Tarpara Kenil J, Goyal Rohit, Sheshamani Niyutna, Singh Navneet, Kumar Hem, Mirdah Waseem F, Gupta Seema
Department of Oral and Maxillofacial Surgery, Maharaja Ganga Singh Dental College and Research Centre, Sri Ganganagar, IND.
Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, IND.
Cureus. 2025 Apr 18;17(4):e82547. doi: 10.7759/cureus.82547. eCollection 2025 Apr.
Dental implants have become the standard treatment for restoring missing teeth, offering both functional and esthetic benefits. The surgical approach (flap versus flapless) may influence peri-implant tissue healing, postoperative discomfort, and long-term implant success. This study aimed to compare postoperative pain, peri-implant probing depth (PD), and crestal bone height (CBH) changes between the flapless and flapped implant placement over a 12-month period post functional loading of implants.
A prospective cohort study was conducted with 20 patients who required single posterior dental implants. Patients were allocated into two groups: flapless (n = 10) and flap (n = 10). The allocation was based on clinical evaluation and patient preferences. Soft tissue assessment included PD measurements at six and 12 months at the four peri-implant sites using a periodontal probe. Hard tissue assessment included CBH measurements at baseline, six months, and 12 months post functional loading using standardized intraoral radiographs. Pain intensity was evaluated on postoperative days 3 and 7 using the visual analog scale (VAS). All data were analyzed using appropriate parametric and non-parametric tests, with significance set at p < 0.05.
Postoperative pain was significantly lower in the flapless group compared to the flap group at both day 3 (3.1 ± 0.74 vs. 5.7 ± 0.95, p = 0.001) and day 7 (0.5 ± 0.71 vs. 2.4 ± 1.17, p = 0.001). PD was significantly lower in the flapless group at six months (p < 0.05), although by 12 months, the differences between the groups were not statistically significant. Both groups showed significant intragroup reductions in PD over time (p = 0.001). The CBH decreased slightly in both groups over 12 months, but no significant intergroup differences were observed at any time point (p > 0.05).
Flapless implant placement was associated with significantly lower postoperative pain and more favorable soft tissue healing with reduced PD at six months than the flap technique. However, both approaches demonstrated comparable changes in CBH at 12 months. These findings suggest that flapless surgery may offer early postoperative benefits without compromising long-term hard tissue stability.
牙种植体已成为修复缺失牙的标准治疗方法，具有功能和美观双重益处。手术方式（翻瓣与不翻瓣）可能会影响种植体周围组织愈合、术后不适以及种植体的长期成功率。本研究旨在比较在种植体功能加载后的12个月内，不翻瓣和翻瓣种植体植入术后的疼痛、种植体周围探诊深度（PD）和嵴顶骨高度（CBH）变化。
对20例需要单颗后牙种植体的患者进行了一项前瞻性队列研究。患者被分为两组：不翻瓣组（n = 10）和翻瓣组（n = 10）。分组基于临床评估和患者偏好。软组织评估包括在术后6个月和12个月时，使用牙周探针在种植体周围四个位点测量PD。硬组织评估包括在功能加载后的基线、6个月和12个月时，使用标准化口腔内X光片测量CBH。使用视觉模拟量表（VAS）在术后第3天和第7天评估疼痛强度。所有数据使用适当的参数和非参数检验进行分析，显著性设定为p < 0.05。
不翻瓣组术后疼痛在第3天（3.1±0.74 vs. 5.7±0.95，p = 0.001）和第7天（0.5±0.71 vs. 2.4±1.17，p = 0.001）均显著低于翻瓣组。不翻瓣组在6个月时PD显著更低（p < 0.……此处原文有误，应为p < 0.05），尽管到12个月时，两组之间的差异无统计学意义。两组随时间推移PD均有显著的组内降低（p = 0.001）。两组在12个月内CBH均略有下降，但在任何时间点均未观察到显著的组间差异（p > 0.05）。
与翻瓣技术相比，不翻瓣种植体植入术后疼痛显著更低，6个月时软组织愈合更有利，PD降低。然而，两种方法在12个月时CBH变化相当。这些发现表明，不翻瓣手术可能在不影响长期硬组织稳定性的情况下提供早期术后益处。
