FLAPLESS VERSUS CONVENTIONAL FLAP APPROCH FOR DENTAL IMPLANT PLACEMENT IN THE MAXILLARY ESTHETIC ZONE

Document Type : Original Article

Authors

1 B.D.S. Faculty of Dentistry Thamar University, Yemen

2 Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry Alexandria University

3 Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry Alexandria University.

4 Lecturer of Oral Medicine and Periodontology, Faculty of Dentistry Alexandria University

Abstract

INTRODUCTION: Dental implantology, a special field of dentistry dealing with the rehabilitation of the damaged chewing apparatus due to loss of the natural teeth, is currently the most intensively developing field of dentistry. Missing teeth can be replaced using dental implants, which are inserted into root bearing parts of the mandible or maxilla. The success and long-term prognosis of implant prosthetic therapy depend primarily on the anchorage of the implant in the jaw bone OBJECTIVES: The main objective of this study was to assess clinically and radiographically the flapless versus conventional flap surgical technique in the maxillary esthetic zone. MATERIALS AND METHODS: This study was a randomized controlled clinical trial. It included 16 dental implants. The patients were divided in to two groups: group A, eight implants were placed in the maxillary aesthetic region using flapless procedure, and group B eight implants were placed in the maxillary esthetic region using flap procedure. All patients followed by clinical and radio-graphical evaluation over a period of 6 months. RESULTS: The flap technique showed statistically significant higher mean pain severity and duration, plaque index, probing depth, healing score than the flapless technique. The radiographic evaluation of the flapless implant surgery showed marked decrease in the amount of crestal bone loss in comparison to conventional flap. The mean horizontal and vertical bone loss around implants was significantly less in group A than in group B. There was no difference in bone density between both groups. CONCLUSIONS: The flapless implant surgery reduces the amount of crestal bone loss, soft tissue inflammation, pain, edema, bleeding and consequently soft tissue recession than the conventional flap technique

Keywords

Main Subjects

References

1. Henry PJ. Tooth loss and implant replacement. Aust Dent J. 2000;45:150-72.
2. Al-Sabbagh M. Implants in the esthetic zone. Dent Clin North Am. 2006;50:391-407.
3. Ozan O, Turkyilmaz I, Yilmaz B. A preliminary report of patients treated with early loaded implants using computerized tomography-guided surgical stents: flapless versus conventional flapped surgery. J Oral Rehabil. 2007;34:835-40.
4. Oh TJ, Shotwell J, Billy E, Byun HY, Wang HL. Flapless implant surgery in the esthetic region: advantages and precautions. Int J Periodontics Restorative Dent. 2007;27:27-33.
5. Nidhin R, Vasunni GK, Ajay O, Kurien B. Comparative Evaluation Of Crestal Bone Levels Following Implant Placement With Flap And Flapless Techniques In Posterior Edentulous Areas Of The Mandible-An In Vivo Study. IOSR-JDMS. 2014;13:95-9.
6. Lindeboom JA, van Wijk AJ. A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement. Clin Oral Implants Res. 2010;21:366-70.
7. Rocci A, Martignoni M, Gottlow J. Immediate Loading in the Maxilla Using Flapless Surgery, Implants Placed in Predetermined Positions, and Prefabricated Provisional Restorations: A Retrospective 3‐Year Clinical Study. Clin Implant Dent Relat Res. 2003;5:29-36.
8. Fortin T, Bosson JL, Isidori M, Blanchet E. Effect of flapless surgery on pain experienced in implant placement using an image guided system. Int J Oral Maxillofac Implants. 2006;21:298-304.
9. Plonka AB, Sheridan RA, Wang HL. Flap Designs for Flap Advancement During Implant Therapy: A Systematic Review. Implant Dent. 2017;26:145-52.
10.Jeong SM, Choi BH, Li J, Ahn KM, Lee SH, Xuan F. Bone healing around implants following flap and mini-flap surgeries: a radiographic evaluation3 between stage I and stage II surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:293-6.
11.Jeong SM, Choi BH, Kim J, Xuan F, Lee DH, Mo DY, et al. A prospective clinical study of soft tissue conditions and marginal bone changes around dental implants after flapless implant surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111:41-6.
12.Pjetursson BE, Karoussis I, Bürgin W, Brägger U, Lang NP. Patients' satisfaction following implant therapy. Clin Oral Implants Res. 2005;16:185-93.
13.Atsuta I, Ayukawa Y, Kondo R, Oshiro W, Matsuura Y, Furuhashi A, et al. Soft tissue sealing around dental implants based on histological interpretation. J Prosthodont Res. 2016;60:3-11.
14.Kotz S, Balakrishnan N, Read CB, Vidakovic B. Encyclopedia of statistical sciences. 2nd ed. Hoboken, N.J.: Wiley-Interscience; 2006.
15.Kirkpatrick LA, Feeney BC. A simple guide to IBM SPSS statistics for version 20.0. Student ed. Belmont, Calif.: Wadsworth, Cengage Learning; 2013.
16.Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12:335-41.
17.Oh TJ, Yoon J, Misch CE, Wang HL. The causes of early implant bone loss: myth or science? J Periodontol. 2002;73:322-33.
18.Gomez-Roman G. Influence of flap design on peri-implant interproximal crestal bone loss around single-tooth implants. Int J Oral Maxillofac Implants. 2001;16:61-7.
19.Barunawarty Y. Assessment of the increased calcification of jaw bone with CT-Scan after dental implant placement. Imaging Sci Dent. 2011;41:59-62.

Files

Share

How to cite

Statistics