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Background and objective: Flapless implant surgery has been suggested as a suitable treatment technique for implant placement, but limited information exists regarding the clinical conditions after flapless implant surgery. This study aimed to compare flapless implant surgery with traditional flap implant surgery clinically and radiographically. Methods: Sixty patients (23 males and 37 females) participated in the present study. The patients were divided into two groups, in the Group 'A' 30 implants were placed by traditional flap surgery and in Group 'B' 30 implants were placed by flapless implant surgery (punch technique). Clinical and radiographic examinations were carried out to assess the implants condition. Clinical examination included implant mobility which was assessed by using universal torque ratchet at the end of healing period (6 months). The periapical radiograph was carried out to assess marginal bone loss around the implants at three and six months after implantation. Results: Two implants failure were reported; one implant for each of the Group 'A' and 'B'. There was no significant difference between the two groups with regard to the marginal bone resorption (P = 0.487). The success rate for both groups was 96.6%. The study showed a non-significant relation of age and gender with the success rate. Conclusion:The flapless implant surgery could offer advantages over the classic protocol and should have the potential to increase the patients' acceptance of the procedure.

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Implant placement in severely atrophic jaws is especially challenging because of the poor quality and quantity of the future implant bed. Although various bone augmentation procedure like ridge augmentation, sinus lift these procedures are possible today but it may lead to surgical morbidity they increase the risks and costs of dental implant treatment as well as the number of necessary operations. Also sometimes the patient is not agreeing for such extensive surgical procedures, according to the well-known implantological rules for dental restorations, crestal implants are indicated in situations when an adequate vertical bone supply is given but single piece dental implant (basal implants) is a viable treatment option derives support from the basal bone area which usually remains free from the infection and less prone to resorption.