Department of Surgery, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Oral and Maxillofacial Surgery, New York University Langone Medical Center and Bellevue Hospital Center, New York, NY, USA.
Oral Maxillofac Surg. 2023 Jun;27(2):245-250. doi: 10.1007/s10006-022-01057-y. Epub 2022 Mar 29.
This study aims to identify whether dental implants placed using a flapless technique have a higher early failure rate, defined as failure within 6 months of placement, compared to implants placed with flap elevation when a surgical guide is not used.
A retrospective cohort study was conducted to evaluate implants placed with either flapless (FL) or mucoperiosteal flap (MF) surgery between 2006 and 2012 at the Philadelphia VA Medical Center (PVAMC). Implant status after FL or MF surgery was assessed using dental encounter and radiographs at subsequent follow-up appointments to assess for early implant failures within 6 months of implant placement.
The FL technique was used to place 89 implants in 38 subjects, while the MF technique was used to place 381 implants in 139 subjects. Early failure occurred in 37 implants, of which 13 occurred in the FL group and 24 occurred in the MF group. FL surgery was found to be associated with a 265% increase in early implant failure (OR 2.653; 95% CL 1.287-5.469) and was statistically significant (p = 0.0064). Residents were over 200% more likely to have an early implant failure when using the FL technique (OR 2.314; 95% CL 1.112-4.816), CONCLUSIONS: Analysis revealed flapless implant placement was associated with higher early implant failure rates. In addition, early failures were more likely to occur when residents placed an implant using the flapless technique. While FL surgery can result in long-term success, it is a more technique-sensitive approach that requires greater clinical skill and stricter case selection to perform.
本研究旨在确定在不使用手术导板的情况下，与使用翻瓣技术相比，无瓣技术（FL）植入物的早期失败率（定义为植入后 6 个月内失败）是否更高。
回顾性队列研究评估了 2006 年至 2012 年期间在费城退伍军人医疗中心（PVAMC）使用无瓣（FL）或黏膜骨瓣（MF）手术植入的植入物。使用后续随访预约中的牙科就诊和射线照片评估 FL 或 MF 手术后的植入物状态，以评估植入后 6 个月内的早期植入物失败。
FL 技术用于植入 38 名患者的 89 个种植体，MF 技术用于植入 139 名患者的 381 个种植体。早期失败发生在 37 个种植体中，其中 13 个发生在 FL 组，24 个发生在 MF 组。FL 手术与早期种植体失败的风险增加 265%相关（OR 2.653；95%CL 1.287-5.469），且具有统计学意义（p=0.0064）。使用 FL 技术时，住院医师发生早期种植体失败的可能性高出 200%（OR 2.314；95%CL 1.112-4.816）。
分析表明无瓣植入物放置与更高的早期种植体失败率相关。此外，当住院医师使用无瓣技术植入种植体时，早期失败的可能性更大。虽然 FL 手术可以取得长期成功，但它是一种更具技术敏感性的方法，需要更高的临床技能和更严格的病例选择来实施。
