Flapless Implant Surgery. Better results, enhanced osseointegration.

Flapless Implant Surgery:  An Experimental Study
By: Seung-Mi Jeong, Byung-Ho Choi, Jingxu Li, Han-Sung Kim, Chang-Yong Ko, Jae-Hyung Jung, Hyeon-Jung Lee, Seoung-Ho Lee, Wilfried Engelke


Objective:

The purpose of this study was to examine the effect of flapless implant surgery on crestal bone loss and osseointegration in a canine mandible model.


Materials & Methods:

In 6 mongrel dogs, bilateral, edentulated, flat alveolar ridges were created in the mandible. After 3 months of healing, 2 implants in each side were placed by either flap or flapless procedures. After a healing period of 8 weeks, microcomputerized tomography at the implantation site was performed. Osseointegration was calculated as percentage of implant surface in contact with bone. Additionally, bone height was measured in the peri-implant bone.


Results:

The mean osseointegration was greater at flapless sites (70.4%) than at sites with flaps (59.5%) (p < .05). The mean peri-implant bone height was greater at flapless sites (10.1 mm) than at sites with flaps (9.0 mm) (p < .05).


Conclusions:

Flapless surgery can achieve results superior to surgery with reflected flaps. The specific improvements of this technique include enhanced osseointegration of dental implants and increased bone height.

Clinical feature after implant placement.
Fig. 1. Clinical feature after implant placement.
A: Flapless surgery
B: Flap surgery
Three-dimensional micro-CT showing the bone (yellow) around the implants (gray).Fig. 2. Three-dimensional micro-CT showing the bone (yellow) around the implants (gray).
A: Flapless surgery 
B: Flap surgery
Three-dimensional micro-CT overview of the bone-to implant contact area (red) around the implant surface (gray).

Fig. 3. Three-dimensional micro-CT overview of the bone-to implant contact area (red) around the implant surface (gray).
A: Flapless surgery
B: Flap surgery

Table showing the parameters of bone-to-implant contact and bone height around dental implants when placed either without or with a flap

 

 

 

 

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