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Flapless Immediate Implant Placement With and Without Bone Grafting: A Systematic Review and Meta-Analysis
Saeed Sadat Mansouri1, Farhan Musaie2, Abbas Mirzaei3
1Department of Periodontology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Clinical and Experimental Dental Research
|July 23, 2025
Summary
Bone grafting during flapless immediate dental implants may improve alveolar bone preservation. Further research is needed to confirm these findings for hard and soft tissue changes.
Area of Science:
- Dental Implantology
- Periodontology
- Oral Surgery
Background:
- Immediate dental implant placement is a common procedure.
- The management of the peri-implant gap, particularly with bone grafting, is crucial for hard and soft tissue stability.
- Flapless surgery aims to minimize surgical trauma.
Purpose of the Study:
- To evaluate the impact of bone grafting in the peri-implant gap on hard and soft tissue changes after flapless immediate implantation.
- To compare outcomes of flapless immediate implants with and without bone grafting.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) up to March 2024.
- Searched Embase, PubMed, Web of Science, and Cochrane databases, supplemented by manual searches.
- Included 5 RCTs with 179 patients and 179 immediate implants; follow-up ranged from 6 to 12 months.
Main Results:
- No significant difference in horizontal bone changes within 0-3mm apical to the bone crest.
- Significant improvement in horizontal bone changes at 4-5mm apical to the reference point with bone grafting.
- No significant difference in vertical midfacial soft tissue changes between groups.
Conclusions:
- Flapless immediate dental implants with bone grafting show potential for enhanced alveolar bone preservation.
- Further investigation is warranted to fully understand the effects on various hard and soft tissue parameters.
