title: Flapless Versus Traditional Dental Implant Surgery: Long-Term Evaluation of Crestal Bone Resorption.
abstract: OBJECTIVE
  The literature reports that flapless compared with traditional implant surgery can be associated with several advantages, including the maintenance of peri-implant hard tissues. This study investigated vertical bone resorption during long-term follow-up after implant placement with flapless versus traditional surgery.
  
  
  METHODS
  In this prospective, randomized controlled clinical trial, 40 patients underwent implant placement at the Maxillofacial Department Surgery of the Istituto Stomatologico Italiano Hospital in Milan, Italy. Patients were randomly assigned to the control or experimental group. The control group had implants placed with open flap surgery (traditional surgery), whereas the experimental group had implants placed with flapless surgery. The distance between the first implant thread and the marginal crestal bone level was measured at the basal, loading, and long-term control points. The basal recording was performed just after implant placement. The loading measurement was recorded at the time of implant loading, after 2 months of healing for the lower jaw and after 3 months of healing for the upper jaw, and the long-term control record was registered 36 months after implant placement. Statistical analysis was performed using mean values and standard deviations based on bone resorption in the 2 groups. To detect statistical differences, the Student t test was applied. Differences were considered significant if P values were less than .05.
  
  
  RESULTS
  The control group (open flap surgery) was comprised of 19 patients, and the experimental group (flapless surgery) was comprised of 21 patients. No statistical differences were found in peri-implant bone resorption between the 2 groups at the basal, implant loading, and 3-year control recordings.
  
  
  CONCLUSIONS
  According to this study, the approach to implant surgery does not seem to influence peri-implant bone resorption in humans, at least for the period measured in this study.
authors.affiliation: Resident, Maxillofacial Surgery Department, Istituto Stomatologico Italiano, Milan, Italy. Electronic address: siervo@isimilano.eu.
authors.forename: Luca
authors.initials: L
authors.lastname: Pisoni
authors.affiliation: Resident, Maxillofacial Surgery Department, Istituto Stomatologico Italiano, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ordesi
authors.affiliation: Private Practice, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Siervo
authors.affiliation: Department Head, Department of Periodontology, Istituto Stomatologico Italiano, Milan, Italy.
authors.forename: Andrea Edoardo
authors.initials: AE
authors.lastname: Bianchi
authors.affiliation: Resident, Maxillofacial Surgery Department, Istituto Stomatologico Italiano, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Persia
authors.affiliation: Scientific Director, Maxillofacial Surgery Department, Istituto Stomatologico Italiano, Milan, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Siervo
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology*; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants