Clinical Effect Of Flapless Implant Includes Post-extractional Immediate Implant With Immediate Loading

Objectives The purpose of this study is to choose suitable implant sites for performing flapless and immediate implants when the torque of fixture reached to somewhat more than 35 Ncm and then combined with immediate loading.After permanent crown restoration had been finished,all patients were then enrolled in a follow-up program for6-12 months.The statistical results and success rates of flapless implant with immediate loading were discussed and compared in regular against immediate implant.Evaluate flapless implantation including immediate implant and edentulous area implant,when the torque reach to a little bit over than 35 Ncm,build up resin temporal crown to give immediate loading.Two to three months post-operation,reexaminations were done to evaluate the clinical standard for final restoration.According to the results we can calculate the success rate for immediate loading when applying to flapless implantion.Materials and Methods This thesis collected 10 patients,through the analysis of oral conditions of each case,perform complete evaluation before the surgeries,according to the examination results of clinical oral conditions and radiological findings,treated 24 teeth by using flapless implant technique.Divided into 2 groups,group 1 six patients(11teeth)including single or multiple tooth which needed to be extracted with immediate implant owing to hopeless treatment,and group 2 other five patients(13 teeth)were single implant by using flapless surgery.Patients were examined by taking x-ray and CBCT before surgery to check the height,width and density of bone,then complete the treatment plans.Four patients were treated by Nobel Direct?Groovy one-piece implant,six patients were treated by Nobel Replace?Groovy two-piece implant.The patients with immediate implant treatment,were had their tooth extracted,cleaned the granules tissue and the remaining PDL in the socket,then using the periodontal probe to check the wallof the socket,after confirmed the the integrity of the bony wall,insert the implant and control torque a bit more than 35 Ncm,immediate loading after the surgery with resin temporary crown.patients with the missing tooth were confirmed the location of surgical are according to the result of examination,sounding the soft tissue thickness by using the periodontal probe,then penetrate the pilot drill through the soft tissue into alveolar bone of the edentulous area,finally insert the implant with control torque a bit more than35 Ncm,then immediate loading with resin temporary crown.After 2 to 3 months of the surgery,another clinical evaluation for the osseointegration status had been performed with periapical x-ray film,after then complete permanent crown restoration if needed.Result Treated 10 patients(24 implants)by using flapless implant technique with immediate loading,no post operative swelling in group 1 single implant flapless surgery,mild swelling and pain in group 2 immediate flapless implant after tooth extraction.No severe pain was complained by all patients.23 out of 24 implants observed good osseointegration by radiology assessment after 2 to 3 months post-op while re-visiting,no mobility,no visual sign of inflammation,no gingival recession,then permanent crown restoration are finished.After then OPD follow up 3 to 12 months.All the implants are stable,no slackness,no exposures of the implant,no gingival recession were found.Conclusion According to the results: 1.Comparing to traditional flap surgery,flapless implantation with immediate restoration simplified the processes and decreased the times of patients' revisits.Patients don't have to wait for 2 to 3 months for secondary surgery procedure,whether immediate implant or edentulous area implant,using flapless technique substantially reduces the post operative discomfort.2.The cases which were suited to immediate implant,or sufficient height,width and density of the bone for missing tooth,treated by flapless implant surgery with torque a bit more than 35 Ncm,immediate loading is adapt to front and back tooth.3.To ensure higher success rate of the surgery,preoperative examinations for flapless implantation should be more conscientious and careful.