Risk For Flapless Implantation And Case Report

Objective:Flapless dental implant placement is possible in selected patients but limited to those sites with adequate or augmentable attached gingival and available bone volume and density may be augmented by pre-, intra-, or postoperative procedures. Clinically, it is a tremendous challenge to create natural gingival esthetics after immediate or delayed implant placement. Because osseointegration is now considered highly predictable, the current trend is to develop techniques that can provide function, esthetics, and comfort with a minimally invasive surgical approach. To achieve those goals, flapless implant surgery using a tissue punch technique has been suggested.Methods: This paper presents clinical cases of single-tooth implants placed in the esthetic region (anterior maxilla) and posterior area, which illustrate systematic approaches to flapless implant surgery for immediate and delayed loading protocol. For these cases, a tissue punch technique using a surgical guide fabricated with the aid of a radiographic stent was performed to provide access for implant site preparation and placement. The implants were loaded either immediately or 4 months after implant placement. With the planned flapless surgical technique, reduced operative time, accelerated postsurgical healing, and increased patient comfort and satisfaction were achieved. This paper also describes precautions of the flapless implant surgery in case selection, surgical techniques, and prosthodontic protocol.Results: In conclusion, appropriate case selection and prothodontic protocols are considered to be the key elements in the success of flapless implant surgery.