Two philosophies shape implantology: one-stage and two-stage healing.
In the one-stage approach implants heal "open": after placement they project above the mucosa while they heal, with the head of the implant above mucosal level. The separate procedure to expose the implant is not needed.
How long a placement takes depends on the difficulty of the procedure and the number of implants. After surgery a patient should not drive or take an active part in traffic for several hours. It is best to be collected or to take a taxi home.
In the two-stage approach the implant is placed at the level of the exposed bone and the mucosa is sutured over the implant head. After healing, the implant is exposed in a small second procedure so that the prosthetic work can begin. Where placement is combined with bone grafting, the two-stage approach offers protection against external influences.
Two routes
To see the bone as clearly as possible for placement, the dentist exposes it by raising a mucoperiosteal flap. Where there is plenty of bone, implants can be placed without raising a flap at all (transgingival placement). Special drills prepare the implant site. A surgical guide can help find the exact direction for drilling so that the implant is optimally positioned and aligned. The implant is placed precisely in the jawbone. Primary stability – the first mechanical stability – is one of the key factors for successful healing (osseointegration).
Two different philosophies shape how implants heal. A distinction is drawn between one-stage (open) and two-stage (closed, submerged) healing.
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