Does implant staging choice affect crestal bone loss?

J Oral Maxillofac Surg. 2012 Feb;70(2):307-13. doi: 10.1016/j.joms.2011.09.006. Epub 2011 Dec 14.


Purpose: The purpose of the present study was to compare the crestal bone loss around implants placed according to either a 1-stage or 2-stage implant installation procedure using a digital subtraction radiography technique.

Materials and methods: In the present randomized clinical trial, screw-shaped tapered implants were inserted in the posterior mandible of patients needing fixed partial dentures. In each edentulous area, according to the randomization table, 1 implant was inserted using a 1-stage procedure (group 1) and 1 was placed using a 2-stage approach (group 2). The implants were temporized with the relined denture after 2 weeks. All implants were functionally loaded with fixed partial dentures after 3 months. Crestal bone loss (primary outcome variable) was measured using a digital subtraction radiography technique. Standardized radiovisiographs were taken after implant insertion, after fixed partial denture installation (3 months after surgery), and after 6 and 12 months of functional loading. The data were analyzed using the Wilcoxon signed ranks test (α = 0.05).

Results: Eleven patients (mean age 46.9 years, 3 women and 8 men) were included in the study. A total of 34 implants were inserted, 17 using a 1-stage protocol and 17 using a 2-stage protocol. Three months after implant placement, the 2-stage implants showed significantly more crestal bone loss (0.65 ± 0.71 mm) than the 1-stage implants (0.41 ± 0.53 mm; P = .02). However, after 6 and 12 months of functional loading, both groups showed comparable changes in bone level (P > .05).

Conclusions: No differences were found between 1-stage and 2-stage implant placement in crestal bone loss after 1 year of functional loading.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alveolar Bone Loss / diagnostic imaging
  • Alveolar Bone Loss / etiology*
  • Alveolar Process / diagnostic imaging
  • Dental Implant-Abutment Design
  • Dental Implantation, Endosseous / methods*
  • Dental Prosthesis Design
  • Dental Prosthesis, Implant-Supported
  • Denture, Partial, Fixed
  • Female
  • Follow-Up Studies
  • Humans
  • Immediate Dental Implant Loading
  • Jaw, Edentulous, Partially / diagnostic imaging
  • Jaw, Edentulous, Partially / rehabilitation
  • Jaw, Edentulous, Partially / surgery
  • Male
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Middle Aged
  • Radiography, Dental, Digital
  • Subtraction Technique
  • Surgical Flaps
  • Treatment Outcome
  • Young Adult