Open Healing: A Minimally Invasive Protocol with Flapless Ridge Preservation in Implant Patients

Abstract

We aimed to validate the safety and efficacy of the minimally invasive “open healing” flapless technique for post-extraction socket and alveolar ridge preservation, while assessing the alveolar bone changes. The study enrolled (n = 104) patients (0.55 sex ratio), with atraumatic extraction of (N = 135) hopeless teeth, followed by either immediate placement of tissue level implants (N1 = 26), or later stage implant insertion (N2 = 109). No flap was raised in either situation. Post-extraction sockets were filled with deproteinized bovine bone granules and covered by collagen resorbable membrane—left purposely exposed during healing. This yielded an uneventful healing, with sufficient bone formation, while avoiding soft-tissue problems. The need for additional augmentation was assessed clinically and by calibrated CBCT scans at six months, before either loading (N1) or implant insertion (N2). Implant success and survival rate were evaluated at 12-, 24-, and 60-month follow-up control sessions. The inserted implants had a survival rate of 98.5% and a success rate of 94.8% at five-year follow-up. Open healing technique with flapless approach can be favorable for preserving the 3D architecture of the post-extraction socket, as well as the alveolar ridge width and height.

Clinical Effect and Aesthetic Evaluation of Minimally Invasive Implant Therapy

“…Conventional implant surgery is difcult to be accepted by patients because of its long operation time, frequent follow-up visits and relatively serious complications such as postoperative bleeding, swelling, and pain. Minimally invasive implant surgery signifcantly shortens the operation time, reduces the pain, edema and local infammatory reaction caused by conventional surgery, and greatly reduces the fear of patients, which is in line with the development trend of minimally invasive and painless implant surgery [11][12][13]. Te results of this study show that the operation time, antibiotic use time, swelling degree and pain degree of patients in minimally invasive surgery group are signifcantly lower than those in conventional surgery group.…”

New Operative Protocol for Immediate Post-Extraction Implant in Lower-First-Molar Region with Rex-Blade Implants: A Case Series with 18 Months of Follow-Up

“…However, other authors have described the correlation between bone resorption. the surgical and prosthetic techniques employed [10,11], and the timing of the insertion of the implant [12][13][14]. Many authors have focused to a greater extent on how to fill the socket and which biomaterial to use to avoid bone resorption after extraction and to obtain bone in the socket with good gloveless properties and good quality [15][16][17][18][19][20][21].…”