Buccal bone loss after immediate implantation can be reduced by the flapless approach


Submitted: 8 June 2017
Accepted: 8 June 2017
Published: 30 October 2011
Abstract Views: 507
PDF: 1209
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Authors

  • Arthur Belém Novaes Jr. Professor and Chairman of Periodontology, Department of Oral Surgery and Periodontology, School of Dentistry of Ribeirão Preto of the University of São Paulo, SP, Brazil.
  • Raquel Rezende Martins De Barros Post-doctoral student, Department of Oral Surgery and Periodontology, School of Dentistry of Ribeirão Preto of the University of São Paulo, Brazil.
  • Vula Papalexiou Professor of Periodontology, Center of Biologic and Health Science, School of Dentistry, Catholic Pontifical University, PR, Brazil.
  • Adriana Luisa Gonçalves De Almeida Graduated in Biology and Microscopic and Image Analysis Laboratory Technician of the Department of Oral Surgery and Periodontology, School of Dentistry of Ribeirão Preto of the University of São Paulo, SP, Brazil.
Aim The aim of this study was to evaluate the buccal bone remodeling after immediate implantation with flap or flapless approach. Material and Methods The mandibular bilateral premolars of 3 dogs were extracted and immediately three implants were placed in both hemi-arches of each dog. Randomly, one hemi-arch was treated with the flapless approach, while in the contra lateral hemi-arch tooth extractions and implant placement were done after mucoperiosteal flap elevation. Non-submerged healing of 12 weeks was provided for both groups. Histomorphometric analysis was done to compare buccal and lingual bone height loss, bone density and bone-to-implant contact in the groups. Fluorescence analysis was performed to investigate the dynamic of bone remodeling in the different groups. Results There was a significant association between the surgical flap and the extent of bone resorption around immediate implants. The loss of buccal bone height was significantly lower in the flapless group when compared to the flap group (0.98 mm x 2.14 mm, respectively, p<0.05). The coronal and apical buccal bone densities of the flap group were significantly higher when compared to the lingual components, showing anatomical differences between the bone plates. Fluorescence analysis showed no major differences in bone healing between the flap and flapless groups, supporting that the higher loss of buccal bone height is linked to the anatomic characteristics of this plate and to the negative influence of the detachment of the periosteum in immediate implant therapy. Conclusion The flapless approach for immediate post-extraction implants reduces the buccal bone height loss.

Supporting Agencies


Belém Novaes Jr., A., Martins De Barros, R. R., Papalexiou, V., & Gonçalves De Almeida, A. L. (2011). Buccal bone loss after immediate implantation can be reduced by the flapless approach. Journal of Osseointegration, 3(3), 45–55. https://doi.org/10.23805/jo.2011.03.03.01

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