A Split Mouth Study on Crestal Bone Architectural Changes by Flapped and Flapless Implant Surgical Procedures

Background: Rehabilitations by dental implants have often been utilized as an efficient procedure for restoring missing teeth. For implant placement two types of surgical methods are well documented. Conventional surgical approach involves raising a mucoperiosteal flap to gain access and see the underlying alveolar bone, instead there is this procedure which does not involve the reflection of the flap. Both the techniques are known to have their individual benefits and shortcomings. The present study was aimed to evaluate the longitudinal comparison and evaluation of hard tissue changes around endosseous implants placed using flapped as well as flapless surgical procedures in mandibular first molar region.

Materials and Methods: A total of 10 healthy patients with bilateral mandibular first molar were involved in the study and 20 endosseous implants were inserted (10 in each group). Radiographic assessment was done for deviations in the marginal bone levels on both mesial and distal side and their average value was calculated at 1 month, and 3 months. All these parameters were statistically analyzed using the paired Student t test, and two-way ANOVA test and were considered to be significant if the p value was ≤ 0.05.

Results: During the 3 months observation period, the change in crestal bone height around the implants placed by flapless and flap surgery were statistically significant. The flapless group showed less reduction in the crestal bone height compared to the flap group.

Conclusion: Both flap and the flapless techniques of endosseous implant placement had statistically significant effect on peri-implant bone loss over the 3 month period.