Emitis N Naeini1, Melissa Dierens1, Mandana Atashkadeh2, Hugo De Bruyn1,3. 1. Department of Periodontology, Oral Implantology, Removable & Implant Prosthodontics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. 2. Periodontology and Oral Implantology, All Saints Green Dental Practice, Norwich, United Kingdom. 3. Department of Periodontology and Implantology, College of Dental Science, Radboud University Medical Centre, Nijmegen, The Netherlands.
Abstract
BACKGROUND: Flapless implant surgery is mostly performed using guided surgical protocols, however, long-term studies on free-handed flapless surgery for single implants are lacking. PURPOSE: This prospective study evaluates bone level changes, peri-implant health, and complications of solitary implants placed using a conventional flap (F) or flaplessly (FL) after 6-9 years. MATERIALS AND METHODS: Fifty-three single TiUnite Brånemark implants were originally inserted in 49 patients using an one-stage delayed loading protocol with flap (n = 27, F) or flaplessly (n = 26, FL) based on available bone volume and surgeon's decision-making. Thirty-six patients with 37 implants participated in the prospective follow-up investigation 6-9 years later whereby survival, bone level changes, peri-implant health, and complications were assessed. RESULTS: After 88 months (range 76-107), all implants were survived. For F and FL combined, the overall average radiographic bone level was above the first implant thread, 1.26 mm apical of the implant-abutment junction (SD 1.08; 0-4.9) and statistically comparable. Bone loss from time of loading was 0.49 mm (SD 1.1; -1.3 to 2.8) for F and -0.89 mm (SD 1.0; -2.8 to 0.7) for FL (P < .01), suggesting regrowth of bone in FL due to initial countersinking. One implant (2.7%) had a probing depth above 5 mm. CONCLUSION: Free-handed flapless implant surgery for single implants with neighboring teeth is a predictable long-term treatment provided when there is sufficient bone volume.
BACKGROUND: Flapless implant surgery is mostly performed using guided surgical protocols, however, long-term studies on free-handed flapless surgery for single implants are lacking. PURPOSE: This prospective study evaluates bone level changes, peri-implant health, and complications of solitary implants placed using a conventional flap (F) or flaplessly (FL) after 6-9 years. MATERIALS AND METHODS: Fifty-three single TiUnite Brånemark implants were originally inserted in 49 patients using an one-stage delayed loading protocol with flap (n = 27, F) or flaplessly (n = 26, FL) based on available bone volume and surgeon's decision-making. Thirty-six patients with 37 implants participated in the prospective follow-up investigation 6-9 years later whereby survival, bone level changes, peri-implant health, and complications were assessed. RESULTS: After 88 months (range 76-107), all implants were survived. For F and FL combined, the overall average radiographic bone level was above the first implant thread, 1.26 mm apical of the implant-abutment junction (SD 1.08; 0-4.9) and statistically comparable. Bone loss from time of loading was 0.49 mm (SD 1.1; -1.3 to 2.8) for F and -0.89 mm (SD 1.0; -2.8 to 0.7) for FL (P < .01), suggesting regrowth of bone in FL due to initial countersinking. One implant (2.7%) had a probing depth above 5 mm. CONCLUSION: Free-handed flapless implant surgery for single implants with neighboring teeth is a predictable long-term treatment provided when there is sufficient bone volume.