title: Flapless implant surgery using a mini-incision.
abstract: BACKGROUND
  Traditional flapless implant surgery using a soft tissue punch device requires a circumferential excision of keratinized tissue at the implant site. A new flapless implant technique that can submerge implant fixtures is needed.
  
  
  OBJECTIVE
  This article describes a flapless implant surgery method using a mini-incision and compares the effects of soft tissue punch and mini-incision surgery on both the amount of osseointegration and the bone height around the implants using a canine mandible model.
  
  
  METHODS
  Bilateral, edentulated, flat alveolar ridges were created in the mandibles of six mongrel dogs. After a 3-month healing period, two implants were placed on each side of the mandible using either soft tissue punch or mini-incision procedures. After an additional 3-month healing period, a second stage surgery and transmucosal abutment attachment was performed for mini-incision implant cases. Following a 2-month healing period, the dogs were sacrificed to evaluate the osseointegration and bone height around the implants.
  
  
  RESULTS
  Average bone height was 9.6 ± 0.4 mm in the soft tissue punch group and 9.8 ± 0.3 mm in the mini-incision group (p > .05). Average osseointegration was 70.4 ± 6.3% in the soft tissue punch group and 71.2 ± 7.1% in the mini-incision group (p > .05). No significant differences were noted between the two groups in vertical alveolar ridge height or bone/implant contact.
  
  
  CONCLUSIONS
  Our findings support the clinical use of mini-incision implant surgery at sites where implants need to be protected below the soft tissue during the early phase of healing, particularly for patients with poor bone quality and/or low primary implant stability.
authors: Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors: Seung-Mi
authors: SM
authors: Jeong
authors: Byung-Ho
authors: BH
authors: Choi
authors: Feng
authors: F
authors: Xuan
authors: Ha-Rang
authors: HR
authors: Kim
mesh_terms: D000539:Alveolar Process / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D000818:Animals; D003758:Dental Implantation, Endosseous / Q000295:instrumentation* / Q000379:methods*; D003762:Dental Instruments; D004285:Dogs; D005260:Female; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D016348:Osseointegration; D013524:Surgical Flaps; D055114:X-Ray Microtomography