Flapless Procedure (flapless + procedure)

Distribution by Scientific Domains


Selected Abstracts


Accuracy assessment of computer-assisted flapless implant placement in partial edentulism

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2010
N. Van Assche
Van Assche N, van Steenberghe D, Quirynen M, Jacobs R. Accuracy assessment of computer-assisted flapless implant placement in partial edentulism. J Clin Periodontol 2010; 37: 398,403. doi: 10.1111/j.1600-051X.2010.01535.x Abstract Aim: To assess the accuracy of implants placed flapless by a stereolithographic template in partially edentulous patients. Material and Methods: Eight patients, requiring two to four implants (maxilla or mandible), were consecutively recruited. Radiographical data were obtained by means of a cone beam or a multi-slice CT scan and imported in a software program. Implants (n=21) were planned in a virtual environment, leading to the manufacture of one stereolithographic template per patient to guide the implant placement in a one-stage flapless procedure. A postoperative cone beam CT was performed to calculate the difference between virtual implant (n=21) positions in the preoperative planning and postoperative situation. Results: A mean angular deviation of 2.7° (range 0.4,8, SD 1.9), with a mean deviation at the apex of 1.0 mm (range 0.2,3.0, SD 0.7), was observed. If one patient, a dropout because of non-conformity with the protocol, was excluded, the angular deviation was reduced to 2.2° (range 0.6,3.9, SD 1.1), and the apical deviation to 0.9 mm (range 0.2,1.8). Conclusion: Based on this limited patient population, a flapless implant installation appears to be a useful procedure even when based on accurate and reliable 3D CT-based image data and a dedicated implant planning software. [source]


A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2010
Jerome A. Lindeboom
Abstract Background: Flapless implant surgery is considered to offer advantages over the traditional flap access approach. There may be minimized bleeding, decreased surgical times and minimal patient discomfort. Controlled studies comparing patient outcome variables to support these assumptions, however, are lacking. Aim: The objective of this clinical study was to compare patient outcome variables using flapless and flapped implant surgical techniques. Patients and methods: From January 2008 to October 2008, 16 consecutive patients with edentulous maxillas were included in the study. Patients were randomly allocated to either implant placement with a flapless procedure (eight patients, mean age 54.6±2.9 years) or surgery with a conventional flap procedure (eight patients, mean age 58.7±7.2 years). All implants were placed using a Nobel guide® CT-guided surgical template. Outcome measures were the Dutch version of the Impact of Event Scale-Revised (IES-R), dental anxiety using the s-DAI and oral health-related quality of life (OHIP-14). Results: Ninety-six implants were successfully placed. All implants were placed as two-phase implants and the after-implant placement dentures were adapted. No differences could be shown between conditions on dental anxiety (s-DAI), emotional impact (IES-R), anxiety, procedure duration or technical difficulty, although the flapless group did score consistently higher. The flap procedure group reported less impact on quality of life and included more patients who reported feeling no pain at all during placement. Conclusions: Differences found in the patient outcome variables do suggest that patients in the flapless implant group had to endure more than patients in the flap group. To cite this article: Lindeboom JA, van Wijk AJ. A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement. Clin. Oral Impl. Res. 21, 2010; 366,370. doi: 10.1111/j.1600-0501.2009.01866.x [source]


Ridge alterations following tooth extraction with and without flap elevation: an experimental study in the dog

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2009
Mauricio G. Araújo
Abstract Background: Different approaches were advocated to preserve or improve the dimension and contour of the ridge following tooth extraction. In some of studies, socket ,flapless extraction' apparently had a successful outcome. Aim: The objective of the present experiment was to compare hard tissue healing following tooth extraction with or without the prior elevation of mucosal full-thickness flaps. Material and methods: Five mongrel dogs were used. The two second mandibular premolars (2P2) were hemi-sected. The mesial roots were retained. By random selection the distal root in one side was removed after the elevation of full-thickness flaps while on the contralateral side, root extraction was performed in a flapless procedure. The soft tissue wound was closed with interrupted sutures. After 6 months of healing, the dogs were euthanized and biopsies were sampled. From each experimental site, four ground sections , two from the mesial root and two from the healed socket , were prepared, stained and examined in the microscope. Results: The data showed that the removal of a single tooth (root) during healing caused a marked change in the edentulous ridge. In the apical and middle portions of the socket site minor dimensional alterations occurred while in the coronal portion of the ridge the reduction of the hard tissue volume was substantial. Similar amounts of hard tissue loss occurred during healing irrespective of the procedure used to remove the tooth was, i.e. flapless or following flap elevation. Conclusion: Tooth loss (extraction) resulted in marked alterations of the ridge. The size of the alveolar process was reduced. The procedure used for tooth extraction , flapless or following flap elevation , apparently did not influence the more long-term outcome of healing. [source]


Surgical navigation for implant placement using transtomography

CLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2008
Frederic Bousquet
Abstract Objectives: To present a new guidance technique using transtomography in the operating room and to test the accuracy of this surgical protocol. Material: A new concept of operating room, integrating when necessary this imagery to secure flapless procedures by intraoperative control, is described. This operating room concept, including X ray protection of the operators, is explained in addition to the transport system of the panoramic machine for its transfer to the patient who remains seated on his surgical chair. Methods: Twenty-five single-tooth edentulous patients were treated by implant placement with a flapless or a minimally invasive procedure using transtomographic navigation. The surgical protocol is explained: after the first limited drill through mucosa and bone, intraoperative transtomography is performed with a custom-made titanium guide inserted into the bone. Images show the drilling axis in three dimensions. This form of navigation allows rectifying the drill axis. We explain how this protocol respects asepsis. Results: The mean angular deviation was 2.04° in the mesiodistal direction (range: 0°,4.8°, variance: 2.88) and 2.71° in the buccal or the palatolingual direction (range: 0°,5.4°; variance: 2.63). Implant tip deviation was calculated: the mean mesiodistal tip deviation was 0.42 mm, and the mean buccal or palatolingual tip deviation was 0.5 mm. The maximum tip mesiodistal deviation was 1.08 mm and the maximum vestibular or palatolingual tip deviation was 1.22 mm. Conclusion: This protocol appears to be as accurate as other guided or navigation systems. The advantages and limitations of this technique are explained, followed by future prospects with the new 3D cone beam computed tomography developed with the same panoramic machine. [source]