title: Histopathological comparative analysis of peri-implant soft tissue response after dental implant placement with flap and flapless surgical technique. Experimental study in pigs.
abstract: OBJECTIVE
  The aim of this study was comparing the effect of flapless vs. flap technique of implant placement on inflammation degree of peri-implant soft tissue, through histopathological analysis.
  
  
  METHODS
  The experiment was conducted on five domestic pigs. Nine weeks after tooth extraction, implants were installed. Each animal received six implants in mandible. According to split-mouth design, randomly one side was used for flapless technique using mini-incision, while on the other side, flap was raised. After 7, 14, 21, 28, and 90 days, the experimental animals were sacrificed. Samples for histopathological analyzes were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The degree of inflammatory response in the peri-implant soft tissue was estimated through ordinal scores from 0 to 3.
  
  
  RESULTS
  In the flap group Score 3 indicating high degree of inflammation was present from day 7 to day 21, in contrast to flapless group where Score 3 was not recorded during the entire follow-up. Three months after implantation, there were no signs of inflammation neither around flap nor around flapless implants.
  
  
  CONCLUSIONS
  Flapless surgical implantation technique using mini-incision decreases peri-implant soft tissue inflammatory reaction compared with flap surgery.
authors.affiliation: Department of Dental Medicine, Faculty of Medical Science, University of Priština, Kosovska Mitrovica, Serbia.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Vlahovic
authors.affiliation: School of Dentistry, University of Belgrade, Belgrade, Serbia.
authors.forename: Aleksa
authors.initials: A
authors.lastname: Markovic
authors.affiliation: Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
authors.forename: Mileta
authors.initials: M
authors.lastname: Golubovic
authors.affiliation: School of Dentistry, University of Belgrade, Belgrade, Serbia.
authors.forename: Miodrag
authors.initials: M
authors.lastname: Scepanovic
authors.affiliation: School of Dentistry, University of Belgrade, Belgrade, Serbia.
authors.forename: Milena
authors.initials: M
authors.lastname: Kalanovic
authors.affiliation: School of Dentistry, University of Belgrade, Belgrade, Serbia.
authors.forename: Ana
authors.initials: A
authors.lastname: Djinic
mesh_terms: D000818:Animals; D003757:Dental Implantation / Q000009:adverse effects / Q000379:methods; D015921:Dental Implants; D004195:Disease Models, Animal; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D017695:Soft Tissue Injuries / Q000209:etiology* / Q000473:pathology*; D013524:Surgical Flaps; D013552:Swine; D014945:Wound Healing
chemical_list: D015921:Dental Implants
keywords: dental implant placement; flapless; histopathology; inflammation; mini-incision; peri-implant soft tissue