Two Stage Implant Therapy
This leaflet has been written solely to explain “Two Stage Implant Therapy”.
In the first stage of surgery, a Titanium dental implant is placed into the bone and is then covered over with the gum and left to heal. After a suitable healing period a second surgery is performed to gain access to the implant and a healing abutment (a small cylinder) is fitted on the implant suturing the gum around this healing abutment. Now the healing abutment perforates the gum and can just be seen in the mouth. The gum is then left to heal around this healing abutment.
Integration of the implant into bone
The word integrate is used to describe the growth of your own natural bone onto the Titanium metal surface of the implant. The healing period for implant integration varies in different areas of the mouth from 8-12 weeks in the lower jaw to 6 months in the back of the upper jaw. If a bone graft is used, healing may take a little longer.
Healing abutment cleaning is very important….
After both stages of surgery, cleaning is very important. For the first 7 days cleaning is achieved using a mouthwash containing Chlorhexidine (either Savacol or Curasept) to limit the formation of bacterial plaque. After the second stage of implant surgery when the healing abutment is fitted, a very soft toothbrush can be used gently from day 7 around the healing abutment to prevent the formation of any dental plaque. After 10 days healing normal brushing must be resumed and the healing abutment must be kept perfectly clean to prevent bacterial products of plaque leading to inflammation of the surrounding soft tissues.
When is it necessary to provide two stage implant therapy?
Two stage implant surgery is necessary if there is insufficient bone or the bone has insufficient strength to allow the implant to be screwed in tight. If the bone is poor quality or if there is insufficient bone volume to cover the implant a bone graft may have to be provided to achieve the best clinical outcome. This must then be covered during the healing period.
How is treatment provided?
First stage surgery is usually provided under general anaesthetic to allow bone grafting to be provided or multiple site surgery to be provided. Second stage surgery placing the healing abutment is normally performed with local anaesthetic, with or without intravenous sedation in the practice.
After surgery to place an implant, a post-surgical review is arranged to check the healing site and make sure that there have been no post-surgical complications. Such problems may include infection and or excessive swelling. After the second stage minimal surgery for uncovering, a further review will take place at around 7-10 days after surgery.
It is normal practice to use a Chlorhexidine mouthwash (Savacol or Curasept) for around 10 days to reduce dental plaque formation and thereby prevent infection. In addition patients are given antibiotics to avoid post-surgical infection and some pain killers, although post-surgical pain is usually fairly minimal. It is advised that patients should avoid any anti-inflammatory drugs after implant placement surgery including over the counter drugs like Nurofen. However, anti-inflammatory drugs can be safely taken after the uncovering procedure (stage 2 surgery).
Contact the friendly team at NQ Surgical Dentistry today on (07) 4725 1656 or call in to see us at 183 Kings Rd, Pimlico QLD 4812
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