Immunohistochemical analysis of blood vessels in peri-implant mucosa: a comparison between mini-incision flapless and flap surgeries in domestic pigs.
OBJECTIVE
The aim of this experimental study is to compare the effect of mini-incision flapless versus flap technique of implant placement on the amount of vascular structures and blood vessel elements in peri-implant soft tissue, using immunohistochemical analysis.


METHODS
The experiment was conducted on five domestic pigs. Each animal received six implants in mandible according to the split-mouth design. On one randomly chosen jaw side, mini-incision flapless surgery was performed, whereas on the opposite jaw side, flap was raised. After 3 months of implant healing through submerged approach, the experimental animals were sacrificed and samples for immunohistochemical analyses were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The study outcome was the presence of vascular structures and elements of the blood vessels in the peri-implant mucosa per microscopic field, estimated through ordinal scores from 0 to 2. Effects of surgical approach, site of implantation, and their interaction on vascular scores of peri-implant mucosa were assessed by Brunner and Langer nonparametric analysis of longitudinal data.


RESULTS
Statistically significant effect of surgical approach on vascularity of peri-implant mucosa has been revealed in the second mucosal layer, where flapless approach provided higher vascularity compared with flap approach (P = 0.002). In the remaining two layers, surgical approach did not affect mucosal vascularity significantly (layer 1: P = 0.071; layer 3: P = 0.433).


CONCLUSIONS
The flapless surgical implant placement approach using mini-incision provides better vascularization of peri-implant mucosa after 3 months of healing compared with flap surgery.
Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia.
Zoran
Z
Lazić
Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
Mileta
M
Golubović
School of Dentistry, University of Belgrade, Belgrade, Serbia.
Aleksa
A
Marković
School of Dentistry, University of Belgrade, Belgrade, Serbia.
Miodrag
M
Šćepanović
School of Dentistry, University of Belgrade, Belgrade, Serbia.
Tijana
T
Mišić
Department of Dental Medicine, Faculty of Medical Science, University of Priština, Kosovska Mitrovica, Serbia.
Zoran
Z
Vlahović
D000818:Animals; D003758:Dental Implantation, Endosseous / Q000379:methods*; D007150:Immunohistochemistry; D008334:Mandible / Q000601:surgery; D009061:Mouth Mucosa / Q000098:blood supply* / Q000601:surgery; D013524:Surgical Flaps; D013552:Swine
blood vessels; dental implant placement; flapless; immunohistochemistry; mini-incision; peri-implant mucosa