What is the effect of initial implant position on the crestal bone level in flap and flapless technique during healing period?

Abstract

PurposeThe level of the implant above the marginal bone and flap design have an effect on the bone resorption during the healing period. The aim of this study is to detect the relationship between the level of the implant at the implant placement and the bone level at the healing period in the mesial and distal side of implants placed with flapless (FL) and full-thickness flap (FT) methods.MethodsTwenty-two nonsubmerged implants were placed with the FL and FT technique. Periapical radiographs were taken of the patient at implant placement, and at 6 and 12 weeks. By using computer software, bone level measurements were taken from the shoulder of the healing cap to the first bone implant contact in the mesial and distal side of the implant surface.ResultsAt 6 weeks, the correlation between the crestal bone level at the implant placement and crestal bone level of the FT mesially was significant (Pearson correlation coefficient=0.675, P<0.023). At 12 weeks, in the FT mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.297, P<0.346). At 6 weeks in the FT distally, the correlation was nonsignificant (Pearson correlation coefficient=0.512, P<0.107). At 12 weeks in the FT distally, the correlation was significant (Spearman correlation coefficient=0.730, P<0.011). At 6 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.083, P<0.809). At 12 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.062, P<0.856). At 6 weeks in the FL distally, the correlation was nonsignificant (Spearman correlation coefficient=0.197, P<0.562). At 12 weeks in the FL distally, the correlation was significant (Pearson correlation coefficient=0.692, P<0.018).ConclusionsA larger sample size is recommended to verify the conclusions in this preliminary study. The bone level during the healing period in the FT was more positively correlated with the implant level at implant placement than in the FL.

Minimally invasive flapless vs. flapped approach for single implant placement: a 2‐year randomized controlled clinical trial

“…Another study conducted by Al‐Juboori et al. () evaluated the effect of initial implant position on the crestal bone level in flap and flapless technique during healing period. Twenty‐two non‐submerged implants were placed with the flapless and flap technique with a follow‐up of 12 weeks.…”

“…This rich vascularity provided a good defense mechanism against bacterial invasion (Al‐Juboori et al. ).…”

“…In the flapped sites on the other site, the countersinking procedure was more controlled according to the guidelines of the manufacturer because visual inspection in situ was possible. However, after 1-4 years observation, no statistically difference of MBL was demonstrated between both groups (De Bruyn et al 2011). Another study conducted by Al-Juboori et al (2013) evaluated the effect of initial implant position on the crestal bone level in flap and flapless technique during healing period. Twenty-two non-submerged implants were placed with the flapless and flap technique with a follow-up of 12 weeks.…”

“…The authors attributed the results to the rich blood supply to the alveolar bone when the periosteum and blood vessels were preserved from cutting in the flapless group. This rich vascularity provided a good defense mechanism against bacterial invasion (Al-Juboori et al 2013).…”

Marginal Bone Changes around Dental Implants after LIPUS Application: CBCT Study

“…One of the etiological factors of marginal bone loss is the disruption of the periosteum and blood supply during flap elevation and placement of implant [17]. Some studies showed that less marginal bone loss was noticed when flapless technique is used as compared with full-thickness flap technique that showed more marginal bone loss during healing period [18][19][20][21].…”