Stage I Implant Surgery

In the preceding units you have already learnt the principles, diagnosis and treatment planning for a patient who requires and is to receive dental implants.The actual process of dental implant placement begins with Stage I Surgery, wherein an appropriately sized and precisely sited hole is drilled in the bones of the mandible or maxilla in region of the planned prosthetic rehabilitation. Successful implant surgery is largely dependent upon good planning and meticulous technique. The former requires an appreciation of the restorative requirements and visualization of the desired end result of treatment, whereas the latter requires adequate surgical training and experience of the selected implant system.

Carl E. Misch 1 has defined Implant Stage I Surgery or Root Form Surgery as the osteotomy carried out to insert an endosteal implant in the proper location and angulation so it maybe used as a prosthetic.The smaller the devital zone that forms around the implant subsequent to the surgical trauma, the more likely rigid fixation will occur. The aim is to provide for a rigid fixation of the implant within the bone so as to abolish movement of the implant in the immediate post-insertion period - primary stabilization. The bone-implant distance should ideally not be greater than 30-40 μm which will prevent intervening fibrous tissue formation and allow for osseointegration,thereby increasing chance of implant success.