Healing of peri-implant tissues after flapless and flapped implant installation.

AIM

The aim of this study was to investigate the consequences of different flapless procedures for the installation of dental implants on peri-implant bone response.

MATERIALS AND METHODS

After bilateral extraction of the mandibular second and third premolars and a 3-month healing period, 30 SLActive(®) implants were installed for 3 months in 10 Beagle dogs according to three different surgical approaches, i.e.: (1) flapped (F), (2) tissue punch flapless (P), and (3) direct flapless (DF).

RESULTS

At harvesting, 29 implants were analysed. Micro-computed tomography and histomorphometrical evaluation (which also included the mobile implants) showed comparable results in bone volume (F=55 ± 9, P=51 ± 4, DF=54 ± 5) and crestal bone level (F=3420 ± 762, P=5358 ± 1681, DF=3843 ± 433). However, the implants inserted using the punch approach revealed a significantly lower first bone contact (F=3420 ± 762, P=5358 ± 1681, DF=3843 ± 433) and bone-to-implant contact percentage (F=70 ± 12, P=48 ± 23, DF=73 ± 12). Considering the gingival response, the barrier epithelium was also significantly deeper around the implants installed using the punch approach (F=1383 ± 332, P=2278 ± 1154, DF=1107 ± 300).

CONCLUSIONS

The results indicate that a flapless surgical technique can be used for the installation of oral implants. In addition, using a tissue punch wider than the implant diameter should be avoided, as it can jeopardize the outcome of the implantation procedure.