A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement.
BACKGROUND
Flapless implant surgery is considered to offer advantages over the traditional flap access approach. There may be minimized bleeding, decreased surgical times and minimal patient discomfort. Controlled studies comparing patient outcome variables to support these assumptions, however, are lacking.


OBJECTIVE
The objective of this clinical study was to compare patient outcome variables using flapless and flapped implant surgical techniques.


METHODS
From January 2008 to October 2008, 16 consecutive patients with edentulous maxillas were included in the study. Patients were randomly allocated to either implant placement with a flapless procedure (eight patients, mean age 54.6 + or - 2.9 years) or surgery with a conventional flap procedure (eight patients, mean age 58.7 + or - 7.2 years). All implants were placed using a Nobel guide CT-guided surgical template. Outcome measures were the Dutch version of the Impact of Event Scale-Revised (IES-R), dental anxiety using the s-DAI and oral health-related quality of life (OHIP-14).


RESULTS
Ninety-six implants were successfully placed. All implants were placed as two-phase implants and the after-implant placement dentures were adapted. No differences could be shown between conditions on dental anxiety (s-DAI), emotional impact (IES-R), anxiety, procedure duration or technical difficulty, although the flapless group did score consistently higher. The flap procedure group reported less impact on quality of life and included more patients who reported feeling no pain at all during placement.


CONCLUSIONS
Differences found in the patient outcome variables do suggest that patients in the flapless implant group had to endure more than patients in the flap group.
Lindeboom
Jerome A
JA
Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. j.a.lindeboom@amc.uva.nl
van Wijk
Arjen J
AJ
D016854:Dental Anxiety / Q000209:etiology; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010149:Postoperative Pain; D011788:Quality of Life; D018709:Statistics, Nonparametric; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D025321:Surgery, Computer-Assisted; D013524:Surgical Flaps