What is two-stage implantation in Barcelona and who needs it?
Two-stage dental implantation is a surgical protocol involving the separate timing of intraosseous element placement and subsequent prosthetics. The submerged method involves placing the implant with complete suturing of the mucous membrane over the cover screw during the osseointegration period. This intervention is indicated for patients regardless of gender, primarily in the age group over 21, when the formation of the facial skeleton is complete. The main reason for seeking treatment is partial or complete tooth loss due to caries, periodontal disease, or mechanical trauma. Symptoms signaling the need for implantation include impaired masticatory function, discomfort while eating, and psychological discomfort due to an aesthetic defect.
Diagnostic measures and severity assessment
Diagnosis of the patient's condition is regulated by the 2026 protocols of the Spanish General Council of Dentists and includes mandatory visualization of bone structures. Cone-beam computed tomography is performed to determine bone density using the Hounsfield scale. The severity of the clinical situation is classified based on bone volume and quality:
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Mild degree: sufficient bone volume, primary implant stability is achieved without additional interventions.
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Moderate degree: deficiency in alveolar ridge height or width up to 4 mm, requires guided bone regeneration.
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Severe degree: pronounced atrophy, where performing a sinus lift or bone block grafting becomes a mandatory preparatory stage.
Indications, contraindications, and defect localization
Indications for two-stage implantation in Barcelona include single tooth gaps, multiple missing teeth, and complete edentulism. The location of the lost teeth influences the choice of tactics: in the frontal area, aesthetic parameters are prioritized; in the chewing zone, functional reliability is key. Contraindications are divided into absolute (severe systemic diseases, uncontrolled diabetes mellitus, oncopathology) and relative (inflammatory processes in the oral cavity, smoking, poor hygiene). Eliminating relative contraindications is part of the preoperative preparation.
Advantages and disadvantages of the classical approach
The advantages of the two-stage method in Spain are determined by the biological patterns of healing. Complete submersion of the implant prevents the osseointegration zone from contacting the oral microflora, minimizing the risk of peri-implantitis. The ability to form a natural gum contour using a gingival former ensures a high aesthetic result. The disadvantages are related to the duration of treatment: from implant placement to the fixation of the permanent crown takes 4 to 8 months. Additionally, the patient requires two surgical interventions, although the second is minimally traumatic and takes about 15-20 minutes.
Stages of surgical and prosthetic treatment
The stages of treatment in dentistry in Barcelona are strictly sequential and regulated. First stage: under local anesthesia, the bone bed is prepared, the implant is placed, the cover screw is fixed, and the mucoperiosteal flap is sutured closed. The waiting period for osseointegration begins — 3-4 months in the lower jaw and up to 6 months in the upper jaw. Second stage: a mini-incision is made, the cover screw is replaced with a gingival former to create a natural contour. After 2-3 weeks, the former is replaced with an abutment — the connecting link between the implant and the crown. The final stage involves taking digital impressions and fixing the permanent prosthetic structure made of zirconium dioxide or E.max ceramic.
Types of structures used
The types of implants used are classified by shape and connection type. In the two-stage protocol, root-shaped constructions made of Grade 4 titanium alloys or Ti-6Al-4V ELI with a treated surface to accelerate osseointegration are primarily used. Abutments can be standard titanium or custom-made using the CAD/CAM method from zirconium dioxide to achieve maximum aesthetics. The choice of a specific model depends on the clinical situation and the patient's tissue biotype.
Rehabilitation and prevention of postoperative complications
Postoperative rehabilitation requires adherence to recommendations aimed at preventing complications. In the early postoperative period, solid and hot foods are excluded, and antiseptic rinses with chlorhexidine solutions are prescribed. Prevention of long-term complications — mucositis and peri-implantitis — involves regular hygiene using an irrigator and interdental brushes, as well as professional check-ups every 6 months. According to Catalan health protocols, follow-up includes assessing tissue stability and, if necessary, correcting occlusal loads. Adherence to these rules ensures predictable long-term function of the implants for 25-30 years.
Conclusion from Corona Dental Clinic
At the Corona Dental clinic, the full cycle of surgical and prosthetic treatment is implemented: from the initial consultation and cone-beam computed tomography to the fixation of permanent zirconium dioxide constructions. We perform sinus lifts (closed and open), guided bone regeneration, and the placement of implants from leading global brands using an atraumatic insertion technique. Special attention is paid to the digital protocol: planning with 3D templates and modeling the future smile. The clinic's doctors master techniques for working with various types of abutments (standard, custom CAD/CAM) and use materials with proven biocompatibility, including Grade 4 titanium alloys and E.max ceramics, guaranteeing an aesthetic and long-lasting result.
