Long-term clinical performance of flapless implant surgery compared to the conventional approach with flap elevation: A systematic review and meta-analysis

Cai, He; Lü, Xing; Sun, Dong-Yuan; Chen, Junyu

doi:10.12998/wjcc.v8.i6.1087

Cited by 11 publications

(4 citation statements)

References 33 publications

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“…Flapless and flap procedures are both widely applied in implanting [39]. As high survival rate is one basic requirement for dental implanting, we have compared SR of the two approaches and found no significant difference, which was consistent with previously published reviews [9][10][11]. In most of the included studies, patients were prescreened using radiographs to make sure that there was enough bone volume for implantation.…”

Section: Discussionsupporting

confidence: 84%

“…Some experts have compared the clinical performances of the two techniques mainly focusing on the SR or success rate of implants, peri-implant marginal bone loss or KM width. Those conclusions of the existing investigations were conflicting, while most of them found comparable clinic effects with similar SR between the two techniques [9][10][11]. However, a study discovered that flapless technique would increase the failure risks of implants [12].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of general and aesthetic effects between flapless and flap techniques in dental implantation: a meta-analysis of randomized controlled trials

et al. 2021

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Background Information about the aesthetic effects of flapless in implant surgeries is scant. Differences of the survival rate (SR) and crestal bone loss (CBL) between the two techniques were also controversial. Thus, this review was aimed to compare the general and aesthetic effects of flapless and flap approaches in implant surgeries. Materials and methods Following the principals of PRISMA, literature databases were searched for the eligible randomized controlled trials (RCTs) comparing the clinical performances of flap and flapless techniques. After that, relevant data of selected studies were pooled and analyzed to compare SR, bleeding on probing (BOP), probing depth (PD), visual analogue scale (VAS), papillae presentation index (PPI), keratinized mucosa (KM) width and CBL between the two techniques. Results Fourteen RCTs were included. No significant difference was found in SR (RR = − 0.01, 95% confidence interval (CI) (− 0.05, 0.04)), BOP (OR = 0.40, 95% CI (0.15, 1.02)), KM width (WMD = − 0.42, 95% CI (− 1.02, 0.17)) between two groups. Subgroup analysis revealed that the difference of CBL was insignificant in two groups (WMD = − 0.13, 95% CI (− 0.63, 0.38)). However, flap techniques would lead more peri-implant PD (WMD = − 0.37, 95% CI (− 0.51, − 0.23)). Subgroup analysis also indicated lower VAS scores in flapless group after 1 day (WMD = − 1.66, 95% CI (− 2.16, − 1.16)) but comparable pain experience after 3 days (WMD = − 0.59, 95% CI (− 1.33, 0.16)). Mean difference of PPI (WMD = 0.32, 95% CI (0.28, 0.35)) between the two groups was significant. Conclusions The flapless procedure showed a superiority in preserving gingival papillae, reducing postoperative pain and peri-implant PD compared to the flap procedure, while exhibiting comparable effects on SR, BOP, KW width changes and CBL. Flapless technique is more recommended at the ideal soft and hard tissue implanting sites.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Comparison of general and aesthetic effects between flapless and flap techniques in dental implantation: a meta-analysis of randomized controlled trials

et al. 2021

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“…Terefore, strict aseptic operation, strict disinfection of instruments and materials, and appropriate anti-infection treatment for patients are required. Minimally invasive implant can reduce the operation steps, shorten the operation time, minimize the damage to patients' gingival tissues, preserve the integrity of gingival papilla, and ensure the tight surrounding of gingival mucosa around the implant after operation [18]. Te attached gingiva closely surrounding the edge of the implant can efectively resist friction and pressure.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effect and Aesthetic Evaluation of Minimally Invasive Implant Therapy

Liu

et al. 2023

Emergency Medicine International

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Objective. To explore the clinical effect and aesthetic evaluation of minimally invasive implant in the treatment of dentition defect. Methods. From April 2020 to May 2021, 60 patients who received implant restoration were collected as the research objects. Randomly divided into minimally invasive surgery group (30 patients) and routine surgery group (30 patients). The postoperative antibiotic use time, pain disappearance time, swelling degree, and pain degree of the two groups were compared. Follow-up for one year, record and compare the success rate of implants and aesthetic evaluation of restoration between the two groups. The evaluation of patients’ satisfaction with restoration was collected and compared. Results. The operation time and antibiotic use time of patients in minimally invasive surgery group were significantly shorter than those in conventional surgery group, and the swelling degree rating was significantly better than that in conventional surgery group, with statistical significance ( P < 0.05 ). The number of patients with no pain (0 degree) and mild pain (degree) in minimally invasive surgery group was significantly higher than that in routine surgery group, and the difference was statistically significant ( P < 0.05 ). One year after the repair, the success rate of implants in minimally invasive surgery group was 100.00% compared with that in routine surgery group (93.33%), and the difference was not statistically significant ( P > 0.05 ). The aesthetic effect scores of patients in minimally invasive surgery group were higher than those in routine surgery group in seven items: proximal gingival papilla, distal gingival papilla, labial gingival margin curvature, labial gingival margin height, root convexity, soft tissue color, and soft tissue texture, with statistical significance ( P < 0.05 ). The satisfaction scores of the patients in minimally invasive surgery group in chewing function, comfort, aesthetics, retention function, and language function were higher than those in conventional surgery group, and the differences were statistically significant ( P < 0.05 ). Conclusion. Minimally invasive implant can achieve the same effect as conventional implant, and it has the advantages of lower postoperative swelling, shorter pain time, better aesthetic effect, and higher satisfaction after restoration.

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“…Faster soft-tissue healing, decreased perioperative hemorrhaging, shorter surgical time, and less patient discomfort postoperatively are other advantages of flapless surgery. On the other hand, the surgical procedure in flapless surgery is performed blindly, which can lead to fenestration of the osteotomy site and implant mispositioning 42 , 43 . A meta-analysis conducted in 2014 compared the flap and flapless surgical procedures for implant placement in healed extraction sockets and indicated that the risk of implant failure was higher in flapless surgery in most of the reviewed studies 38 .…”

Section: Discussionmentioning

confidence: 99%

Sinus floor elevation and simultaneous implant placement in fresh extraction sockets: a systematic review of clinical data

Ekhlasmandkermani

Amid

Kadkhodazadeh

et al. 2021

JKAOMS

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Combining different procedures to reduce the number of surgical sessions and patient discomfort in implant placement and sinus floor elevation has been recommended, and evidence supports good outcomes. The aim of this study was to review the results of clinical studies on sinus floor elevation through extraction sockets and simultaneous immediate posterior implant placement. An electronic search was carried out in PubMed, Scopus, and Web of Science to find English articles published in or before August 2020. A manual search was also performed. Titles, abstracts, and the full-text of the retrieved articles were studied. Thirteen studies met our eligibility criteria: 6 retrospective case series, 3 case reports, 2 prospective cohort caseseries, 1 prospective case series, and 1 randomized controlled trial. Overall, 306 implants were placed; 2 studies reported implant survival rates of 91.7% and 98.57%. The others either did not report the survival rate or reported 100% survival. Sinus floor elevation through a fresh extraction socket and simultaneous immediate implant placement appears to be a predictable modality with a high success rate. However, proper case selection and the expertise of the clinician play fundamental roles in the success of such complex procedures.

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Long-term clinical performance of flapless implant surgery compared to the conventional approach with flap elevation: A systematic review and meta-analysis

Cited by 11 publications

References 33 publications

Comparison of general and aesthetic effects between flapless and flap techniques in dental implantation: a meta-analysis of randomized controlled trials

Comparison of general and aesthetic effects between flapless and flap techniques in dental implantation: a meta-analysis of randomized controlled trials

Clinical Effect and Aesthetic Evaluation of Minimally Invasive Implant Therapy

Sinus floor elevation and simultaneous implant placement in fresh extraction sockets: a systematic review of clinical data

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