Wadhwa B, Jain V, Bhutia O, Bhalla AS, Pruthi G. Flapless versus open flap techniques of implant placement: A 15-month follow-up study. Indian J Dent Res 2015;26:372-7
Aim: To evaluate and compare the effect of flapless and “open
flap” techniques of implant placement on crestal bone height (CBH)
Materials and Methods: This prospective study comprised of 32
implants placed in 16 subjects with a bilateral missing mandibular first
molar. In each subject, one implant was placed with “flapless” and
other using “open flap” technique. Radiographic assessment of CBH was
carried out using standardized intraoral periapical radiograph of the
site at baseline, 3 months, 9 months and 15 months after implant
Statistical Analysis: Data were analyzed using STATA 11.0
statistical software. To determine the changes in CBH from baseline, at
3-, 9-, and 15-month, repeated measures analysis of variance followed by
post-hoc Bonferroni was used for each of the two techniques for
mesial and distal aspects separately. For both techniques, changes in
CBH from baseline to 15 months were compared using an independent t-test with a confidence interval of 95%.
Results: For “flapless” technique, there was no statistically significant (P >
0.05) reduction of CBH in initial 9 months but was significant for the
9–15 months period while for “open flap” technique, statistically
significant (P < 0.05) reduction was observed up to 15 months.
Comparison of both techniques showed significantly lesser reduction
with “flapless” than “open flap” technique. The overall average crestal
bone loss was 0.046 ± 0.008 mm on mesial aspect, 0.043 ± 0.012 mm on
distal aspect with “flapless” technique and 1.48 ± 0.085 mm on mesial
aspect, 1.42 ± 0.077 on distal aspect “open flap” technique.
Conclusions: Both techniques showed a reduction in CBH with time
but the flapless technique showed a lesser reduction. Therefore, the
flapless technique can be considered as a better treatment approach for
placement of implants, especially where adequate width and height of
available bone are present.