Less morbidity with flapless implant

Flapless implant placement requires punch removal of the gingiva without flap reflection, suggesting this technique will be less invasive, and with less tissue destruction, than comparable alternative techniques.

Eleven implants were placed with flapless (FL) technique and 11 implants were placed with full-thickness flap (FT) technique in split mouth technique. FL technique was done with dermal tissue puncture, while FT was performed with crestal incision, including the papillae. Patients were followed-up postoperatively for clinical and morbidity evaluation in both groups.

There was no pain, and there were only mild signs of inflammation, at the sites of flapless implant placement in the 11 patients studied. In contrast, there were complaints of mild to moderate pain and signs of inflammation at the site of full-thickness flap implant placement in the 11 patients studied. In addition, there was gingival overgrowth over the healing cap noted in this group.

FL technique may be recommended for the apprehensive or hyperalgesic patient because of the absence of pain it conveys, as well as the decreased postoperative swelling. Periosteal disruption is responsible for the patient's morbidity postoperatively.