Performance of double acid-etched surface external hex titanium implants in relation to one- and two-stage surgical procedures

Background: The use of external hex titanium implants is widely accepted; however, in the past few years, they have been placed by using not only the traditional two-stage surgical protocol, but also the one-stage surgical protocol. The aim of the present study was to compare the success rates that can be obtained from two-stage surgeries (conventional protocol) and one-stage surgeries when double acid-etched surface external hex titanium implants are used. Methods: A total of 654 double acid-etched surface external hex titanium implants were studied in 195 patients (109 females and 86 males) aged 18 to 79 (mean 49.20). These patients were followed-up both clinically and radiographically for 3 years. Among these implants, 338 were inserted by means of two-stage surgery and 316 were placed following the one-stage surgery protocol. Results: The success rate of the whole sample of double acid-etched surface implants was 99.23%. The results showed a 99.05% success rate for one-stage surgeries and 99.40% rate for two-stage surgeries. Only three of the implants inserted by performing one-stage surgery and two of the implants placed using two-stage surgery failed before they were loaded. No implants were lost after the loading was completed. The bone level at 12 months was 0.58 mm for one-stage-placed implants and 0.54 mm for two-stage-placed implants. At 24 months the bone level was 0.77 mm and 0.68, respectively, and at 36 months 0.89 and 0.83. Conclusion: The similar and high success rates obtained in one- and two-stage surgeries using double acid-etched surface external hex titanium implants demonstrate that it is possible to choose the most convenient surgical procedure for each particular case without increasing the risk of failure.