Evaluation of Osseointegration and Stage II Implant Surgery

After having learnt about the surgical placement of implants(stage I) surgery in the previous unit you would have realized that all the parameters of proper implant selection, atraumatic sequential osteotomy preparation and the attainment of primary stability are focused towards achieving osseointegration. We now progress to the next level where after the suitable healing period after stage I, the clinician needs to assess the success or failure of osseointegration before proceeding to the prosthetic phase of the treatment.

There are two basic approaches in stage I surgery with respect to the transmucosal connection of dental implants. The conventional two stage implants have an implant which is submerged under the mucoperiosteum in Stage I surgery after a cover screw is placed to close the implant abutment connection. In these cases a Stage II surgery entails the uncovering of the implants and establishing an intra-oral communication of the implant with either a healing abutment or an abutment with a provisional prosthesis in order to develop the soft tissue collar around the implant. In the other scenario, where in a one piece(one stage implant) or an implant with a transmucosal collar is used, there exists a intra-oral communication of the implant at the time of Stage I surgery itself and therefore does not require a stage II procedure. All that is needed in these cases is to evaluate the success or degree of osseointegration before progressing to the prosthetic phase.In this unit you will learn how osseointegration helps in the success of the implant treatment. You will also learn how to differentiate between osseointegration and fibro-osseous integration and learn surgical procedure of uncovering of the implants in the maxilla and mandible(stage II implant surgery).