Three‐Year Outcome of Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques

Maló, Paulo; Nobre, Miguel de Araújo; Lopes, Armando

doi:10.1111/jopr.12400

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…Few studies have reported comparable outcome with both the techniques,[ 14 , 15 , 26 - 28 , 33 , 40 - 44 ] while few reported that flapless surgery can affect the bone more than flap surgery. [ 12 , 45 ] Difference in the outcomes could be because of the difference in the operating protocol. Few studies have used tissue punch,[ 10 , 23 , 33 , 43 , 46 ] while others have performed drilling directly through the mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…Freehand flapless surgery could be considered less accurate and lead to greater bone loss as shown in the findings of one study by Maló et al . [ 45 ] The difference in the results could also be attributed to the implant location. Few studies have only included maxillary region,[ 15 , 41 , 42 ] while others included were not specific to the region.…”

Section: Discussionmentioning

confidence: 99%

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Comparative evaluation of circumferential crestal bone loss after 1 year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using cone-beam computed tomography: A randomized controlled trial

Dandekar¹,

Lahoti²,

Gade³

et al. 2023

The Journal of Indian Prosthodontic Society

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Aim: The study was aimed to evaluate circumferential crestal bone level after one year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using CBCT. Setting and Design: The study was designed as a Randomized controlled trial. Material and Methods: 32 implants were placed in single edentulous spaces in the mandibular posterior region after random allocation into two groups: Flap surgery (Group A) and Flapless surgery (Group B). Virtual implant planning was performed using Blue Sky Bio software, and static CBCT guided 3D printed surgical templates were fabricated for all participants of both the groups. Immediate non-functional temporization was performed. Circumferential crestal bone levels were assessed after surgery and one-year follow-up using CBCT and XELIS software. Vertical bone loss (VBL) and horizontal bone loss (HBL) was assessed on four sides: buccal, lingual, mesial and distal. Statistical Analysis Used: Data was analyzed using Statistical Package for Social Sciences IBM Corp. Released 2017, IBM SPSS Statistics for Windows, Version 25.0. (Armonk, NY: IBM Corp.) and Graph Pad Prism 7.0 version. The level of significance was chosen <0.05. Chi square test was performed to assess the difference in the age in the two groups. Mann-Whitney U test was performed to compare the two groups for outcome measure. Graphically, quantile-quantile (Q-Q) plot was made using mean and standard deviation for normality verification of data. Results: 100% survival rate and patient compliance was observed along the one-year follow-up duration. By using Mann-Whitney U test, statistically significant difference was found in the vertical bone loss among participants of Flap surgery (Group A) and Flapless surgery (Group B) on all the four sides after one year of implant placement. However, significant results were not obtained for the difference in the horizontal bone level. Conclusion: Within the limitations of this study, vertical bone loss measured circumferentially was more positively correlated with the implants placed with flap surgery compared to flapless surgery after immediate loading in the posterior mandibular region after one year.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of circumferential crestal bone loss after 1 year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using cone-beam computed tomography: A randomized controlled trial

Dandekar¹,

Lahoti²,

Gade³

et al. 2023

The Journal of Indian Prosthodontic Society

View full text Add to dashboard Cite

show abstract

“…In the studies of Job et al, 25 Malo et al, 49 and Tallarico et al, 58 all implants were loaded immediately and in four other studies 32,35,40,48 immediate implant loading was only done using flapless technique. In the other studies, implants were loaded following conventional protocols.…”

Section: Loading Protocolmentioning

confidence: 99%

“…However, the difference was not significant in eight studies. [28][29][30][31][32][33]52,53 In the studies of Malo et al, 49 and Pisoni et al, 51 marginal bone loss was higher in the flapless group, however Malo et al, 49 reported no statistical analysis for comparison between two groups and Pisoni et al 51 showed no significant difference between the two groups. In the RCTs by Bömicke et al 55 and Kumar et al 57 marginal bone loss was significantly lower in the flapless group.…”

Section: Alveolar Bone Lossmentioning

confidence: 99%

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

et al. 2018

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Aim: This study was aimed to systematically review and compare implant treatment outcome including success and survival rates, marginal bone loss and post-operative pain between flapped and flapless techniques of implant insertion. Material and Methods: An internet search was performed in PubMed and Cochrane Library in June 2018 using relevant keywords limited to human studies and English language. Clinical studies evaluating the survival rate, marginal bone loss (MBL) and rate of complications between flapped and flapless techniques for implant insertion were included. The review process was performed by two reviewers and the relevant data was extracted from the included studies. Data was compared in a qualitative manner. Results: Electronic search resulted in 1872 studies out of which 32 (21 RCTs) were selected based on the inclusion and exclusion criteria including 1528 patients and 3047 implants. No significant difference was found between success and survival rate of implants using two techniques except for one study that reported higher success rate in flapless group. Twelve studies reported higher MBL in the flapped groups while two studies showed higher MBL in the flapless group. Less pain following flapless technique was reported in 9 studies. One study, however, showed more pain in flapless technique. Conclusion: Implant survival rate using flapped and flapless technique is comparable. Also, MBL using flapless technique is similar or less than flapped technique. Concerning post-operative complications, flapless technique would probably have less post-operative pain.

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“…8 The circumferential supracrestal fiberotomy in flapless surgery may sacrifice more limited attached gingival tissue than does traditional open flap surgery. 9 In addition, the high costs of surgical guide manufacture and the demand for accuracy in laboratory production limits the clinical applications when considering patients' desires. 10 A variety of factors contributed to the success of implantation, although consensus cannot be reached on whether each factor leads to significant differences in results.…”

mentioning

confidence: 99%

Comparison Between a Computer-Aided Surgical Template and the Free-Hand Method

Chen

Lin³

et al. 2019

Implant Dentistry

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Background: During implantation planning, dentists should be able to make an informed decision regarding whether to use an implant template to assist the surgery.Purpose: The aim of this metaanalysis was to assess the results of implantation with or without an implant template based on the accuracy, survival rate, and other considerations.Materials and Methods: In January 2018, a systematic review was undertaken for randomized controlled trials and retrospective and prospective cohort studies with relevance to implant accuracy and the survival rate between the implant template and free-hand method. The odds ratios (ORs) of the survival rate and the mean difference of accuracy deviation from the selected papers were estimated by meta-analysis.Results: Of the 362 screened articles, 6 studies were included in the meta-analysis. Comparison of the survival rate of implant surgery with or without an implant template revealed no significant result (OR ¼ 1.71, 95% confidence interval [CI] 0.65-4.51). Significant differences in accuracy were observed in angular (mean difference ¼ −5.45 degrees, 95% CI −0.66 to −4.24 degrees) and apical deviation (mean difference ¼ −0.83 mm, 95% CI −1.12 to −0.54).Conclusions: With the technology of computer-aided surgical template, implant placement can be more accurate than free-hand operation. No significant difference is observed in the survival rate between template and freehand.

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Three‐Year Outcome of Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques

Cited by 7 publications

References 17 publications

Comparative evaluation of circumferential crestal bone loss after 1 year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using cone-beam computed tomography: A randomized controlled trial

Comparative evaluation of circumferential crestal bone loss after 1 year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using cone-beam computed tomography: A randomized controlled trial

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

Comparison Between a Computer-Aided Surgical Template and the Free-Hand Method

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