Open flap versus flapless placement of dental implants. A randomized controlled pilot trial

Abstract

The aim of this study was to compare the immediate postoperative period of participants rehabilitated with dental implants placed with a conventional technique or with a minimally invasive technique, without a mucoperiosteal flap elevation (flapless). Participants who needed implant placement were divided into two groups: one group was operated using a mucoperiosteal flap elevation (G_A), and the other with a flapless surgical technique (G_B). Objective clinical parameters including oral hygiene, mouth opening, inflammation (facial perimeter), surgical time and analgesic consumption, as well as subjective parameters of pain and degree of satisfaction with the procedure, were evaluated. 48 implants were placed in 30 participants (15 participants per group). Oral hygiene index, maximum interincisal opening, pain and analgesic consumption values had a significant difference between groups favoring the flapless technique at 24 h and 7 days but at the 15 days' follow-up the differences were only significant for oral hygiene and pain (P < 0.05); there were no statistically significant differences between groups in terms of facial perimeter values and surgical time (P > 0.05). Average on the degree of satisfaction was of 2.6 (SD 0.8) for G_A and 3.6 (SD 1.02) for G_B (P = 0.06). One implant placed in G_A (2.0%) failed before prosthetic loading due to mobility and pain at 3 months' follow-up. Participants operated for implant placement with flapless surgical technique go through less postoperative discomfort. Both techniques show high success rates, but to perform a flapless technique patients must be properly selected.

Dental implant placement with flapless and flapped technique: A systematic review

“…Regarding the level of evidence,21 out of 32 reviewed studies were randomized clinical trials (RCTs). 26,30,31,[33][34][35]40,[42][43][44][45][46]48,51,[53][54][55][56][57][58] The exclusive results of these studies were similar to the results of all studies combined. In RCTs, no difference in implant survival rate between both techniques were found.…”

“…Although in nine studies The study of Jané-Salas et al, 56 showed that the patients in the flapless group had less complications, pain and mouth opening reduction compared to the patients in the flap group.…”

Indications for 3-D diagnostics and navigation in dental implantology with the focus on radiation exposure: a systematic review

“…After 5 years, clinically insignificant marginal bone loss was detected at implants placed with navigation [ 53 ]. Postoperative swelling and bleeding, however, were reduced [ 37 , 53 , 54 , 59 – 61 ] due to the minimally invasive approach provided by navigation-guided dental implant placement [ 60 ].…”

Three-Dimensional Radiographic Outcome of Free-Handed Flaplessly Placed Mini Dental Implants in Edentulous Maxillae after 2-Years Function

“…Flapless surgery uses rotary burs or a tissue punch to gain access to the bone without flap elevation, so the periosteal vascular supply and surrounding soft tissue are not disturbed. This minimally invasive surgical technique has many advantages [12]. It allows a shorter surgical time with minor postoperative discomfort.…”