One-Piece vs. Two-Piece Implants: Which is Better?

by Dental-Pedia
One-Piece vs. Two-Piece Dental Implants: Which is Better?

Dental implants usually consist of three components — the implant body, the abutment, and the restoration. The implant body is implanted into the jawbone, the abutment protrudes from the gum and supports the prosthetic tooth, and the restoration is the visible part of the tooth crown. 

Of the various dental implant systems and shapes that have developed, especially in the early days of implantology, two basic forms have essentially remained: one-piece and two-piece implants. Below, we highlight the unique features of one-piece and two-piece implants. 

One-piece implants consist of a single workpiece whose abutment protrudes from the mucosa after implantation.

One-Piece Dental Implants 

One-piece implants consist of a single workpiece whose abutment protrudes from the mucosa after implantation. There is no dividing line between the intrabony and the prosthetic implant area. These implants are mainly used for larger work in the posterior region, but single tooth gaps, also in the anterior region, can also be restored with one-piece implants. 

Advantages of one-piece implants:

One-piece implants are much more resistant to fracture and insertion costs are usually lower because there is no cost for an abutment. If one-piece implants are placed in a minimally invasive way, the stress on the patient caused by the operation is considerably less. 

Disadvantages of one-piece implants:

The prosthetic part, the abutment, protrudes into the oral cavity, so there is a risk of lateral loads which endanger the success of the implantation. This can be prevented by a suitable temporary restoration, e.g., by splinting with the adjacent teeth. Since the abutment is firmly attached to the implant, the dental crown that is to be anchored on the implant cannot always be optimally aligned. 
Alignment plays a major role in the function of the dental prosthesis and, above all, in esthetics. The use of prep caps can compensate for this disadvantage. Prep-caps are a type of abutment for one-piece implants that compensate for insertion divergences of the implant. 

Two-piece implants are also called two-stage implants. The implant consists exclusively of an intrabony part, which is inserted into the jawbone.

Two-Piece Dental Implants 

Two-piece implants are also called two-stage implants. The implant consists exclusively of an intrabony part, which is inserted into the jawbone. The prosthetic part, the implant head, is placed later after the implant has successfully grown into the jawbone. 

The implant body is inserted so deeply that it is flush with the gum (mucosa) or just below it. After the implant has successfully grown into the jawbone, an abutment is screwed onto the implant body to support the dental crown.
Depending on the insertion method (conventional with incisions and sutures or minimally invasive without incisions and sutures), this procedure proceeds differently. Two-piece implants can close individual gaps, but they can also be used for larger jobs up to the restoration of an edentulous lower jaw. 

Advantages of two-piece implants:

Since no abutments protrude into the oral cavity with two-piece implants, lateral loads (lateral shear forces) are practically excluded. Different shapes and materials are available for the implant abutment (abutment) in different angles, so that the subsequent denture can be optimally fitted into the tooth row. 

Disadvantages of tow-piece implants:

With two-piece implants, there is a gap between the implant body and the abutment. Depending on the construction of the implant, bacteria can get into the interior of the implant through this gap and pose an increased risk of infection. Unlike the one-piece implant, two-piece implants may require two surgeries to fit the implant with the prosthesis, but this depends on the placement protocol. 

Abutments for Two-Piece Implants

The abutment is the prosthetic abutment for a two-piece implant, on which the final prosthesis or matrices for fixing a removable prosthesis are attached. In the case of difficult insertion conditions, an aesthetically satisfactory solution can only be achieved with a two-part implant. 

The abutment is the prosthetic abutment for a two-piece implant, on which the final prosthesis

Premium implant systems, which are designed for all implantological indications, usually have a wide range of different abutments: as straight and angled versions, in different angulations (angles), and different materials, e.g., titanium or ceramic/zirconium dioxide. 

Titanium implants have been used widely for dental implantation for decades. But in recent years, it has become increasingly clear that titanium implants increase the risk of bacterial infections, plaque adhesion, and peri-implantitis. Ceramic implants (zirconium dioxide) address the primary problems associated with titanium implants because they minimize the risk of bacterial infections and peri-implantitis, ensuring optimal gingival health. 

Your dental implant surgeon should ideally discuss all of your options while curating a treatment plan.  

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