title: Morphogenesis of the peri-implant mucosa: a comparison between flap and flapless procedures in the canine mandible.
abstract: OBJECTIVE
  Although it has been shown that the exclusion of the mucoperiosteal flap can prevent postoperative bone resorption associated with flap elevation, there have been only a few studies on the peri-implant mucosa following flapless implant surgery. The purpose of this study was to compare the morphogenesis of the peri-implant mucosa between flap and flapless implant surgeries by using a canine mandible model.
  
  
  METHODS
  In six mongrel dogs, bilateral edentulated flat alveolar ridges were created in the mandible. After 3 months of healing, 2 implants were placed in each side by either the flap or the flapless procedure. Three months after implant insertion, the peri-implant mucosa was evaluated by using clinical, radiologic, and histometric parameters, which included the gingival index, bleeding on probing, probing pocket depth, marginal bone loss, and the vertical dimension of the peri-implant tissues.
  
  
  RESULTS
  The height of the mucosa, length of the junctional epithelium, gingival index, bleeding on probing, probing depth, and marginal bone loss were all significantly greater in the dogs that had the flap procedure than in those that had the flapless procedure (P < .05).
  
  
  CONCLUSIONS
  These results indicate that gingival inflammation, the height of junctional epithelium, and bone loss around nonsubmerged implants can be reduced when implants are placed without flap elevation.
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, South Korea.
authors.forename: Tae-Min
authors.initials: TM
authors.lastname: You
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Choi
authors.forename: Jingxu
authors.initials: J
authors.lastname: Li
authors.forename: Feng
authors.initials: F
authors.lastname: Xuan
authors.forename: Seung-Mi
authors.initials: SM
authors.lastname: Jeong
authors.forename: Sun-Ok
authors.initials: SO
authors.lastname: Jang