Over the years, the improved surgical techniques for inserting implants have become diversified following increasing requests by patients for rehabilitation more attentive to function but also to aesthetics, with minimal invasive surgery. In fact, the trend is to continue to improve both the functional and aesthetic aspect, but above all, to minimise the surgical aggressiveness of the surgery in order to improve the patient’s post-operative course.
This study involved evaluating the clinical cases performed with the flapless method in order to define its indications and thresholds compared to other methods. The study examined 83 implants inserted in 30 patients (19 female and 11 male) whose conditions were such to allow inserting the implants using the flapless method.
Patients having conditions that could interfere with the osseointegration processes (smoking, diabetes, bone metabolism pathologies, parafunctions) were excluded from the study.
All patients underwent initial preparation prior to treatment. In 13% of the cases, the rehabilitation occurred with immediate loading, in 87% of the cases with deferred loading.
The advantages of the flapless technique are:
• The possibility to perform a non-traumatic surgery, respectful of the bone physiology and non- invasive;
• Reduced surgery time;
• No need to prepare surgical flaps, therefore no stitches;
• Greater comfort for the patient;
• Less pain and bleeding;
• Possibility to associate immediate loading of the implant, if requested;
• The respect of the biological width and soft tissues around the implant, thanks to the positioning of the smooth neck of the implant outside the bone;
• The positioning of connecting elements, which constitute points of weakness and retention of the plaque above crestal level, thanks to the use of the single-step technique.
The disadvantages connected to the use of this method are:
• The impossibility to combine with bone or tissue augmentation techniques;
• The danger of deviating from the correct trajectory, piercing the cortical layers;
• The risk of the epithelium colonising the implant site;
• Impossibility to manage the soft tissues for increasing the attached gingival band;
• Learning curve for being able to take full advantage of the potentials that this method has to offer.
