Flap vs. "flapless" surgical approach at immediate implants: a histomorphometric study in dogs

Area of Science:

• Dental Implantology
• Oral Surgery
• Periodontology

Background:

• Immediate implant placement into extraction sockets is a common procedure.
• Alveolar bone remodeling and resorption are critical factors affecting implant success.
• Surgical approach (flap vs. flapless) may influence bone healing and dimensional stability.

Purpose of the Study:

• To compare alveolar process remodeling around implants placed immediately into extraction sockets.
• To evaluate the effect of flap vs. flapless surgical techniques on bone dimensional changes.
• To assess bone resorption at the buccal bony crest following immediate implant placement.

Main Methods:

• Six Labrador dogs were used, with implants placed immediately into extraction sockets of mandibular premolars.
• One side received a full-thickness mucoperiosteal flap (control), while the contralateral side used a flapless approach.
• Histomorphometric analysis was performed after 4 months of healing.

Main Results:

• All implants achieved osseointegration (n=6) after 4 months.
• Similar bone resorption occurred at both flap and flapless sites.
• Buccal bony crest resorption measured 1.7 mm (control) and 1.5 mm (test).

Conclusions:

• Flapless immediate implant placement does not prevent alveolar bone resorption.
• The surgical approach (flap vs. flapless) did not significantly affect dimensional changes of the alveolar process.
• Both techniques yielded comparable outcomes regarding bone remodeling post-extraction and immediate implant placement.