Comparative Study of Crestal Bone Loss Around Implants Placed Using Flapless Versus Flapped Technique.

BACKGROUND

Crestal bone loss is a critical determinant of long-term implant success. The choice of surgical technique-flapless versus flapped-may influence peri-implant bone preservation.

OBJECTIVE

To compare the crestal bone loss around dental implants placed using the flapless technique versus the conventional flapped technique over a 6-month follow-up period.

METHODS

A prospective, randomized clinical trial was conducted involving 40 systemically healthy patients requiring single-tooth implants in the posterior mandible. Participants were randomly assigned to two groups: Group A (flapless technique, n = 20) and Group B (flapped technique, n = 20). Standardized periapical radiographs were taken at baseline, 3 months, and 6 months to assess marginal bone loss. Crestal bone levels were measured mesially and distally using calibrated digital software. The primary outcome was mean crestal bone loss. Data were analyzed using paired and unpaired t-tests.

RESULTS

At 6 months, the mean crestal bone loss in Group A was 0.48 ± 0.16 mm, while Group B showed 0.82 ± 0.21 mm. The difference between groups was statistically significant (P <0.001). Intragroup analysis revealed significant bone loss from baseline to 6 months in both groups (P <0.05), but bone preservation was significantly better in the flapless group.

CONCLUSION

The flapless implant placement technique demonstrated significantly reduced crestal bone loss compared to the flapped approach. Minimally invasive protocols may contribute to better preservation of peri-implant tissues in suitable clinical scenarios.