title: Minimally invasive flapless implant placement: follow-up results from a multicenter study.
abstract: BACKGROUND
  The placement of implants using a minimally invasive flapless approach has the potential to reduce operative bleeding and postoperative discomfort and minimize crestal bone loss. This article presents follow-up data on a prospective clinical study of implants placed using a flapless procedure.
  
  
  METHODS
  The original study reported on 57 patients (33 female patients with an age range of 24 to 86 years; 24 male patients with an age range of 27 to 81 years) recruited from three clinical centers (Tucson, Arizona; Gothenburg, Sweden; and Tel Aviv, Israel) who received 79 implants. After an average of 3 years and 8 months, the patients were contacted and invited to return to their respective clinics for reexamination. Thirty-seven patients with 52 implants returned for a follow-up examination; the remaining 20 patients (27 implants) were not available for reexamination and were considered study drop-outs.
  
  
  RESULTS
  The cumulative survival rate at the 3- to 4-year follow-up examination remains at 98.7%, reflecting the loss of one implant. The mean probing depth at abutment connection was 2.2 mm, as reported in the initial study (examination 2 at approximately 2 years postplacement); it was 2.4 mm at the 3- to 4-year second follow-up examination. This change was not clinically or statistically significant. Bleeding score changes also were not significant between the two intervals. The average crestal bone level was -0.7 mm at examination 2 and -0.8 mm at examination 3, a change that approached significance (P <0.06).
  
  
  CONCLUSIONS
  Minimally invasive flapless surgery offers patients the possibility of high implant predictability with clinically insignificant crestal bone loss for up to 4 years. Proper diagnosis and treatment planning are key factors in achieving predictable outcomes.
authors.affiliation: branebill@comcast.net
authors.forename: William
authors.initials: W
authors.lastname: Becker
authors.forename: Moshe
authors.initials: M
authors.lastname: Goldstein
authors.forename: Burton E
authors.initials: BE
authors.lastname: Becker
authors.forename: Lars
authors.initials: L
authors.lastname: Sennerby
authors.forename: Dean
authors.initials: D
authors.lastname: Kois
authors.forename: Philippe
authors.initials: P
authors.lastname: Hujoel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010512:Periodontal Index; D011446:Prospective Studies; D011859:Radiography; D055815:Young Adult
chemical_list: D015921:Dental Implants