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Comparison of Two/Three Piece & Single Piece Dental Implants

ConsiderationsSingle Piece [BASAL] ImplantsTwo – Three Piece Implants
Basic designThe implant and the abutment are fused – they are manufactured as one pieceThe implant and the abutment are separate. The abutment is either cemented or cold welded. If the abutment is secured with a screw onto the implant, then it can be considered to be three piece.
Implant Placement ProceduresSingle sitting surgical procedure and very often flapless (no open surgical procedures are necessary). Implant procedures are less time consuming than that required for bridgework.Very often more complex surgical procedures are necessary, spread over 2 or 3 sittings in a period of 3-6 months (Implant placement, Healing Screw placement & Abutment Placement)
LoadingImmediate Loading – ie patient can be given the crown(s) / bridge(s) the very next dayDelayed Loading – very often a waiting period of minimum of 3 months is necessary before loading the implants with prosthesis.
Prosthodontic ProceduresConventional impressions of the implants can be made just as is the case with conventional bridgework. Less time consuming.Requires more complex procedures and is more time consuming.
Sizes & DesignsA wide range of sizes and designs are available suiting various bone types and measurements. The designs even help avoid bone augmentation and sinus lifts.Limited sizes and designs are available thereby limiting their application
CostThese work out a lot more cost effective in comparison with two/three piece implantsExpensive – with respect to the costs of the implants as well as the time taken for multiple procedures
From the patient’s point of viewLess complex placement procedure, less number of sittings and crown(s) & bridges can be cemented in a day or two… more or less like that of a conventional bridgework & costs are comparable with that of conventional bridgeworkMore complex placement procedure involving two or more surgical phases. Crowns / bridges are cemented only after 3 months after the healing phase. Much more expensive than the conventional bridgework.
Long term maintenanceBeing a single piece, the strength provided by the implant is excellent and there is no separate root portion and abutment portion. Maintenance is very simple… maintenance is just the same as that of conventional bridgeworkBeing two piece, the relation between the root portion and the abutment portion can present problems. Studies have proved that two piece implants experience higher mechanical stress under oblique loading. Maintenance of these implants are more complex… very often screws (when used) are to be tightened at periodic intervals as there will be micro-movement between the implant and the abutment.
Healing time – clinicallybone healing time clinically not SignificantProlonged healing significant
Masticatory ForcesTransferred to the basal plate deep into the cortical bone areas which are able to accept large loads and have great capacity of regeneration.Act in the vertical direction along the sides of the screw structure.
Bone Grafting ProceduresNot requiredEssential in cases of deficiency in bone height. Grafting procedures give Unpredictable results.
Smoking PatientsBest option for smokers.Failure rate for smokers is nearly 100%
Controlled Diabetic PatientsBlood Sugar variation does not affect the survival of implant at all.Crestal implants always run risk of failure where there are good blood sugar variation.

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