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I read on some articles saying that two-piece (kind of nut-and-bolt system) dental implants might have gap as time goes, because a man chews foods everyday.

Some bad bacteria (anaerobic bacteria such as Porphyromonas gingivalis) may live in the gap, as I read from a dentist's article.

However, most famous dental implants are still two-piece system, although I found that many small manufacturers produce one-piece system.

What are the advantages and disadvantages of one-piece system? Are there any guidelines for helping patients decide between one-piece and two-piece implants?

  • Good edit, @Lucky. I retracted my close vote. – Carey Gregory Mar 15 '16 at 14:37
  • I would always a teeth bridge. This takes very less time than a dental implant. Most of the times the dentist gives you an option or alternative – hellojoe Nov 14 '18 at 9:05
  • There is also a snap system ( like a western shirt) . I have 4 implants each in upper and lower jaws and the dentures snap in and out each day. The snap inserts need to be replaced about once a year. It has worked for 10+ years. – blacksmith37 Jul 2 '19 at 15:41
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The simplest answer is that both types of systems are more or less equal.

Long answer: It's actually the dentist that needs to be aware of a few concepts:

  1. The angle of the bone in which the implant is placed relative to the position of the crown that will be on top of it. they are not always in line. The ideal scenario is second from left, while the worst one is 3rd from the left. Nobody wants a screw to show up in the front of the crown! To remedy this problem it is possible to use the second stage in a 2-piece system to reangulate the crown. enter image description hereenter image description here

  2. Amount of gingival tissue between the bone and the mouth. If the gingiva isn't very thick, it might be advantageous to remove the intermediate step, so that as little as possible metal shows through the gingiva.

  3. Ability of the bone to endure immediate loading of the implant. If both the implant and the platform come in one piece, the implant will be exposed to forces in the mouth immediately after being placed, while the two piece option permits us to temporarily bury and avoid putting immediate stress on the implant, thereby enabling it to better integrate the bone, especially if the later is of poor quality.

  4. To address your concern about a micro crack appearing between the two pieces, it is most often due to the insufficient tightening of the screw. At least 15-25 Newtons need to be applied, using an implant screw, to sufficiently tighten the the pieces to avoid the appearance of a micro crack and further of the screw.

My source, excluding professional formation:

http://www.oralhealthgroup.com/features/the-one-piece-implant-design-prospective-case-report/
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