgery definitely has higher success rates, but requires two surgeries. The one stage dental implant surgery is great for fast aesthetics provided YOU DO NOT CHEW HARD ON THE DENTAL IMPLANT! Failures in the one stage dental implant surgery are mostly associated with patients biting hard on them. Once the two months of osseointegration is complete you can chew on the implant all you want.